Five Major Psychiatric Disorders Genetically Linked

In the largest genetic study of psychiatric illness to date, scientists have discovered genetic links between 5 major psychiatric disorders.

Investigators from the Cross-Disorder Group of the Psychiatric Genomics Consortium have found that autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), bipolar disorder (BD), major depressive disorder (MDD), and schizophrenia share common genetic risk factors.

via Five Major Psychiatric Disorders Genetically Linked.

Hmmmm.  Looks like what we already know from our own experience is being borne out by science.  That’s validating.  But even better, the specifics are being discovered, which explain the mechanisms of how our brains differ from neurotypicals.  This will inevitably–and quickly, it looks like–lead to the ability to diagnose specific neuropsychiatric conditions with a simple blood test.  And this, in turn, will bring to a close the era of trial-and-error medication.

The fact that these 5 disorders are very closely linked and, in fact, often overlapped, explains why so many of us have features of more than one illness on objective testing.  And it explains, to me anyway, why so many times medications just do not work, sending us on a seeming merry-go-round of medication trials.

I will never forget the time a rather dull psychiatrist had me on an SSRI, and it was not helping my depression (because she had failed to make the diagnosis of Bipolar Disorder), so she upped the dose until I was completely zombie-fied.  Then, when I complained of oversedation, she prescribed Provigil, a powerful stimulant used to treat narcolepsy, or to keep Air Force pilots awake for 48 hour shifts.  That put me in the hospital.

These results explain why so many of us are On The Spectrum and also have MDD, or are Bipolar and have ADD/ADHD.  Or, very hard to treat, Bipolar plus MDD, which makes medication selection maddeningly difficult, because treating bipolar depression is NOT the same thing as treating Major Depressive Disorder, and vice versa, so it often happens that either the MDD is treated and triggers a manic episode, or the BP is treated and the person is still plagued with persistent depression.

And there’s another piece of good news here: having a “physical” genetic illness that can be seen and quantified takes Mental Illness out of the “it’s all in your head, snap out of it” category.  We will be seen as people who have “legitimate” genetic disorders like Celiac Disease and Cystic Fibrosis.  I’m hoping this will dial the stigma factor way, way down.

Let’s hope.

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11 Comments

  1. Actually, you can’t have both MDD and BD. They’re both Axis I diagnoses, and if you are diagnoses bipolar, MDD is ruled out automatically. A good doctor will then treat your bipolar depression, not necessarily in the same way as unipolar depression, in addition to your (hypo)mania, psychosis, and any other symptoms that present.

    Reply
    • That’s what I thought too. But this is brand-new, cutting-edge genetic research which is going to change the way we understand things, and the DSM will have to change too. This explains why some people have treatment resistant bipolar depression. Since there is an overlap in the areas of the genes that carry the mutations, it is now clear that people CAN have both BP and MDD, or more correctly, a “mixed” syndrome. So the DSM is going to have to change the way it classifies the Axis I diagnoses. Might not make it into DSM V, but maybe VI.

      And I totally agree with you, that treating the BP depression with BP meds is critical. I was treated with antidepressants for years with no improvement but lots of side effects, until I found a good doctor who immediately saw the problem and got me on my L&L cocktail (Lithium and Lamectil). Whew, what a relief that was! Such a relief from spending all day fantasizing about ways to kill myself. But I wonder if this new genetic research might stimulate Big Pharma to design some new drugs that might be better for treating these “crossover” syndromes. Interesting, eh?

      Reply
      • Interesting, yes, but it took almost a decade-and-a-half for the DSM V, two decades if you don’t count the DSM IV-TR. And I would guess that regardless of research, that’s a change that will be a lot tougher to get psychiatrists to swallow, so maybe the DSM VII or VIII. But, cheers! At the current rate that’s only 40-60 years!

        Reply
  2. Well, there was one pdoc who thought I either had ADD or Asperger’s. My current pdoc thinks I might have Asperberger’s, but there’s been no diagnosis or anything like that. I could either have MDD or bipolar disorder. Actually, I’m diagnosed with bipolar disorder these days, but it seems I experience the depression for the most part. My mania usually comes only in mixed-episode form. So there’s that.

    I still have a problem with seeing some aspects of mental illness as *purely* genetic, though, but that’s just a personal thing. I don’t want to discount the impact of personal experiences. I would feel invalidated if I found out my parents’ behavior when I was a kid wasn’t a contributing factor. My state seems to be more genetic than I initially thought, but I do think personal experiences can impact how those genetics manifest themselves.

    But hmm. Perhaps being able to spot something in the genetics before personal experience factors in could minimize the impact of those experiences. I still think for many, it’s probably a combination of genetics and life experience, however. I wouldn’t like the idea of medicating people purely because something was in their genes if their life experiences wouldn’t triggered those genes.

    I’m not sure if I’m making sense. Sorry if I’m not. I’m tired. Ultimately, I agree with you; the genetic information would show that these conditions aren’t imaginary. (Sadly, I think many people do view them as imaginary.)

    Reply
    • Almost nothing is purely genetic. I just got 23and me results, one of the cool things is that they show – for well established results, at least, not preliminary reports – the amount of disease risk from genetics versus other factors. As far as we know with today’s science, of course.

      Reply
      • Something I’ve been pondering, with the help of my psychologist who reminds me about it nearly every Thursday, is that those lovely people who f*cked me over as a child are also mentally ill (untreated) and yes, certainly their “nurture” very much shaped my “nature.” There’s also a very well known phenomenon of inducible gene expression (think lactose intolerance), and I suspect there’s an aspect of that lurking in here somewhere. I don’t know about you guys, but when I’m in a serene, controlled, predictable environment I do much better than if I’m in the middle of chaos. Getting back to “nature,” the number of suicides in my family is astonishing. Most of them diagnosed with MDD, but that was in the olden days…so who really knows….

        Reply
    • It’s so true that finding a “physical” cause for MI would be incredibly validating. And I agree with you entirely that life experiences certainly contribute to the expression of genetic predisposition.

      Reply
  3. Fascinating! Can’t wait for this to get to where we can use it. I have always known that my Bipolar depressions are very, very different from my MDD depressions. It is like you said, they think they can skip the MDD because Bipolar includes depression. So you never really get MDD treated,even when your Bipolar is very stable. Plus of course the risks of anitdepressants in a Bipolar person of becoming manic.

    Reply
    • Yes, it’s such a delicate balance. I once treated someone for depression with acupuncture and he flipped into full-on mania! And he had suffered with only depression for years. Go figure.

      Reply

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