While having less resilient genes, may make mental illness more likely, people who do experience mental illness experience it to varying degrees. Some people only experience a ‘situational depression’ which is also sometimes referred to as an adjustment disorder. This can happen after traumatic events such as interpersonal conflict or the death of a loved one. While a situational depression may eventually progress to a clinical depression (persistent depression), with situational depression it is most prudent to start with psychotherapy.
Psychotherapy can help equip individuals with the right mindset, skillset and coping mechanisms to accept and overcome stressful life events. This is especially useful in failure, loss and grief. Only when depression/ anxiety become clinical, or an individual displays signs of more alarming mental illness, is it appropriate to introduce medication. This is not because medication is harmful, in fact, in many cases medication is lifesaving. Medication can reverse and prevent some of the long-term epigenetic changes that take place in the brain as a result of mental illness (i.e. Inflammation, changes in neuroplasticity, neurotransmitter production etc.) but it isn’t without hurdles.
Approximately 70% of people will respond and show signs of improvement on the first-time use of a psychotropic or anti-depressant medication. However, 30% continue to struggle. This is likely why mental illness is the leading cause of disability worldwide. Response to psychotropic medications at its’ most condensed, is a two-step process. The first step is called metabolism and takes place by way of the liver. This whereby the medication is absorbed, circulated and cleared by the body. The main hurdle lies with clearance. Many people clear drugs from their body too slowly, leading to accumulation and more pronounced or severe side-effects. Whereas others clear the drug far too quickly, leading to no effect at all. Metabolizing these drugs normally is only the first step. The second step is that these drugs must travel into the brain by way of the blood brain barrier and attach to the right receptor in order to give their stated effect. All human beings have genetic variations, these variations are not mutations, but rather polymorphisms that express as poor response to one medication, and excellent response to another. This two-step process leads to a long journey of trial and error, before finally finding a drug that treats the illness.
Thanks to the strides made by science, the journey need not be this long. Once clinical depression, anxiety, schizophrenia etc. are diagnosed, a genetic drug compatibility test can help you find the medication that is most likely to be effective for YOU, with the least incidence of side-effects as per your genetic make-up. The journey of mental illness is debilitating enough, as can be introducing a new drug into the body, but it doesn’t have to end in hopelessness, it can end in success, with the help of pharmacogenetics.