Understanding the Anxiety and Depression Types—Type 2: Pure Depression

Anxiety and Depression Types—Type 2: Pure Depression

Depression is not a single or simple disorder. The sadness or emptiness you experience may be very different than the hopelessness or helplessness someone else feels. But traditional psychiatry doesn’t typically recognize these differences and often gives everyone who is depressed the same diagnosis and the same treatment plan. This will never work because depression is a symptom of many different causes. You need to find the root cause.


Depression is a symptom with many different causes. You need to find the root cause. Click To Tweet

Giving someone the diagnosis of depression is exactly like giving them the diagnosis of chest pain. Why don’t doctors give people the diagnosis of chest pain? Because it doesn’t tell you what’s causing it or what to do about it. It could be from a blocked artery, grief, or heartburn from the pepperoni pizza you ate. There are many biological issues that contribute to depression that psychiatrists, psychologists, and other healthcare providers may miss.

Based on the brain SPECT imaging work at Amen Clinics, which has the world’s largest database of functional brain scans related to behavior (over 160,000 scans from 155 countries), as well as clinical experience with tens of thousands of patients over more than 30 years of practice, it has become evident that there are not only multiple causes of depression but also multiple types of depression. Specifically, the neuropsychiatrists at Amen Clinics have identified 7 types of depression and anxiety, which occur together 75% of the time.

This blog series will explore each type, including the common symptoms, brain SPECT findings, and effective interventions.


Type 2: Pure Depression results from excessive activity in the brain’s emotional center, the deep limbic system. This type is associated with primary depressive symptoms that range from chronic mild sadness (dysthymia) to the devastating illness of major depression. If you’re struggling with these feelings, you may be one of those people who tries to smile through your depression, or you may be among those who can barely get out of bed.

Some of the most famous, creative individuals we’ve scanned, including musical artists, actors, and writers, have overactivity in the deep limbic center. People with this brain pattern tend to be sensitive, deeply feeling, and empathic, which can be channeled in their art.


Some of the most common symptoms seen in people with Pure Depression include:

  • Persistent sad or “empty” mood
  • Loss of interest or pleasure in activities that are usually fun, including sex
  • Restlessness, irritability, or excessive crying
  • Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism
  • Sleeping too much or too little, early-morning awakening
  • Loss of appetite and/or weight loss, or overeating and weight gain
  • Decreased energy fatigue, feeling “slowed down”
  • Thoughts of death or suicide, or suicide attempts
  • Difficulty concentrating, remembering, or making decisions
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
  • Persistent negativity or chronic low self-esteem
  • Persistent feeling of dissatisfaction or boredom

Although these are the most typical problems associated with Pure Depression, they are not the only ones. At Amen Clinics, patients complain of myriad other depressive symptoms that many people aren’t often aware of.


The SPECT findings that correlate with Pure Depression are markedly increased activity in the deep limbic area at rest and during concentration and decreased prefrontal activity at rest that improves with concentration. Deactivation of the prefrontal cortex at rest and improvement with concentration is a finding that is very common but not always present. In a study of more than 15,000 patients at Amen Clinics, we saw a significant correlation between increased activity in the limbic system and self-reporting of being negative or feeling chronic guilt, having crying spells, and experiencing feelings of helplessness and hopelessness.

The limbic system is one of the most interesting and critical parts of being human and is power-packed with functions, all of which are critical for human behavior and survival. The limbic system typically includes the:

  • Thalamus—a large structure deep in the center of the brain that relays information to and from the outside world and the cerebral cortex.
  • Amygdala—an almond-shaped structure in the temporal lobes, involved in emotional and fear responses.
  • Hippocampus—a seahorse-shaped structure that helps memories get into long term storage.
  • Hypothalamus—about the size of a pearl, is an important emotional center, controlling the chemicals that make you feel hungry, sexual, sleepy, exhilarated, angry, or unhappy.
  • Olfactory cortex—our sense of smell, which connects to emotional and memory centers.


In traditional medicine, antidepressants are often prescribed as the first line of defense for depression, but these drugs are not the cure-all many people expect. A 2014 study found that in over 50% of depressed patients, taking antidepressants failed to provide full remission of their symptoms. Unfortunately, treatment-resistant depression is far too common.

At Amen Clinics, relying solely on medication for mental health issues (which are really “brain health” issues) is never the solution. Rather, taking a brain-body approach that addresses all the contributing factors of depression is the best way to feel better fast and make it last. There are many alternatives to antidepressants that can help, such as:

  • Kill the ANTs: Learning to eliminate the ANTs (automatic negative thoughts) and replacing them with more helpful thoughts can completely change your life.
  • Practice gratitude: Gratitude helps direct your attention to positive feelings and away from negative ones. A wealth of research suggests that a daily practice of gratitude, as simple as writing down several things you’re grateful for every day, can improve our emotions, health, relationships, personality, and career.
  • Get moving: Research shows that physical activity improves mood, anxiety, and even cognitive health in patients with depression.
  • Eat right: Consume mood foods that make you feel better.
  • Use your sense of smell: Your limbic system is the part of your brain that directly processes your sense of smell. Certain scents—such as lavender and jasmine—are known to have mood-enhancing effects. Use an essential oil diffuser and essential oils with these scents.
  • Supplements: Omega-3 fatty acids, saffron, s-adenosylmethionine (SAMe), and vitamin D can help.

