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Breakthroughs, Briefly

The 5 Types of Anxiety and Depression

More precise diagnoses will make for better-tailored treatments, Stanford psychiatrists say.

Illustrations: Michele McCammon (6)

By Diana Aguilera

Researchers led by professor of psychiatry and behavioral sciences Leanne Williams have identified five subtypes of anxiety and depression based on symptoms and brain activity. The Stanford-led study, published in JAMA Psychiatry in December, aims to differentiate mental illnesses so that doctors can match treatments more precisely to the symptoms they seek to alleviate. Therapies for anxiety and depression typically include an inexact mix of counseling, medication and lifestyle changes.

  • Tension: Defined by irritability. People feel excessively sensitive, touchy and overwhelmed. The nervous system is hypersensitive.

  • Anxious arousal: Characterized by the struggle to concentrate, retain memories or control thoughts. Physical symptoms include a racing heart, sweating and feeling stressed. Often, patients think there’s something wrong with their brain, Williams says. “They say things like, ‘I feel like I’m losing my mind.’”
Anxious Arousal

  • Melancholia: Marked by isolation. The lack of social interactions causes distress. “This is more the stereotypical image people might have of depression, where someone is obviously sad and feeling like their quality of life is really poor.”

  • Anhedonia: Defined as the inability to feel pleasure. In fact, Williams says, “people say they can’t feel anything. They feel complete emptiness.” Individuals can function reasonably well, but the condition makes building relationships and physical intimacy difficult. “These are some of the most distressed people.”

  • General anxiety: Characterized by worrisome thoughts. “People ask, ‘What if this happens? What if I can’t control this?’” It can manifest as physical stress.
General Anxiety
Diana Aguilera is a STANFORD staff writer.

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