Exposure Therapy when Patients Present with Comorbid Depression

Depression is one of the most common emotional disorders, and it is even more common when one is suffering from an anxiety disorder. The goal of this chapter is to discuss how depression impacts anxiety and its treatment, with a par­ticular focus on treatment via exposure therapy. First, we discuss the prevalence of depression in anxiety and related disorders and how depression might impact the natural course of anxiety. Second, we briefly describe why depression may be more common in patients diagnosed with anxiety or a related disorder. Third, we present considerations that should be considered when conducting exposure with anxious patients who are also depressed. Finally, we discuss how depression can influence exposure treatment and how to adapt or manage in such situations. In summary, this chapter discusses many challenges that can occur when conducting exposure ther­apy with depressed, anxious individuals. We provide a number of cognitive and behavioral strategies to help manage these issues in order to instill hope in both the patient and the therapist alike, thereby facilitating improvement in both anxiety and depression via treatment.