Depression, anxiety, panic attacks, and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time.

At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.


  1. I a man going to try some of these especially the dietary supplements.
    I already walk two miles a day when I can.
    I have had suggestions from several sources to dwell on what I have and be grateful for it instead of ruminating on what I don’t have over and over.

    Comment by Margaret Tabor — November 27, 2020 @ 5:22 AM

  2. Why would you expand on Type 2 deppression when my results are Type 9? I would also like to take the test again as I did it in a rush. Is there a way?
    Many thanks.

    Comment by susana i adrianzen — November 27, 2020 @ 6:48 AM

  3. A good 12 step program will help you make these suggestions a way of life and give you personal support. Get a copy of Alcoholics Anonymous from the library and read it. Tell them it is for a friend. No one ever asks for it for themselves. I once saw a list of 70 support groups that used the 12 steps for their specific issue. AA, OA, SA etc. Google any of them.

    AMEN Class of 1995

    Comment by William Harris — November 27, 2020 @ 7:18 AM

  4. Hi Amen clinics…
    I am from india
    I suffered from my childhood anger,anxiety,depression,crying spells ,at one point I am not able to understand what I am reading(education is affected ),not communicate with frnds,always I felt choking sensations,excessive negative thoughts,no frnds,no girl frnds….always single😒😔…
    How to I take SPECT scan ???
    Because I am from india

    Comment by Sampath Marupatla — November 27, 2020 @ 7:49 AM

  5. I have been suffering 30 years with depressant, I am 70 years old woman.I am getting worse. I have worked out at least 3 to 4 times a week for those 30 years!!! I am beyond the point of giving up!!! Ps I been on several antidepressant!!! I just feel this is a hopeless!!

    Comment by Kathleen Roderick — November 27, 2020 @ 9:00 AM

  6. I am a 74 year old woman diagnosed with bipolar disorder at age 19 years old. How do I go about taking the SPECT Scan ?

    Comment by Samantha Gerland — November 27, 2020 @ 12:39 PM

  7. I suffer from anxiety and depression that was magnified after years of caring for and loosing my relatives until I am the sole survivor of my family. I also lost my career which was my life’s work. I was doing bette; loosing 140 lbs and taking supplements so far until my husband and I were laid off from the COVID19 effect. The cancelling of my wedding and a trip that would chart a course back to my life’s work left me devastated. Limited exercise, fear of loosing everything and then taking a work from home desk job that is unfulfilling and unhealthy have taken a toll on my path. I am back on anxiety meds for months and barely functioning. Just struggling every day. All day. Is this type 2? Any ideas?

    Comment by Paula Martin — November 27, 2020 @ 1:51 PM

  8. I used to say half joking that SAMe prevented me from slapping a few people. Said with merriment but true. It is a wonderful supplement especially for women. A remarkable mood influencer sold OTC .

    Comment by Cee — November 28, 2020 @ 1:18 PM

  9. Do you ever address dietary causes? Gluten can have negative effects on neurotransmitters in the gut/brain without causing celiac. Also low thyroid and stressed out adrenals can cause depression and anxiety. The amino acid tyrosine can help some people with depression and GABA can help with anxiety especially when medication doesn’t seem to help . people

    Comment by Diane — November 28, 2020 @ 10:26 PM

  10. Went to see my Primary Doctor. Told him feeling depressed. Prescribed me,Escaptorlacan 20 MG. Taked it every morning. Helped me an little bit. Stayed inside my room working on my massive puzzle. Go outside walking. Yesterday seen up in the sky,many Crows flying. Had Brain Scans done. Depression can be inherited?

    Comment by John Vasilakos — November 29, 2020 @ 3:25 AM

  11. Doc, Staff, Students, and to those of us finding ways to resolve ourselves in this world

    Certainly, not sure which bucket I fit in. All I know is that one of your student residents prescribed me a healthful and helpful pathway of nutritional supplements, along with Lots of Greens, none with buds ….

    Thank you for these Lessons. You are helping me, and I am so grateful for your studies and your philosophical dissertations.

    Cheers! and Roll Tide!

    Comment by Alabama.Brian — November 29, 2020 @ 6:11 AM

  12. I discovered online dance and movement classes (some are donation-based or very affordable) which started during the pandemic. Taking these everyday reduced my stress levels to pre-motherhood levels!

    I’m an active person, and this saved me. My favorite are the “gaga people” classes, although there are movement classes everywhere.

    Comment by Tiffany — December 1, 2020 @ 1:32 PM

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