Depression is the number one mental health issue in the US, with more than 16 million Americans suffering from a depressive episode each year. Symptoms typically include sadness, irritability, lack of energy and motivation, disturbed sleep, poor concentration, physical aches, slow movements, and thought of suicide or death. Depression is typically treated with a combination of psychotherapy and medication. However, finding the right medication for depression isn’t simple. By some estimates, between 70 and 80 percent of people don’t get the right medication on the first try. While trial and error may help many people find a medication that effectively treats their depression, studies show that antidepressants are only effective for about 40 to 60 percent of people with moderate or severe depression. Why don’t antidepressants work for everyone? A new study suggests a possible answer: Childhood trauma. The study was conducted by a team from the Okinawa Institute of Science and Technology Graduate University. The team collected clinical data from 134 participants, half of whom had recently been diagnosed with depression. They administered questionnaires to gather data about participants’ life history, sleep patterns, mental health, and sources of stress. Participants were also given blood tests and each participant was examined under an fMRI machine that allowed the team to map 78 brain regions and the connections between them. All of this data was used to find patterns or clusters that might yield insight into different forms of depression. After compiling the data and devising a new statistical model, five data clusters emerged, defined by two important factors: childhood trauma and the initial severity of the depressive episode. Three of those five data clusters corresponded to subtypes of depression. The fMRI images showed that in types of depression where there was low connectivity between the angular gyrus–a brain region involved with attention, spatial processing, language, and numbers–and other regions of the brain, antidepressants were most likely to improve symptoms. However, if there was high connectivity between the angular gyrus and other parts of the brain, and participants had experienced childhood trauma, they were unlikely to respond to antidepressants. This is just one study of many trying to figure out why some forms of treatment for depression work for some people but not others. Others have focused on matching brain images or EEG patterns to certain types of medication. These studies are important because the wrong medication doesn’t only waste time and money, but it may actually make patients feel worse. Getting the right treatment as soon as possible significantly reduces the chances of another episode and of other long-term consequences of depression.
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