Study findings are not yet conclusive
Brain scans show there are six different types of anxiety and depression, experts say. This discovery could lead to improved treatment for people with mental disorders.
< /span>
The combination of anxiety and depression is estimated to be the most common mental health problem in Britain, affecting around 8% of the population, with similar rates in the US.
However, many people with the disorder are forced to undergo a variety of treatments, including psychotherapy and medications, in the hope of finding one that works.
Data shows that four out of 10 patients don't find a treatment that works on the first try, leaving them to suffer longer. But now, it seems, everything may change.
A team of American and Australian scientists used brain scanning technology to find new specific types of depression and anxiety, hoping to one day help speed up the process.
To do this, they collected data from a sample of 1,051 patients with depression and anxiety, 850 of whom are not currently undergoing treatment. Patients underwent brain scans while they were at rest and also when they were asked to perform an emotional task (for example, reacting to photographs of sad people).
Experts from the University of Sydney and Stanford University in California then compared these results between patients and healthy people to identify any differences.
The goal was to find out whether the lights «lighted up» or not. different parts of the brain in different patients, showing that parts of the organ behave differently in some participants.
They also assessed each participant's symptoms of depression and anxiety to also identify any common features between patients with similar brain scan results.
The end result was that the scientists were able to group the patients and divide depression and anxiety into six different subtypes . They were called DC+SC+AC+, AC-, NSA+PA+, CA+, NTCC-CA- and finally DXSXAXNXPXCX.
The brain scan subtypes varied, with certain neural pathways being over- or under-active in at rest or in response to certain stimuli.
For example, CA+ patients (258 people) were found to have a hyperactive cognitive control circuit — the part of the brain responsible for planning and preparation.
While DC+SC+AC patients (169 participants) responded more slowly when it came to responding to photographs of sad people.
Some also had differences in symptoms. For example, DC+SC+AC+ patients suffered from more severe concentration problems and impulsivity compared to other groups.
On the other hand, NSA+PA+ patients (154 subjects) had much more severe anhedonia (a term for a person experiencing a lack of interest, pleasure, or enjoyment in life experiences).
In the final part of their study, the researchers also tested whether any of them were more effective among patients receiving therapy or medications of certain subtypes.
They found that DC+SC+AC+ patients responded better to behavioral treatments such as cognitive behavioral therapy compared to other subtypes.
This was especially true for AC- patients (161 people), who, in contrast, had the worst response to behavioral treatment among all groups.
The authors of the study, published in the journal Nature Medicine, said that finding more specific diagnoses of depression and anxiety and, as a result, determining which treatments will be more effective for each type, will improve patient outcomes.
“The dominant diagnostic approach in psychiatry is “one size fits all.” leads to a trial-and-error cycle of treatment options that is time-consuming, costly and frustrating, with 30-40% of patients not achieving remission after trying one treatment,” – the researchers note.
While they said their results were promising, they noted that they should be taken with caution and that other studies would need to replicate their findings.
Other experts have been concerned about the “one size fits all” approach for years. to patients suffering from depression. These concerns largely stem from the use of a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs), taken by millions, and its libido-suppressing side effects.
Some report that they have become «asexual» zombies even years after they stopped taking the drugs. Some studies even suggest that they may increase the risk of heart problems in young people or even, paradoxically, increase the risk of suicide.
However, such research is not clear: other experts note that similar trends may be related to the patients suffering from depression that the drugs are intended to relieve, rather than to the drug itself. And many people who take them say they work.
People with depression are thought to have low serotonin levels, although there is scientific debate about this. However, some experts suspect that the drugs may cause the release of too much serotonin, which could have consequences for people's health.
Psychiatrists advise patients concerned about the side effects or potential side effects of antidepressants to talk to their doctor about possible treatment options. Sometimes doctors may suggest an alternative dose, a different drug, or prescribe a different medicine to combat side effects.