Learn what is Mixed Anxiety-Depressive Disorder and its symptoms, how anxiety and depression overlap, and what I learned after my diagnosis.
You worry constantly, yet somehow don’t have the energy to deal with the things you’re worrying about.
Your mind says, “Something could go wrong.”
Another part of you says, “I don’t have the energy for this anymore.”
I know that combination because I have lived it.
I was diagnosed with Mixed Anxiety-Depressive Disorder at 40. I am 46 now, and one of the most useful things I have learned is that anxiety and depressive symptoms don’t always arrive separately.
Sometimes they exist together—and that can be surprisingly difficult to recognise.
I am not a psychiatrist, psychologist or doctor. This article is based on my personal experience and what I have learned through my diagnosis and treatment. It is not medical advice or a diagnosis.
What Is Mixed Anxiety-Depressive Disorder?
In simple terms, Mixed Depressive and Anxiety Disorder involves symptoms of both anxiety and depression occurring together.
The clinical terminology is worth clarifying. The ICD-11 uses the name Mixed Depressive and Anxiety Disorder (6A73). The diagnostic concept involves both depressive and anxiety symptoms being present, while neither set of symptoms on its own meets the diagnostic threshold for another depressive or anxiety disorder.
For the clinical rather than personal explanation, see this research on the ICD-11 Mixed Depressive and Anxiety Disorder diagnosis.
For me, however, the definition became much easier to understand like this:
Anxiety presses the accelerator. Depression applies the brake. Living with both can feel like having your foot on both pedals.
What Are the Symptoms of Mixed Anxiety and Depression?
The exact experience differs from person to person, and symptoms need professional assessment.
But anxiety and depressive symptoms can overlap in ways that make the experience confusing.
| Anxiety side | Depressive side | Where they can overlap |
| Excessive Worry | Low mood | Poor concentration |
| Restlessness | Low motivation | Fatigue |
| Feeling on edge | Loss of interest | Sleep problems |
| Physical tension | Low energy | Irritability |
| Expecting problems | Withdrawal | Difficulty functioning |
The National Institute of Mental Health’s guide to anxiety describes symptoms such as excessive worry, irritability, restlessness, concentration problems, fatigue, sleep difficulties, headaches, muscle aches and stomach aches.
This is important because anxiety isn’t only a thought or emotion. It can feel physical too.
What MADD Felt Like to Me
A symptom list is useful.
But it doesn’t necessarily tell you what Monday morning feels like.
For me, the difficult part was the contradiction.
I could worry intensely about something while simultaneously lacking the motivation to deal with it.
I could be tired but unable to mentally switch off.
I could continue working and handling responsibilities while internally feeling that something wasn’t right.
That creates a strange situation:
You can appear functional without actually feeling well.
You go to work.
Answer messages.
Pay bills.
Deal with family responsibilities.
Talk to people.
Maybe even laugh.
And because you’re still functioning, you tell yourself:
“Obviously nothing is seriously wrong. I just need to handle things better.”
I told myself versions of that for years.
Anxiety + Depression Can Create a Difficult Cycle
One way I understand my experience is:
Worry
↓
Overthinking and poor sleep
↓
Mental and physical fatigue
↓
Lower motivation and capacity
↓
Tasks start accumulating
↓
More things to worry about
↓
More anxiety
This isn’t a medical model.
It’s simply a pattern I learned to recognise in myself.
And recognising the pattern was important because earlier I treated each part separately.
Bad sleep was just bad sleep.
Irritability was a bad mood.
Exhaustion meant I needed rest.
Overthinking was simply my personality.
Eventually I began seeing connections.
Why Can MADD Go Unnoticed for Years?
I was diagnosed at 40.
That naturally made me wonder:
How did I get to 40 without properly understanding what was happening?
One reason, I think, is that human beings adapt remarkably well.
You learn to function around the problem.
Persistent worrying becomes:
“I’m an overthinker.”
Irritability becomes:
“That’s just my nature.”
Mental exhaustion becomes:
“Work is stressful.”
Difficulty relaxing becomes:
“I’m always busy.”
And low motivation becomes:
“I need to push myself harder.”
For men especially, talking about stress, work pressure, acidity or poor sleep may sometimes feel much easier than saying:
“I’m struggling mentally.”
I explore that physical side more deeply in my article Why Anxiety in Men Shows Up as Acidity, High BP & Irritability.
Normal Worry vs. Something Worth Discussing
Everybody worries.
Everybody feels low sometimes.
Having a difficult week doesn’t automatically mean you have a mental-health disorder.
A useful distinction is how persistent the symptoms become and how much they interfere with everyday life.
The National Institute of Mental Health explains that anxiety disorders involve more than occasional worry or fear; anxiety can persist and interfere with everyday activities.
