Depression can be difficult to diagnose, and once diagnosed, it can be challenging to treat. Some patients are prescribed medication, such as selective serotonin reuptake inhibitors (SSRIs), but those medications can take up to two weeks to reduce symptoms. If a patient discovers that the medication is not a good fit, either because the side effects outweigh benefits or the medication is not effective in addressing the symptoms, the patient could have a long period of trial-and-error before the right treatment has been identified. An article appearing in Healthline shows that a more streamlined diagnosis process may be possible for depression patients. The article highlights a study that examined the possibility of using urine and blood tests to determine whether a patient has depression. The study authors also identified five separate types of depression distinguishable in the test results. Led by William Walsh, PhD, president of the Walsh Research Institute, the researchers examined the blood and urine chemistry tests as well as the medical history of 2,800 patients diagnosed with depression. They found that five depression biotypes accounted for 95 percent of the cases examined. Thirty-eight percent of depression patients tested positive for undermethylated depression, in which there is low activity in the serotonin receptors. This may be due to a rapid reabsorption once serotonin is released. This type of depression is not caused by a serotonin deficiency, but rather an inability for the serotonin to remain in the synapse long enough. Many patients with this type of depression respond well to SSRIs. Another type of depression, called pyrrole depression, affected 17 percent of the patients in the study. These patients also experienced a reduction in depression symptoms when they were treated with SSRIs. Depression symptoms seemed to stem from a combination of low serotonin production and high levels of oxidative stress. In 15 percent of patients, copper overload resulted in symptoms of depression. In these patients, SSRIs do not seem to be effective, nor do they adversely affect the patient. Improved symptoms can be achieved through the normalizing of copper levels using nutrient therapy. Patients tend to be women that are also intolerant of estrogen. Twenty percent of patients experience low-folate depression, which is aggravated by treatment with SSRIs. These patients benefit from folic acid and vitamin B12 supplements. In toxic depression, the patient experiences a high level of toxic metals, which usually consists of lead poisoning. This type of depression was found in 5 percent of depressed patients. Given the removal of lead from paint and gasoline, this type of depression should remain relatively rare. According to Walsh, a urine test can be used to diagnose pyrrole depression, and blood tests can identify the other four types. Walsh is working to train doctors in this approach, beginning in Australia, with plans to expand the training to the U.S. later this year.