All depressive illnesses are not created equal

At last! A doctor that differentiates between different types of depression…

Most doctors rate depression according to its severity. They may state that you are experiencing a major depressive episode or a mild depressive episode, or perhaps you have seasonal affective disorder (SAD).


Dr Henry Emmons has a different approach. He classifies depression as follows:

• Anxious Depression


• Agitated Depression


• Sluggish Depression

This is a potential break-through in diagnosis and the possibilities it offers for treatment. According to Emmons you may be a combination of the above three types but most likely show a preference to one type or another.

More significantly, each type of depression is attributed to an excess or deficit of chemicals (neurotransmitters) in the brain. Many people will already know that low levels of serotonin, otherwise known as the happiness brain chemical, can lead to depression and disrupted sleep patterns. However Emmons suggests that dopamine and norepinephrine also have a role in depression. This is not entirely new, however the attribution of specific types of depressions and tailored treatment is new.

Anxious Depression is characterised by low levels of serotonin and feelings of inadequacy and excessive worry, together with insomnia and potential carbohydrate cravings.

Agitated Depression is said to result from an excess of dopamine and norepinephrine resulting in restlessness, anger, irritability and digestive problems.

Sluggish Depression is characterised by increased sleep, withdrawal and passivity due to low levels of dopamine and norepinephrine.

In Emmons’ book The Chemistry of Joy he suggests eating plans for each type of depression, together with generalised recommendations for vitamin supplementation. Most of the information on vitamin supplementation will be familiar and include the usual mainstays, such as B complex, folic acid, omega 6 (fish oil) and the like.

Interestingly Emmons speculates that Selective Serotonin Reuptake Inhibitors (SSRIs), which are commonly prescribed for depression, are not effective long term. This contradicts accepted wisdom, however his reasoning is sound. He hypothesizes that SSRIs simply manipulate existing stores of serotonin and do not help create new sources of serotonin. Accordingly, if an individual has difficulty manufacturing serotonin then over time the existing stores will be depleted as the SSRIs can not stop re-uptake indefinitely. It’s an interesting theory. I couldn’t find any source for this from published research and it appears to be based on Emmons’ observations of his patients but I think the theory has merit.

Emmons favours a combination of lifestyle changes and supplements to treat depression. He does not rule out medication but seems to prefer a diet rich in tryptophan (the precursor to serotonin) together with 5-HTP. If you have a deficit of dopamine and norepinephrine then dopamine/norepinephrine enhancing foods and supplements are recommended.

Emmons’ book also recommends ‘Mindfulness Mediation’ and making lifestyle changes according to your Ayurvedic body type, a philosophy made popular by Deepak Chopra in several books including Perfect Health.

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Check out part 2 of this article on The Chemistry of Joy: Mindfulness Meditation