Aim: The aim is to assess the interplay between anxiety and depression was also assessed by comparing the HAD scales with biochemical serum markers of anxiety and depression, namely cortisol and serotonin during surgical removal of third molar. Materials & Methods: A prospective randomized study was conducted using 30 healthy patients (male-13,female-17) between 18-45 years, requiring surgical extraction of impacted mandibular third molar were included in the study. Hospital anxiety and Depression Scale (HAD) scale is a questionnaire used to assess levels of Anxiety and Depression. Blood samples were collected before and after the surgical procedure. The blood samples was analysed for serum cortisol and serotonin, these results were compared with the HAD questionnaire results. Results: The results were analysed using the Student ‘t’ test and Chi square test. The comparison between the pre and post extraction cortisol (C1 and C2) values suggested that the mean post-operative value was in the higher range of the physiological limits with p <0.05 whereas the pre and post extraction (S1 and S2) was within the normal limits with p value >0.005. Conclusion: The study showed that patients were only anxious but showed no signs of depression after surgical removal of the third molar. Study concludes depression does not co-exist with anxiety in immediate pre and post-operative setting.