Unlocking Personalized Depression Treatments

A new era in our understanding of mental health.

Photo from the New York Public Library, courtesy of Unsplash

Depression is a complex mental health condition that affects over 280 million individuals worldwide according to the World Health Organization (WHO), but treating it often involves a frustrating trial-and-error process. 

Stanford Medicine Study

A groundbreaking study led by Stanford Medicine and published in June of 2024 identified six distinct biological subtypes, or “biotypes” of depression. Using brain imaging including functional MRI, or fMRI technology, to measure brain activity, researchers scanned volunteers both at rest and when engaged in activity to test their cognitive and emotional functioning. 

This allowed researchers to focus on specific regions of the brain and their connections, especially those already known to play a role in depression.

Brain Circuits Related to Depression

According to Newport Healthcare, these circuits include the default mode (D): an active circuit when the individual isn’t focusing on anything, salience (S), Attention (A), Negative mood circuit activated by sad stimuli (NS), Negative mood circuit activated by conscious threat stimuli (NTS), Negative mood circuit activated by nonconscious threat stimuli (NTC), Positive mood circuit (P), and the Cognitive circuit (C). The six depression subtypes are then derived from the interactions seen in these brain circuits.

Study Results and Optimal Treatment Types

After receiving fMRI imaging, out of the 801 participants who had previously been diagnosed with depression or anxiety in the Stanford study, 250 were randomly assigned to receive one of three common antidepressants or behavioral talk therapy. 

According to the study, patients with the subtype defined by overactivity in cognitive brain areas experienced the best response to the antidepressant venlafaxine, commonly known as the brand Effexor. 

Individuals with the subtype with brains exhibiting higher levels of activity in the amygdala, hippocampus, and anterior cingulate cortex, the three brain regions associated with depression, saw better results with behavioral talk therapy.

A third subtype, with lower levels of activity at rest in the circuit that controls attention, were the least likely to see improvement with behavioral talk therapy. 

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Tailoring Mental Health Treatment in the Future

By targeting these specific biotypes, doctors can potentially predict which therapies, whether medical or behavioral treatment, will work best for a given patient. Due to the nature of depression and scientists’ understanding of it, depression treatment up until now has been trial and error, with patients frequently trying various treatments to find one that “works.”

As we move forward into a world where mental health treatments can be tailored to an individual, Stanford’s research paves the way for a more effective, compassionate system – backed by science-based strategies and the emerging precision psychology.