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Is Depression a Genetic Disease?

Millions of people experience one or more episodes of depression during their lifetime. At such times, many fear that if news of this were to get out it would diminish the level of respect people have for them. Attempting to avoid the stigma of being viewed as having a mental illness, they shy away from revealing what they are experiencing.

Some promote the idea that depression is a disease with genetic factors playing an important role in its development. This line of thinking is theorized to reduce stigma because it reduces any blame for the person who is having the experience. But others say that promoting the idea that this group of people have faulty genes will actually increase stigma even if it does reduce blame.

With this as background, let’s take a look at the latest research regarding the genetic influence on depression. Then I’ll chime in on how I think we can better help to reduce stigma for people who become depressed.

Latest Research Study

On April 4, 2017, Molecular Psychiatry published an article titled, “Collaborative meta-analysis finds no evidence of a strong interaction between stress and 5-HTTLPR genotype contributing to the development of depression.”

Peter Simons

A couple of weeks later, Peter Simons, writing for the excellent website, Mad in America, summarized the research article, making it far more accessible to the average reader. It can be retrieved from the internet for free HERE. I heartily recommend it.

Photo credit: Pixabay

Very briefly, Peter Simons explains that after many failed attempts by researchers to find a genetic basis for depressed mood, a 2003 study claimed to have discovered a link between depression and a genotype known as 5-HTTLPR.

The 2003 study has earned a celebrity status in the literature on genetics and psychiatry, having been cited over 4000 times. However, it has also been the subject of controversy. Researchers have noted that studies finding such powerful genetic effects often turn out to be false positives. Indeed, the conclusions of the 2003 study have been questioned by numerous researchers who failed to replicate their initial result.”

The current study attempted to replicate the initial findings with a large sample of over 38,000 people of European ancestry, using methods that are viewed as “rigorous best practices.” The team of researchers involved in the study found that the presence of the 5-HTTLPR genotype did not increase a risk of depression, even in those who experienced significant life stressors and traumatic events. However, as expected, stress and trauma by themselves were strongly associated with the development of depression.

Peter Simons adds that the researchers also wanted to determine if a particular subgroup of people might be at increased risk of depression when they had the 5-HTTLPR genotype, even though they found no such effect for the general population.

“They conducted further analyses and found that there were no subgroups for whom this genetic basis of depression was significant. That is, the researchers were unable to find a single group for whom this genetic component plays a role. Instead, their data confirmed yet again the most consistent finding in depression literature–stress and trauma are strongly linked with depressive symptoms, and genetics are not.”

If We Can’t Blame It On Genetics, How Else Can We Seek to Reduce Stigma?

As we have seen above, the argument that depression is a genetic disease currently has little scientific support. Nevertheless, there are people who will continue to insist that it is due to genetics because some research indicates that if you have family members who experience depression, you are at an increased risk of also having this type of experience.

One of the difficulties in interpreting this line of research has to do with the plain fact that we all experience a good deal of suffering in our lives. Where are we to draw the line between those who are experiencing the usual amount of suffering given their life circumstances and those who are experiencing more than the usual amount?

As someone who is familiar with how this line is drawn in practice, I can say with confidence that it is pretty blurry. Moreover, just because some human characteristic runs in families does not mean that those with that characteristic have a disease or illness. I have seen research that creativity, musical talent, athleticism, shyness, risk taking, political affiliation, and many other characteristics as well, run in families. Are all such characteristics to be viewed as diseases?

Some view people who are prone to have depression experiences as having an artistic temperament. Many learn to appreciate these visits of melancholy as something of extraordinary valueWilliam James. Thus, in an earlier post titled William James’s Personal Bout With a “Mental Disorder,” we looked at how the brilliant psychologist and philosopher came to view his “bass notes of experience.” On this subject, he wrote that many so called “healthy-minded” individuals believe that those who worry are “morbid-minded” and “diseased,” but it may very well be true that “the world’s meaning most comes home to us when we lay them most to heart.”

