Trump Card Against Depression

On an annual basis, more than 300 million people suffer from depression globally. Put this into perspective, that is about the size of the entire US population. And of the 300 million people, 800,000 die annually from suicide. Fortunately, the story doesn’t end with grim numbers. Over the past decade, scientists have made significant progress in understanding the root cause of depression through the study of genes and such findings may just be the catalyst to saving lives in the future.

As early as 2004, scientists from Duke University Medical Center, Marc Caron and James B. Duke have discovered that a specific gene mutation influenced the level of serotonin production in mice. (Serotonin is a brain chemical that is vital to the healthy functioning of the brain, and low level of serotonin has been linked to depression and high-level anxiety.) This is one of the earlier studies that mark depression as a mental illness that is linked to our genetics. Fast forward to today. According to research published in Nature Genetics in 2018, researchers have now identified as many as 44 gene variants in human beings that may be linked to depression. The key takeaway from the research published in Nature Genetics is this: the root cause of depression is highly complex and is potentially connected to not one, but many genes. This could potentially explain why SSRI (Selective Serotonin Reuptake Inhibitor), a class of drugs used to raise the level of serotonin available and thereby treat depression, is not effective or even has an adverse effect on some patients. In essence, people have different gene variations, and they all react differently to SSRI. Therefore, for depression to be treated more effectively, medication will have to become more personalized.

Personalized medicine for depression may look like this: first, researchers will continue to discover more gene variants linked to depression. Second, researchers will continue to establish genetic biomarkers and study whether there is a specific pattern in the gene sequence, variation, and mutations that can help determine the optimal medicine for patient A vs patient B. And data indicates that the researchers’ cost to studying gene is decreasing at a faster rate than the Moore’s Law. While cost is not perfectly correlated with the rate of genome knowledge accumulation, it is still positively correlated, which gives me the confidence that gene therapy will become an effective tool to resolve nature-driven depression.

As a result, psychotherapy will look very different in the near future as well. If psychotherapy of the past was more of an art, it will become a better mix of science and art, where counselors will diagnose the genetic make-up of the patient, provide patient-tailored medicine, and also provide 1:1 counseling services to touch upon the nurturing aspect of each patient’s lives. As of now, gene therapy seems to be the next most feasible tool for humanity to fight against depression.