Winnipeg Based Psychological Services
Depression and Anxiety
There is high comorbidity (co-occurrence) rates between anxiety disorders and depression. Fifty-eight percent of individuals identified with Depression also reported experiencing one or more Anxiety Disorders during their lifetime (Kessler et al., 1996). Research also observed that 56% of individuals identified with an anxiety disorder met diagnostic criteria for depression (Clark, 1989). There also is a high co-occurrence of mental health difficulties and addiction in youth and adults (click here for more information). A combination of Cognitive Behavior Therapy (CBT) and psychiatric medication has been identified as highly effective to treat symptoms of anxiety and depression.
Fear and anxiety are an adaptive response to danger and threat (Barlow, 2002) that motivate individuals to relieve a negative emotional state (Mowrer, 1947). Everyone when faced with danger, a threat, or a negative situation typically experiences an adaptive fear response that is elicited when fearful stimuli are encountered and abates when the threat diminishes (Rosen & Schulkin, 1998). This fear response is different in anxiety disorders in that individuals often anticipate and overestimate the level of threat associated with objects (e.g., dogs, spiders), places, (crowds, restaurants), and/or activities (e.g., flying, driving, test taking) that contributes to the experience of an intense emotional response (e.g., panic attacks). Individuals who endure anxiety disorders often avoid situations, places, or objects that contribute to heightened and prolonged feelings of fear, worry, and distress; negatively affecting one’s quality of life [i.e., social, occupational, or other important aspects of their life; Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV-TR; American Psychiatric Association, 2000)]. Approximately a quarter of individuals (i.e., 28.8%) endorsed having experienced an anxiety disorder in their lifetime (Kesler, Berglund, Demler, Jin, & Walters, 2005). The economic cost related to anxiety disorders having been estimated to be over $42 billion per annum (in 1990 dollars; Greenberg et al., 1999). Click here for more information on Anxiety Disorders.
Major Depression occurs when a person experiences either a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a two week period. This change must represent a negative change in an individual's functioning. When face with depression, the individual reports experiencing a depressed mood most of the day (e.g., feeling sad, empty, or is tearful), nearly every day, negatively impacting one's quality of life [i.e., social, occupational, or other important aspects of their life; Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV-TR; American Psychiatric Association, 2000)]. Major depression Diagnostic criteria for mental disorders can be viewed as falling into one of four categories. Affective or mood symptoms include depressed mood and feelings of worthlessness or guilt. Behavioral symptoms include social withdrawal and agitation. Cognitive symptoms, or problems in thinking include difficulty with concentration or making decisions. Somatic or physical symptoms include insomnia or hypersomnia (sleeping too much), a significant loss of, or gain of, weight, and/or a reduction in one's libido (sex drive). According to the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, fourth edition; American Psychiatric Association, 2000) as many as 25% of women and 12% of men will experience an episode of major depression at one point in their lives. Those with a parent or sibling who has had major depression may be 1.5 to 3 times more likely to develop the condition than those who do not. The development of major depressive disorder may be related to certain medical illnesses in that as many as 20%-25% of those who have illnesses such as cancer, stroke, diabetes, and myocardial infarction are likely to develop major depressive disorder that can negatively impact the effectiveness of treatment. The economic cost related to depression in the United States in the year 2000 was estimated to be over $81 billion per annum (Greenberg et al., 2003). Click here for additional information on cognitive behavior therapy and depression.
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (5th ed.). Washington D.C.: American Psychiatric Association.
Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd Eds.). The Guildford Press: New York.
Clark, L. A. (1989). The anxiety and depressive disorders: Descriptive psychopathology and differential diagnosis. In P. C., Kendall., & D. Watson (Eds.), Anxiety and depression: Distinctive and overlapping features, (pp. 83-129). New York: Academic Press.
Greenberg, P. E., Sisitsky, T., Kessler, R. C., Finkelstein, S. N., Berndt, E. R., Davidson, J. R. T., Ballenger, J. C., & Fyer, A. J. (1999). The economic burden of anxiety disorders in the 1990s. Journal of Clinical Psychiatry, 60, 427-435.
Greenberg, P.E., Kessler, R.C., Birnbaum, H. G., Leong, S. A., Lowe, S. W., Berglund, P. A., & Corey-Lisle, P. K. (2003). The Economic Burden of Depression in the United States: How Did It Change Between 1990 and 2000? Journal of Clinical Psychiatry, 64, 1465-1475
Kessler, R. C., Nelson, C. B., McGonagle, K. A., Liu, J., Swartz, M., & Blazer, D. G. (1996). Comorbidity of DSM-III-R major depressive disorder in the general population: Results from the US National Comorbidity Survey. British Journal of Psychiatry, 168, 17-30.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., & Walters, E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 593-602.
Mowrer, O.H. (1947). On the dual nature of learning: A reinterpretation of “conditioned” and “problem solving.” Harvard Educational review, 17, 102-148.
Rosen, J. B.,& Schulkin, J. (1998). From normal to fear to pathological anxiety. Psychological Review, 105, 325-350.