If you have an infection, we can grow a culture of the bacteria that caused it and usually prescribe an antibiotic to fight it. If you have Type 1 diabetes, we know that your pancreas has stopped making insulin and, while we cannot fix it, we can prescribe insulin injections to prevent it from being fatal. If you have Parkinson’s disease, we know that a large number of your dopamine neurons have died, and we can reduce the adverse consequences for years with L-dopa drugs. But with mental illnesses like depression, bi-polar disorder, schizophrenia and autism spectrum disorders, we are still in the dark; their cause is unclear, and their treatment is less than satisfactory. We all wish it were not so.
Mental illness in the Scriptures is often described as demon possession. We know that life events can have a profound effect on people’s mental health; and if you have a family history of mental illness, you are more likely to face mental health problems. In other words, these disorders can be described in biological, social and spiritual terms, making our understanding of how to address them complex. How these various levels of understanding come together is not clear.
The American Psychiatric Association publishes a manual called the Diagnostic and Statistical Manual of Mental Disorders (DSM) in an attempt to describe mental illnesses. With the most recent edition, DSM-V, which came out five years ago, the hope was that the definitions of mental health disorders could be articulated based on advances in neuroscience and thus enable diagnoses grounded in brain disorder. This hope proved premature – our brains are too complicated. We do know some things – such as that Prozac is a drug that changes the serotonin system in the brain and helps some people suffering from depression – but much is still shrouded in mystery. Maybe in a future edition of the DSM, we can move beyond describing these disorders solely by their behavioural symptoms and get at the root causes. Something for us to pray for – a better understanding of what goes wrong in a mental illness.
One of the most recent attempts to get at the heart of what goes wrong is an American National Institute of Health initiative called PsychENCODE. This initiative published its first finding last month, in December 2018’s Science. PsychENCODE is mapping the genes of the brain and how they are controlled and expressed by analyzing and comparing the post-mortem brains of individuals who suffered from mental illness and those of individuals with no mental illness. By looking at thousands of brains, we can start to find out which genes are different and how these differences interact with and compound one another.
Previous studies have found many genes each with a small impact on the likelihood of developing mental illness, but it was not clear how these multiple small-impact genes interact. One early finding of PsychENCODE is that genes involved in the packaging and release of neurotransmitters appear especially active in bipolar disorder and schizophrenia but not in autism. This knowledge suggests specific locations and processes in the brain to examine for indications that a person might be prone to these disorders. It may also lead to drugs effective in treating these individuals or preventing the expression of the disorder.
The results of this initiative are preliminary, but as we advance our understanding of the processes that these genes control, we open the door to a better understanding of the underlying biology of mental illnesses. The raw data from these studies are publicly available to other researchers, making possible collaborations and novel insights by other researchers. We can pray that these genetic advances will provide the foundation on which to build a better understanding of the social, psychological and spiritual aspects of these debilitating mental disorders.
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