n the past, depression was often described as “melancholia”, which referred to severe sadness, low mood and loss of interest. Treatment historically included institutional care and “moral treatment”. During the 20th century, treatments such as antidepressant medication and ECT became increasingly common (Berrios, 1988).

Generalised Anxiety Disorder (GAD) was not always recognised as a separate diagnosis. In the past, conditions involving long-term anxiety and nervousness were described using terms such as “neurasthenia” and “anxiety neurosis”. The modern concept of GAD developed through changes in psychiatric classification during the 20th century (Rynn & Brawman-Mintzer, 2004).

The ICD-11 provides standardised criteria for diagnosing depression and GAD. However, one difficulty is that symptoms can overlap between disorders, and people with the same diagnosis can have different symptoms and levels of severity. This can make diagnosis and treatment decisions more complicated (WHO, 2024).

Clinicians manage these difficulties by looking at the whole person rather than only the diagnosis. They consider symptoms, severity, functioning, physical health, other mental health conditions, social circumstances and previous treatment. NICE recommends personalised treatment for depression, which can include psychological therapies and medication (NICE, 2022). For GAD, treatment can include self-help, psychological therapies such as CBT and medication depending on the person's needs (NICE, 2011).

References

Berrios, G.E. (1988). Melancholia and depression during the 19th century: a conceptual history. British Journal of Psychiatry.
Rynn, M.A. & Brawman-Mintzer, O. (2004). Generalized anxiety disorder: acute and chronic treatment. CNS Spectrums.
World Health Organization (WHO) (2024). Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders. WHO publication
NICE (2022). Depression in adults: treatment and management (NG222). NICE guidance
NICE (2011, updated 2020). Generalised anxiety disorder and panic disorder in adults: management (CG113). NICE guidance

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