So rather than asking only:
“Do I feel anxious?”
It can be useful to notice:
- Is this happening repeatedly?
- Is it interfering with my sleep?
- Is concentrating becoming difficult?
- Is it affecting work or relationships?
- Am I constantly exhausted?
- Have I stopped enjoying things I normally enjoy?
- Is worry taking up a large part of my day?
These questions cannot diagnose MADD.
They can, however, help you recognise when something deserves a proper conversation with a qualified professional.
The Physical Symptoms Matter Too
Something else I didn’t understand properly earlier was how physical anxiety could feel.
Anxiety can involve physical symptoms such as muscle tension, headaches, stomach aches, sweating, light-headedness and breathlessness.
That creates another potential trap.
Physical symptom → worry about symptom → increased anxiety → notice symptom even more
I have learned not to automatically assume that a physical symptom is caused by anxiety.
Persistent or concerning physical symptoms deserve appropriate medical evaluation.
But I’ve also learned not to pretend that mental and physical health exist in completely separate boxes.
I discuss this specifically in Why Anxiety in Men Shows Up as Acidity, High BP & Irritability.
What Changed After I Was Diagnosed at 40?
Diagnosis didn’t suddenly make everything disappear.
What changed was my understanding.
Before diagnosis, the question was often:
“Why can’t I handle this better?”
Afterwards, I could ask:
“What is happening here, and how should I respond to it?”
That is a much more useful question.
I started noticing patterns instead of judging every difficult day as a personal failure.
I became more conscious of sleep.
I recognised when worry was escalating.
I understood that thoughts could feel convincing without necessarily being facts.
And importantly, I became more willing to accept professional help.
What Has Helped Me Personally
I deliberately call this “what helped me”, not “how to treat MADD.”
Treatment decisions belong between an individual and qualified healthcare professionals.
From my own experience, these things have mattered:
- Recognising my patterns earlier instead of waiting until I feel completely overwhelmed.
- Taking sleep seriously, because poor sleep makes anxiety and low mood harder for me.
- Questioning anxious predictions instead of automatically accepting them as facts.
- Maintaining some routine, particularly during low-motivation periods.
- Moving physically, even when I don’t feel particularly motivated.
- Writing things down, which helps get repetitive thoughts out of my head.
- Accepting professional support instead of believing I should solve everything through willpower.
Most importantly, I stopped making “never feeling anxious again” the definition of recovery.
For me, progress is often much less dramatic.
Sometimes progress means recognising what is happening sooner.
Sometimes it means responding differently.
And sometimes it simply means having a bad day without turning it into a judgement about my entire life.
Medical disclaimer: I am sharing my personal experience of being diagnosed with Mixed Anxiety-Depressive Disorder and general educational information. I am not a psychiatrist, psychologist or medical professional. This article is not intended to diagnose or treat any condition and is not a substitute for professional healthcare.
Frequently Asked Questions
Is Mixed Anxiety-Depressive Disorder the same as anxiety?
No. The ICD-11 concept of Mixed Depressive and Anxiety Disorder involves both depressive and anxiety symptoms occurring together, rather than anxiety symptoms alone. A qualified professional needs to determine which diagnosis, if any, applies to an individual.
Can you have anxiety and depression at the same time?
Yes. Anxiety and depressive symptoms can occur together. However, several different diagnoses can involve anxiety and depression, so experiencing both does not by itself mean someone has MADD.
What can MADD feel like day to day?
From my personal experience, it can feel like a tug-of-war between worry and exhaustion: your mind remains occupied with problems while your energy and motivation to deal with them can be low.
Can anxiety cause physical symptoms?
Anxiety can be associated with physical symptoms including muscle tension, headaches, stomach aches, sweating, light-headedness and breathlessness. New, persistent or concerning physical symptoms should not automatically be attributed to anxiety and should be appropriately evaluated.
Should I diagnose myself from MADD symptoms?
No. A symptom list or blog post cannot establish a mental-health diagnosis. If anxiety or depressive symptoms are persistent or interfering with everyday life, discussing them with a qualified healthcare or mental-health professional is a more appropriate next step.
The One Thing I Wish I Had Understood Earlier
For years, I was trying to answer:
“What is wrong with me?”
Today I think a better question is:
“What is happening to me, and what can I learn about it?”
That change sounds small.
For me, it wasn’t.
I was 40 when I finally had a name for what I had been experiencing. Six years later, I am still learning how anxiety, low mood, physical health, responsibilities and everyday life interact.
That’s why I am writing these articles.
Not because I have all the answers.
But because sometimes reading another person’s experience helps you recognise something in your own.
If you have experienced anxiety and low mood together, what did you notice first—the worrying, the low energy, the physical symptoms, or something else?
Share your experience in the comments.
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