6 types of depression and anxiety have been identified according to brain activity - what can this help us with?

Scientists studied the brain activity of people with depression and anxiety and distinguished 6 different forms of brain activity, symptoms and response to treatment . The research team also determined which type of treatment might be most effective. The findings will help doctors choose treatments tailored to the patient's brain.

"Psychiatry is dominated by a one-size-fits-all diagnostic approach, which means that different medications are tried until one works," the paper reads , "this is long-term, expensive, and tiring, as 30-40% of patients fail to achieve remission after trying one drug." .

The study was conducted on a total of 801 people. Subjects had the following diagnoses: major depressive disorder, generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, or some combination of these conditions. Most of the patients were not treated with drugs. As a control group, 137 people without the disorder participated in the study, so that the scientists could compare the results.

The researchers performed functional magnetic resonance imaging (fMRI) on each participant and measured 41 indicators of activity and connectivity. They focused on six brain circuits known to play a role in depression. The participants were first scanned while at rest, and then while performing various tasks.

Scientists used machine learning and divided people with anxiety and depression into 6 groups. This depends on which brain circuits were over- or under-active compared to the control group.

"As far as we know, this is the first time we've been able to prove that depression can be explained by different brain dysfunctions," says Leanne Williams, a Stanford University scientist and lead author of the study.

In the next phase of the study, 250 participants will be randomly selected to different treatments. They had to either take one of three antidepressants or be treated with talk therapy.

Venlafaxine was found to work best for one subtype, namely people with overactive cognitive brain regions . Talk therapy worked better for people who had more active parts of the brain associated with depression and problem solving . Those with less activity in the attention circuit were less likely to benefit from talk therapy. This may mean that, in such patients, the activity of the aforementioned circuit must first be increased with medication.

See also: Scientists have identified a new subtype of depression — how to recognize it

Treating depression is sometimes not that easy because medications don't work the same for everyone. Sometimes it takes a long time to find out which medicine works best for an individual. Accordingly, the findings of the researchers will help doctors to choose medicines for patients more easily and effectively.

"It's very tiring to be in the realm of depression and not have a better alternative than a one-size-fits-all approach," says Williams. "The goal of our work is to figure out how to make the right decision the first time."

The work was published in the journal Nature Medicine .