I am not a mental health research expert, but I am an expert on my own experience. This is what I’ve learned.
Q: Is depression caused by genetics or the environment?
A: In short, both. I have a genetic predisposition to depression. Due to two of my genes, my brain simply cannot produce adequate amounts of serotonin (the essential “happy chemical”) on its own. My major depressive episodes were the result of environmental factors interacting with my lack of natural serotonin production, essentially producing a “perfect storm” in my brain that resulted in suicidal thoughts. There is an inverse relationship between serotonin and cortisol (the stress hormone) such that when cortisol increases, the production of serotonin plummets. Therefore, my mental health crises occurred when I had a lot of stress in my life and I was not on medication that helped with serotonin production.
Q: How does genetic testing work?
A: A clinician swipes a small stick on the inside of your cheek to collect cells. Then he sends the cells to the genetic testing company’s lab. The company analyzes several genes that have been found to affect mental health and the way certain medications are metabolized. Then the company sends the genetic report to your clinician. Based on the report, the clinician can prescribe medication that targets your specific genetic deficits.
Q: Can genetic testing help people with all mental illnesses?
A: Genetic testing can help people recover from and manage their depression, bipolar disorder, schizophrenia, and addictions.
Q: What causes suicidal thoughts?
A: In my case, they were caused by too little serotonin and too much cortisol in my brain. When my doctor first saw me, he performed a blood test that indicated my brain was producing only about 20% of the amount of serotonin that a healthy brain should produce. After I was on the right medication for several weeks, my doctor found that my serotonin levels had quadrupled, and my suicidal thoughts faded away. Essentially, my suicidal thoughts resulted from a profound chemical imbalance. I did not wish to punish my family, and I did not really want to die. What I wanted was to feel better and be able to live again without that enduring abstract pain in my head.
Q: What should I say to someone who is depressed or suicidal?
A: Throughout my journey, I witnessed a large spectrum of attitudes that people had about me as a person with depression who was suicidal. The stigma against people with mental illness runs so deep that even some highly “educated” professionals treated me like I was a social pariah unworthy of respect or care. However, I also encountered professionals who were truly compassionate and informed about the biochemical root of depression. In my opinion, people with mental illness should always be treated with dignity and respect such that they are not made to feel ashamed of having thoughts that they probably cannot control. No one wants to be depressed or suicidal. If they could “snap out of it,” they would. If you or someone you know is suicidal, please see the action steps on the “Get Help” page. Inform the person that they will get better and that you are there for them and love them. Tell them that you understand that there is a rational, medical explanation for why they are feeling that way and that it can be treated. Once they are on the right medication, they will not have those horrific thoughts anymore.
Q: Is it wrong or embarrassing to have to rely on medication for mental stability?
A: Not at all. My brain simply cannot produce adequate amounts of serotonin on it’s own, so I have to be on medication to give my brain what it needs. No one thinks it is wrong or embarrassing to wear contacts or glasses because you cannot see without them. No one thinks it is wrong or embarrassing to have to take insulin for diabetes. Why should it be wrong or embarrassing to treat chemical deficits in the brain?
Q: What about side effects of psychotropic medications?
A: One benefit of genetic testing is that it can provide your doctor with information that can help her prescribe medications with minimal side effects. Based on my results, my doctor knew to avoid prescribing certain SSRI’s that would make me gain weight or result in dizziness. I barely notice side effects with my current medication.
Q: Do you have to take medication for the rest of your life?
A: Yes, but I don’t see that as a negative thing. I now know that I need medication to provide my brain with adequate amounts of serotonin so that I can live a happy, balanced life. My inherent biochemical deficit does not mean that I am weak or too dependent.
Q: I am a creative person. Will medication take away my ability to create?
A: I had this fear before I started taking medication. But the answer is no, it will not take away your creativity. While I was depressed, I was unable to focus or be productive. Now that I am on the right medication, I am more creatively productive than I ever have been in my life. Medication has not changed who I am. Mental stability has allowed me to become the best possible version of myself.
Q: Can a pill really solve all your problems?
A: Of course not. Getting on the right medication gave me the mental stability I needed to rebuild my life. Still, every day is not perfect. That’s not how life is. But now I am able to experience the normal range of human emotions. I am able to have the close, balanced relationships I have always wanted to have, and I am able to be productive while doing meaningful work.
Feel free to shoot me an email on the “Contact” page if you have a question that I do not answer here!