A reader, Danielle, wrote:
Hi Dr. Rosen,
"Perhaps she was destined for mental illness through a combination of her genes and the environment in the same way that some children develop cancer, irrespective of any medications they may be taking."
I am doing a report for college on the genetic science behind psychiatric disorders but all the articles I am reading seem so vague. I've discussed with friends who have been diagnosed with such "genetic" disorders and have learned that the process of their diagnoses involved an hour long discussion with a psychiatrist, which sure sounds subjective to me! There are no blood, urine, saliva tests that appear to exist, or at the very least be utilized by those that are working under the "genetic psychiatry" doctrine.
As a man that is obviously very passionate and concerned with those suffering from mental illness and experienced enough to be enraged with Robert Whitaker's research findings, I'd like to hear your research findings, book recommendations, (perhaps your experience with a psychiatric disorder and medicine that helped you), etc?
But I beg of you! Just don't be vague. If you could even write an article on your blog explaining the science of genetic psychiatry (with a list of sources to further enlighten the public with) you'd be doing Psychology Today readers a great service.
You make a compelling comparison between aids and mental illness but leave the reader hungry for more of your juicy thoughts! Are you insinuating that mental illness is terminal?
Thank you for your email. While psychiatry is not my area of professional expertise (I am a pediatric lung and sleep doctor), I do know that there is a growing body of evidence in the scientific literature about the contribution of genetics to the development of mental illness. This contribution is only part of the process underlying the development of mental illness, and should not be understood as meaning that if one carries a specific genetic variation he or she is condemned with certainly to develop major depression or schizophrenia, for example. Instead, it should be understood as that person having an increased susceptibility to developing mental illness in the future, through an interaction of multiple genetic and environmental factors.
One example of this contribution can be found in a paper which appeared in the journal Nature Genetics in April of 2010. Here is the link to it:
Another article which describes the familial component of major depression and its heritibility can be seen here: http://ajp.psychiatryonline.org/cgi/reprint/157/10/1552
If you log onto the Pub Med website http://www.ncbi.nlm.nih.gov/pubmed and do a search, you will be able to review the findings published by hundreds of groups looking at this and other related areas, including trying to identify genetic markers which may render specific individuals with certain diseases more likely to respond to treatment "a" than treatment "b".
As to your question about mental illness being terminal, it certainly is in some cases, in which its severity and inexorable progression renders the patient a shadow of his former self, unable to fend or care for himself, and at risk for the complications of this self-neglect, substance abuse, risk-seeking behavior (for an excellent description of this see the "Noonday Demon" by Andrew Solomon), and of course suicide, which occurs at a much higher rate in people who suffer from mental illness.
Finally, I'd like to clarify that I was not "enraged" with Mr. Whitaker's findings, but felt that the evidence which he presented to make his case that psychiatric medications are the root cause of mental illness was simply unconvincing, and that it was important to caution against embracing the conclusion that all psychiatric medication is harmful. In general, I think that it is very important to maintain a healthy degree of skepticism towards accepted paradigms of thought in medicine, and to challenge them, but that this needs to be done with reproducible empirical evidence. This is much different than using uncontrolled, anecdotal experience to infer a general rule. Failure to understand the difference can lead to very tragic results, as has been shown repeatedly.
Good luck with your studies, and thanks for writing.
Dennis Rosen, M.D.
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