Anxiety and Depression
Anxiety and Depression addresses assessment and stepped treatment for the most common co-occurring mood and anxiety presentations in clinical practice. This page translates evidence into daily choices: differentiating mixed states from unipolar episodes; recognizing substance-induced symptoms; and sequencing CBT/ACT with pharmacotherapy while protecting sleep and functioning. If you’re comparing events like an anxiety and depression conference, you’ll find pragmatic pathways for first-line care, augmentation, and relapse prevention, with options for perinatal, youth, and late-life populations. Because lifestyle and social determinants shape outcomes, we show how movement, nutrition, and social connection join medication and therapy to shift trajectories, and how registries enable measurement-based care that adapts to response.
Complexity is common: panic with agoraphobia, GAD with insomnia, trauma-related hyperarousal, and overlapping OCD traits. We outline how to stage exposure-based work, manage activation and sexual side effects, and avoid polypharmacy by using clear targets and timelines. Precision thinking helps—pharmacogenomic considerations, side-effect profiles, and comorbidity drive selection and dose. When substance use complicates care, align anxiety treatment with risk-reduction and coordinated SUD support. For exposure protocols and OCD-spectrum specifics, see Exposure and Response Prevention, which complements this page’s broader, transdiagnostic focus.
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Assessment and differential
- Map episode timelines, triggers, sleep, and substance patterns.
- Use scales (PHQ-9/GAD-7) to set baselines and track change.
Psychotherapy first-line
- Apply CBT/ACT with behavioural activation and exposure where indicated.
- Integrate skills practice and relapse-prevention plans early.
Medication selection and safety
- Choose SSRIs/SNRIs, bupropion, or mirtazapine based on profile.
- Monitor activation, QTc, weight, and sexual side effects with clear review points.
Sleep and circadian health
- Stabilize sleep with behavioural strategies; avoid dependence-forming hypnotics.
- Reassess anxiety after circadian regularity improves.
Implementation and Special Populations
Perinatal pathways
Balance maternal mental health with foetal safety; coordinate obstetric care.
Youth and school supports
Blend family work, school accommodations, and digital skills tools.
Late-life depression and anxiety
Adjust dosing, watch interactions, and address loneliness and medical comorbidity.
Trauma-informed care
Phase exposure after stabilization; treat nightmares and hyperarousal safely.
Co-occurring SUD
Align therapy with craving management; avoid sedative risks.
Digital and remote care
Use telehealth, apps, and ePROs with privacy safeguards and escalation rules.
Equity and language access
Tailor materials for culture and literacy; reduce cost and transport barriers.
Quality and outcomes
Track symptom scores, function, and QoL; iterate with measurement-based care.
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