Mixed anxiety-depressive disorder is a relatively common diagnosis, affecting women twice as often as men. Current studies indicate that 8% to 10% of the population currently suffer from anxiety-depressive disorder. Anxiety-depressive disorder has been shown to result in longer average work disability than "pure" depression. It is a serious diagnosis that unfortunately often goes unrecognised or is underestimated in GP surgeries.

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As a result of their persistent difficulties, sufferers are exposed to chronic stress, their performance and immunity decline and their quality of life is significantly impaired.

• difficulty concentrating or feeling "empty in the head"
• sleep disturbances (difficulty falling asleep or staying asleep or restless, inadequate sleep)
• irritability, hypersensitivity and easy movement to cry
• a pessimistic, sometimes catastrophic view of the future
• exaggeration of own failures, mistakes and unrealistic level of self-criticism
• increased morbidity, psychosomatic pain (headache, stomach, back pain, etc.)

Anxiety states occur very often, without any apparent objective reasons. The specific reasons for the anxiety are found by the sufferer himself and are usually connected with his perceived (or real, but exaggerated) past failures, which he then projects into the future.

Anxiety is accompanied by various unpleasant physiological changes, manifested by tightness of the throat, sweating, tightness of the stomach, nausea, headache, etc. However, these manifestations are milder compared to the massive rush of anxiety that occurs, for example, in panic attacks. However, they are usually not time-limited and bother the sufferer for a longer period of time.

Patients with anxiety-depressive disorder often feel sadness, hopelessness, exhaustion and often lose the ability to make quick decisions. They suffer from mood swings and are emotionally unstable. However, their difficulties do not reach the level of a clinical depressive episode. They are usually able to carry out their profession and normal daily tasks, but they suffer from demotivation, exhaustion and immune disorders. Their occupational and social performance is reduced as a result of their anxiety-depressive disorder, and they are often limited to the 'bare essentials'. They withdraw into themselves, avoid social life and have reduced self-esteem and often feelings of worthlessness.

Unfortunately, people who suffer from anxiety-depressive disorder are more at risk of alcohol dependence than the general population. Alcohol has relaxing and sedative effects that anxious people benefit from in the short term and find temporary relief. Very often they develop a pathological pattern of drinking called self-medicating alcoholism. In this type of addiction, they do not drink themselves into states of euphoria or loss of control, often just into a state of 'normal' in which they do not feel anxious and can, for example, fall asleep.

But alcohol upsets the already delicate balance of the neurochemical environment in the brains of those affected, leading to permanent psychological exhaustion and exacerbating the anxiety states that are the very triggers of alcohol craving. The sufferer then finds himself in a vicious circle and is usually unable to help himself. A very similar dependence can develop on drugs containing benzodiazepines and sleeping pills.

In the treatment of anxiety-depressive disorder, which is accompanied by addiction, parallel attention must be paid to this problem. A very positive effect can be achieved with Controlled Consumption Therapy.

In the treatment of mixed anxiety-depressive disorder, intensive psychotherapy is the primary treatment, and cognitive-behavioural therapy is the first choice in most cases. Psychotherapy should be complemented by relaxation therapy and training in breathing strategies to manage the physical manifestations of anxiety.

In the case of a chronic course of the disease, psychotherapy should be supplemented with gentle medication. The most commonly used drugs include antidepressants, which affect serotonin reuptake. On the other hand, the long-term administration of anxiolytics containing benzodiazepines is considered inappropriate.