Wednesday May 22, 2013
In a small study involving 52 women, Johns Hopkins researchers found that epigenetic changes in two genes - which can be detected by a simple blood test - were predictive of whether a woman would develop postpartum depression.
Epigenetic changes are those which alter the way genes function without creating any differences in the underlying DNA.
It is not known what causes postpartum depression, but it has long been believed that the sharp drop-off in estrogen after giving birth could be a factor, so the study authors first studied mice, looking for any estrogen-induced epigenetic changes that were likely to be related to postpartum depression. They identified two likely genes as candidates: TTC9B and HP1BP3. They then confirmed their findings in humans by testing for biomarkers of these epigenetic changes during pregnancy and checking to see how well these test results correlated to the later development of postpartum depression.
What the scientists found was that they could predict with 85% certainty just who would go on to develop postpartum depression. "We were pretty surprised by how well the genes were correlated with the development of postpartum depression," said lead author Zachary Kaminsky. "With more research, this could prove to be a powerful tool."
Kaminsky says that if his work continues to go well, a blood test for these two epigenetic biomarkers might eventually be a part of the screening tests which women routinely receive during pregnancy, making it much easier to make treatment decisions for at-risk women.
The study was published online on May 21, 2013 in the journal Molecular Psychiatry.
Friday May 10, 2013
Earlier this month, the National Institute of Mental Health (NIMH) announced that it would be "re-orienting its research away from DSM categories."
According to the director of the NIMH, Dr. Thomas Insel, the Diagnostic and Statistical Manual of Mental Disorders (DSM) - which is a handbook used by clinicians when making diagnoses of conditions such as depression - lacks validity. "Unlike our definitions of ischemic heart disease, lymphoma, or AIDS," said Dr. Insel, "the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure."
What the NIMH proposes in its stead, its Research Domain Critieria (RDoC), could, with its emphasis on genetics, imaging and cognitive science, represent the future of the diagnosis of mental illness. Rather than relying on sets of symptoms in order to make a diagnosis, doctors could, perhaps, order laboratory tests, much like other biologically-based illnesses.
However, we won't see the replacement of the DSM quite yet. Insel noted in his letter on the topic that, "This is a decade-long project that is just beginning."
The fifth edition of the DSM, which is due to be released later this month, has previously faced criticism for its move to make the diagnostic criteria for depression what some considered to be "too broad."
Monday April 29, 2013
Childhood depression is a topic very close to my heart, and, given that National Children's Mental Health Awareness Day is coming up on May 9th this year, I thought I would speak a bit about my experiences.
My first episode of depression that I can remember occurred when I was about seven. I can remember waking up day after day thinking, "I hope today is a good day." It never was a "good day", however.
The depression and anxiety followed me until I was thirty-years-old and decided to see a psychiatrist about how I was feeling. The first time I visited him, I was filled with dread. I wanted to believe that I could feel better, but I knew deep inside that I was just weak and lazy and the doctor was going to tell me that there was nothing medically wrong. Instead, he told me that I had clinical depression and that there was hope for me to get better. Learning that my depression was biologically-based and not a character flaw changed my life completely.
Today, as I look back on my childhood I regret that none of the adults in my life recognized that I was depressed. In fact, there was still quite a bit of stigma surrounding mental disorders back then. I believe that things could have been much different for me if only people were more knowledgeable about depression and I had gotten help with it early on. Luckily, we are much more open and educated about depression today and our children do not have to suffer with depression or carry the burden well into adulthood before getting help. Please, help educate yourself and others so no child has to endure years of depression and self-doubt like I did.
Sunday April 28, 2013
According to the Priory Group, a seasonal variability in suicide rates exists worldwide, with more suicides occurring in the warm, sunny days of spring and early summer than any other time of the year. In the northern hemisphere, May and June and are peak months for suicide, while the southern hemisphere sees a peak in the month of November.
No one is sure why this occurs, but scientists theorize that it has something to do with sunlight and how it affects hormones. It is well known that the shorter days of winter are associated with depression, which is called seasonal affective disorder. It is thought that perhaps when spring returns people start to feel more energetic and this enables them to carry through on suicide plans that they were previously too depressed to carry out.
Suicide Prevention Resources, a non-profit organization based in New York, describes the following suicide warning signs:
- Previous suicide attempts, "mini-attempts".
- Explicit statements of suicidal ideation or feelings.
- Development of suicidal plan, acquiring the means, "rehearsal" behavior, setting a time for the attempt.
- Self-inflicted injuries, such as cuts, burns, or head banging.
- Reckless behavior. (Besides suicide, other leading causes of death among young people in New York City are homicide, accidents, drug overdose, and AIDS.) Unexplained accidents among children and the elderly.
- Making out a will or giving away favorite possessions.
- Inappropriately saying goodbye.
- Verbal behavior that is ambiguous or indirect: "I'm going away on a real long trip.", "You won't have to worry about me anymore.", "I want to go to sleep and never wake up.", "I'm so depressed, I just can't go on.", "Does God punish suicides?", "Voices are telling me to do bad things.", requests for euthanasia information, inappropriate joking, stories or essays on morbid themes.