Some argue that what makes depression a disease is that it is a risk factor for reduced productivity and suicide. There are many examples of people who, when they become depressed, take to their beds for a period of time. And indeed, some people who become depressed, though not most, will violently end their lives.

To get some community and government support for people as they go through these wrenching experiences of depression, currently we have to, for bureaucratic reasons, treat depression as if it is an illness. I am not seeking to eliminate this support, though I bemoan the fact that for many the only support that is offered is a prescription for drugs which I believe in the long run leads to far more harm then good.

In principle, there really is no necessity to provide support only for people who are deemed ill. Communities and governmental agencies have long provided support for people who have suffered from floods, drought, fire damage, and poverty. I believe it would be more helpful to offer support to people who become bed-ridden or suicidal without pathologizing.

To counter stigmatizing these individuals, it is far better than pathologizing their experience if we focus on pointing to the numerous examples of people, such as Abraham Lincoln, who suffered deeply from depression experiences, and yet made enormous contributions to our society. Equally important is to explain that simply being at an increased risk for something doesn’t mean someone has a disease. Risk takers, such as the Wright brothers, are well known to be at an increased risk of an early death, but that characteristic allows some folks to bravely enter into a tiny capsule to explore the moon.

We need a variety of people to do great things, and indeed some of these varieties are riskier than others. Nevertheless, it is misleading to place them in the disease category. It is high time that we diminished respect for converting more and more basic human characteristics into terms denoting diseases, and instead develop a deeper respect for the grand sweep of humanity.

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on.  This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional intelligence.  To begin at the very first post you can click HERE.

 

 

 

 

 

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About the Author

Jeffrey Rubin grew up in Brooklyn, received his PhD from the University of Minnesota and has taught conflict resolution there as well as at a psychiatric clinic, a correctional facility and a number of public schools. He has published articles on anger and conflict resolution and has authored three novels.

4 Comments

  1. Thank you for this important article and the novel ideas herein Dr. Rubin.
    Sharing

    • Much thanks for your kind words of support, Judy.

  2. Your essay touches upon many of the issues in my e-book, Healing Personal Depression… published in 2012. Depression, imhop, is not a “disease” but a manifestation of a phase or stage in life, or reaction to an event or series of events, or a self concept problem: https://www.smashwords.com/books/view/222048

  3. As a psychotherapist in clinical practice, I think the interaction between heritability with modulating variables of stress and trauma pose a complex interactive picture of depression, including variations in subjective experience. I agree that the medical model, especially when it poses medication as the first line, convenient line, and only line of defense, is incomplete and may well do a disservice to many. Especially in the long term, as Dr. Rubin suggests. I also like the idea of not pathologizing it and reducing stigma, and further think that our non-stop culture increases the chances of more severe depressive episodes than would otherwise occur in instances when a person might “travel through” a life-stage episode of realistic depression (i.e. prolonged sadness or grief). A word of caution; however, is that there are a myriad of studies out there and they don’t all agree; furthermore, questioning them critically and ethically is part of our job. This is definitely an important discussion when factoring in the influence of profit on antidepressant studies; however, I do believe I’ve seen cases where there are genetic tendencies to depression. Perhaps these tendencies are impacted by stress and trauma, as the research article cited here suggests. Perhaps the tendency toward moderate or severe depression is inherited with temperament and other traits, but when depression becomes more than what would be diagnosed as moderate depression using an array of symptoms, it does not serve clients and patients to discuss it as learned (and therefore unlearned or changed in simple approaches). It seems to be too complex, with too much variance, for single solutions. It is my opinion, from treating clients with a range of types of depression, that the genetic discussion can be a valuable tool for encouraging effective action (especially if that discussion is evidence-based on solid studies that aren’t skewed in favor of profitable medication sales). I must admit that I’ve seen instances where medication had to be introduced into the clinical discussion more quickly than I preferred, when I really wanted to see a client succeed in a self-selected alternative path, but the risks are sometimes too great and the work involved so challenging, with only small gains, that medication must be put on the table as an option, potentially life-changing, or even as a life-saving recommendation. Needless to say from my comments, Jeff, I found this article stimulating and it contributes well to the discussion! Thank you.

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