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Of a mind to decode the mind
August 2017
by Jeffrey Bouley  |  Email the author
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Throughout much of my life, I had very little contact with overt mental illness. Sure, my mom had a couple pretty serious phobias (but they didn’t interfere with daily living), and I was acquainted with some fellow students in high school and university who clearly dealt with anxiety and/or depression, but no one in my close circles visibly suffered from serious chronic mental health conditions.
Now, I’ll admit that much of this might have had to do with stigmas around mental illness and people hiding their problems—I am nearly 50 after all, and I’m not sure we began to make much progress seeing mental illness in a similar vein as other bodily illnesses until somewhere in the late 1990s—but the fact remains it wasn’t part of my personal experience.
 
When I got married around two decades ago, that changed. No, no, that isn’t a thinly veiled joke about the sometimes crazed nature of marriage. Nor did it have anything to do with my wife directly, though admittedly she has suffered from acute anxiety and panic attacks at various points in our shared life. But many of her close friends and acquaintances have suffered from some pretty serious ailments of the mind, mostly depression.
 
Even had I not been involved in medical and life-sciences journalism for so long and learned so much about mental illness, that would have been a major educational experience for me on the mental health front. I’ve seen the low-level impacts of mental illness on the people who suffer from it and those around them, and I’ve seen the high-level impacts—suicidal ideation and, sadly, actual suicides are among my later-life exposures. Currently, a close friend of the woman I pledged myself to is having a particularly bad patch with treatment-resistant depression—and as you can imagine it’s not his first time in crisis.
 
All of this has served to remind me with ever-increasing awareness (and some dread) just how little we really know about what’s in our heads, even with all these decades of high-tech science. To be honest, whether we’re talking neurology or psychology or any other -ologies of the head, that’s the part of the body we really understand the least. Aside from the complicated nature of the brain and the difficulty studying it directly (or figuring out what all those readings really mean) is the fact that there is still an ephemeral nature to thoughts and emotions, despite the fact that they arise from electrical and neurochemical transmissions in our bodies.
 
How much is “brain” and how much is “mind” for example? Where do we separate the biological from the intellectual to the philosophical, or even the soul? And while it is often so clear how environmental impacts (upbringing, personal lifestyle choices, occupation, etc.) affect other organs, the ways in which they affect our minds are often so much harder to see—or at least, more challenging to sort out from genetics and other inherent nature-related sources.
 
So, as mental health crises play out in my life, no matter how peripherally, it was with great interest and some hope that I read about 23andMe initiating enrollment for a first-of-its-kind study on major depressive and bipolar disorders—one that uses not only the typical tools of science but also the much more modern and recent tool of crowdsourcing that the ubiquity of the web has made possible.
 
On Aug. 2, the company announced that—working in collaboration with the Milken Institute and Lundbeck—it would be conducting this genetic study to gain understanding of the underlying biology of major depressive and bipolar disorders. This study will combine cognitive assessments with genetic data and survey responses to assess how genes influence brain processes such as attention, decision-making and visual perception in individuals who live with these serious mental health conditions.
 
“The unique approach to this study—gathering genetic, cognitive and behavioral data at a potentially remarkable volume and speed through crowdsourcing—could significantly change approaches to personalized medicine research moving forward,” noted a media rep for 23andMe, adding that 23andMe has successfully established research communities to study Parkinson’s disease, lupus, irritable bowel disease and fertility.
 
This upcoming study also will build upon 23andMe’s body of research in mood disorders. In the first finding of its kind on major depressive disorder, noted 23andMe in its announcement of the new study, it co-authored a study identifying 15 genetic regions linked to depression in August 2016.
 
“We know genetics play a role in the development of depression and bipolar; however, there is a long pathway from our genes to the manifestation of complex diseases like these,” said Dr. Emily Drabant Conley, vice president of business development at 23andMe. “We need to look at these conditions in a more comprehensive way to advance our understanding. By studying cognitive function alongside genetics and other environmental variables on a massive scale, we hope to take a significant step forward in the study of depression and bipolar.”
 
Estimates are that just in the United States, we have over 16 million people who suffer from major depressive disorder and another six million who have bipolar disorder. As 23andMe points out, the causes of these disorders is still largely unknown, though the research tends to support the notion that major depressive and bipolar disorders are caused by a combination of genetic, biological and environmental factors.
 
To conduct its research, 23andMe intends to recruit 15,000 people with major depressive disorder and 10,000 people with bipolar disorder, with participant ages ranging from 18 to 50. Said participants need to have been diagnosed by a physician with major depressive disorder or bipolar disorder, have been prescribed medication to treat the condition, live in the United States and have access to the internet through a desktop or laptop computer.
 
“We look forward to leveraging our patient advocacy network and social following to help drive awareness and recruitment efforts for the 23andMe study,” said Melissa Stevens, executive director of the Milken Institute’s Center for Strategic Philanthropy. “Moreover, we are excited to better understand the disease biology of bipolar and major depressive disorders, as doing so will help us guide philanthropists to maximize the return on their mental health giving programs.”
 
As someone who has watched mental illness mostly from the sidelines and still felt dismay at the difficulties in understanding the etiologies and complications, much less finding broadly effective therapeutics, I hope that this and future efforts can truly lead to a revolution in comprehending these ailments of the mind as earlier efforts have with so many other organs in the body.
 
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