Under-25s with ADHD and anxiety could get discount gym memberships

Australian scientists have proposed the existence of a distinct form of depression, termed "circadian depression," which accounts for approximately one-quarter of cases resistant to standard pharmaceutical interventions. The research team suggests that this specific subtype is driven by disruptions in the internal biological clock, making conventional antidepressants ineffective for many sufferers. Instead, the authors argue that therapies targeting sleep regulation, such as melatonin administration and light exposure, offer a safer and potentially more effective alternative. The findings were detailed in a paper published in the British Journal of Psychiatry, drawing on extensive genetic and clinical data from Australia. The study analyzed records from more than 11,000 participants enrolled in the Australian Genetics of Depression Study. Within this cohort, researchers identified 2,604 individuals, representing nearly 25 percent of the sample, who exhibited characteristics consistent with the newly defined circadian subtype. These patients displayed a pattern of illness influenced by seasonal changes, often experiencing excessive sleep during depressive episodes. Persistent fatigue was another hallmark, along with a preference for nocturnal activity, described colloquially as being a "night owl." Beyond immediate symptoms, the analysis indicated that these individuals tended to develop depression at a younger age compared to other patients. Their conditions were frequently more severe, with higher incidences of manic episodes and suicidal ideation. Genetic profiling further revealed an elevated risk for comorbidities, including heart disease, inflammatory conditions, and neurodevelopmental disorders such as attention deficit hyperactivity disorder. Dr. Emiliana Tonini, a mental health researcher at the University of Sydney and the study’s lead author, emphasized that depression is not a monolithic condition. She stated that recognizing specific subtypes allows clinicians to provide earlier access to treatments tailored to the patient’s physiology. Co-author Dr. Jacob Crouse noted that because the condition is linked to circadian rhythms, interventions focused on resetting the body clock should be prioritized. He advised patients who find traditional medications ineffective to consult their clinicians regarding these alternatives. Professor Ian Hickie, a clinical psychiatrist at Sydney University’s Brain and Mind Centre, highlighted the urgency of identifying this subtype among young people. He observed that while selective serotonin reuptake inhibitors are typically the first line of defense, at least a quarter of young patients might benefit more from circadian-focused medical and behavioral strategies, including cognitive behavioral therapy designed to disrupt negative thought patterns. The timing of this publication coincides with rising concerns over antidepressant usage in England. Recent data indicates that one in seven adults in the country was prescribed these drugs last year, marking record-high consumption levels. Health authorities recently issued a safety alert warning that antidepressants can cause long-lasting sexual side effects and suicidal thoughts even after treatment cessation. In parallel, a separate government review led by Professor Peter Fonagy of University College London examined the surge in mental health diagnoses among under-25s. Rates of anxiety and depression in the 16-to-24 age group rose by more than a third over the past decade, climbing from 18.9 percent in 2014 to 25.8 percent in 2024. Prescriptions for antidepressants in England increased from 47.3 million in 2011 to 85.6 million in the 2022-23 period. Additionally, adult prescriptions for attention deficit hyperactivity disorder medications jumped 40 percent, reaching 267,000 in the 2025-26 fiscal year. Despite the novel classification proposed by the Australian team, some experts outside the study expressed skepticism. Professor David Curtis, a genetics specialist at University College London, argued that selecting patients based on specific symptom clusters does not necessarily prove the existence of a new biological subtype. He contended that the term "circadian" is misleading because typical depressive features, such as early morning waking and low mood upon waking, are inherently circadian in nature. Other commentators noted that the evidence is currently insufficient to justify changing clinical protocols broadly. However, the broader discourse on mental health care is shifting toward non-pharmacological solutions. Professor Fonagy and his colleague, Professor Sir Simon Wessely, advocated for "social prescribing," which involves referring patients to community activities like gardening clubs, sports programs, and arts groups. They argued that for many young people, social isolation and lack of engagement are primary drivers of distress, and that exercise and community involvement may be more effective than medication alone. This approach aligns with existing National Health Service schemes that offer discounted gym memberships through general practitioner referrals. The debate continues over whether these lifestyle interventions can adequately address the growing burden of mental health conditions, particularly as costs associated with unemployment and disability benefits for young people reach billions of pounds annually.