Researchers claim there are five types of depression and anxiety


Depression and anxiety have always been difficult to really describe or quantify for both patients and clinical professionals because the conditions can be so amorphous.

While some people with depression may struggle with some symptoms, others may have a completely different experience. Yet, the limited understanding and diagnostic tools mental health workers have been relying on for years would diagnose both with the same condition.

Now, a team of researchers says they have identified five specific categories of depression and anxiety that may help explain why some experience specific symptoms and could possibly lead to more effective targeted treatments.

The five categories, as the authors from Stanford University describe in JAMA Psychiatry, are defined by their specific symptoms and areas of brain activation. They are tension, anxious arousal, general anxiety, anhedonia (the inability to feel pleasure), and melancholia.

In the report, the researchers further describe these conditions as:

  • Tension: This type is defined by irritability. People are overly sensitive, touchy, and overwhelmed. The anxiety makes the nervous system hypersensitive.
  • Anxious arousal: Cognitive functioning, such as the ability to concentrate and control thoughts, is impaired. Physical symptoms include a racing heart, sweating, and feeling stressed. “People say things like ‘I feel like I’m losing my mind,” Williams says. “They can’t remember from one moment to the next.”
  • Melancholia: People experience problems with social functioning. Restricted social interactions further cause distress.
  • Anhedonia: The primary symptom is an inability to feel pleasure. This type of depression often goes unrecognized. People are often able to function reasonably well while in a high state of distress. “We see it in how the brain functions in overdrive,” Williams says. “People are able to power through but at some time become quite numb. These are some of the most distressed people.”
  • General anxiety: A generalized type of anxiety with the primary features involving worry and anxious arousal—a more physical type of stress.

“We are trying to disentangle the symptom overlap in our current diagnoses which can ultimately guide tailored treatment choices,” lead researcher and professor of psychiatry and behavioral sciences, Leanne Williams.

Based on current statistics, depression and anxiety are the leading causes of disability and lost productivity around the world, with only one-third of patients responding to modern treatments. Both conditions also share a number of overlapping symptoms that have led to them being broadly used to diagnose individuals.

Williams and her colleagues believe that by better categorizing and identifying the specific shapes anxiety and depression take, they can improve the treatments available.

“Currently, the treatments would be the same for anyone in these broad categories,” Williams says. “By refining the diagnosis, better treatment options could be prescribed, specifically for that type of anxiety or depression.”

For the study, the team collected and evaluated data collected from 420 individuals. Some of the individuals were clinically healthy, while the others had multiple anxiety and depression diagnoses.

All the participants underwent tests involving brain mapping, a self-reported symptom questionnaire, and psychiatric diagnostic testing to assess how well they functioned in everyday life, their capacity for building social relationships, and general outlook on life.

The tests were then repeated with a second group involving 381 people.

Based on an assessment of the data using machine learning algorithms, the team was able to identify five specific categories across both groups.

Approximately 13% of participants were diagnosed with anxious arousal, 9% with general anxiety, 7% with anhedonia, 9% with melancholia, and 19% with tension.

“Interestingly, we found that many people who did not meet diagnostic criteria, but were still experiencing some symptoms, fell into the tension type,” says Katherine Grisanzio, lead author of the study and research lab manager in Williams’ lab.

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