Psychiatric specifier

With anxious distress

Prominent tension, restlessness, worry, or fear accompanies the current mood episode.

Episode features

Depressive disordersBipolar disorders

At a glance

Applies to: Depressive disorders · Bipolar disorders
Deciding signal: Anxiety is woven into the mood episode and changes its risk and management profile.
Ask this: Is anxious arousal a meaningful part of this mood episode rather than a separate background condition?
Wording outcome: Major depressive disorder, current episode, with anxious distress

Anxiety is better explained by a separate anxiety disorder with an independent course.
Restlessness is more consistent with akathisia, intoxication, withdrawal, delirium, or another medical cause.

Fit and exclusions

Start with the deciding signal, then test chronology, competing explanations, and the effect on diagnostic wording.

Anxious tension or restlessness rises and falls with the mood episode.
Worry, loss-of-control fears, or dread meaningfully increase distress or impairment.
The pattern is present often enough to influence formulation and care planning.

Name the anxiety burden explicitly; it may affect monitoring, tolerability, risk, and pacing of treatment.

Major depressive disorder, current episode, with anxious distress

At a glance

Applies to

Depressive disorders · Bipolar disorders

Deciding signal

Anxiety is woven into the mood episode and changes its risk and management profile.

Ask this

Is anxious arousal a meaningful part of this mood episode rather than a separate background condition?

Wording outcome

Major depressive disorder, current episode, with anxious distress