Nothing in this post is intended to be taken as medical advice. We do not offer medical advice. If you or someone you know needs help, scroll to the bottom of this page for links to important depression and mental health resources, and contact a healthcare provider.

 

 

CHAPTER 4: GENETIC COUNSELING

  • Sifuentes’s history of trying to find an effective medication
  • Introduction to Jehannine Austin
  • Clips from genetic counseling session between Austin and Sifuentes

CHAPTER 5: NATURE AND NURTURE

  • Our limited understanding of brain function and challenges diagnosing depression
  • Complementary nature of medication and psychotherapy
  • Side effects of medication
  • Challenges in receiving care, including Sifuentes’ negative experiences with clinicians

Full interview with Mary Carter

 

Full interview with Rachael Massell:

 

CHAPTER 6: WE REALLY DON’T UNDERSTAND THE BRAIN

  • The complexity of the genetic factors associated with mental illness
  • Limitations of pharmacogenetics, but hope for the future
  • Where genetic testing can help

Full interview with Jehannine Austin:

 

CHAPTER 5.1: THE TINY VACUUM CLEANERS IN YOUR HEAD

  • Introduction to Randy Blakely and Blakely Lab research
  • Overview of neurotransmitters and neurosignalling
  • How antidepressants work

Full interview with Randy Blakely

 

CHAPTER 7: WHAT’S NEXT IN BIOMEDICAL RESEARCH?

  • The emergence of the immune system as a key player in mental health
  • Ketamine as a possible treatment option
  • Hope for pharmacogenetics
  • A quick word on alternative therapies

 

PEOPLE

  • Caroline Leland – Freelance Journalist; Contributing Factors Host & Producer
  • Lucero Sifuentes – Individual living with Major Depressive Disorder
  • Jehannine Austin –  Executive  Director,  BC  Mental  Health  &  Addictions  Research  Institute; Associate Professor, The University of British Columbia
  • Mary Carter – Psychiatric Nurse Practitioner, The Renfrew Center
  • Rachael Massell – Psychotherapist, Independent Practitioner
  • Randy Blakely – Executive Director, Florida Atlantic University Brain Institute; Professor of Biomedical Sciences, Florida Atlantic University

Biology of Depression

  • Brain structure: Imaging studies have shown that the frontal lobe of the brain becomes less active when a person is depressed. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation. (nami.org)
  • Genetics: Mood disorders and risk of suicide tend to run in families. (nami.org)
  • “Although there is not yet a clear consensus about the specific genes that predispose an individual to depression, it is firmly established that depression risk has a heritable component, based on both behavior genetic research (e.g., family, twin studies; see Sullivan, Neale, & Kendler, 2000) and molecular work (e.g., genome-wide complex trait analysis; Lubke et al., 2012) to date. However, there is also evidence that genetic risk is not necessary for an individual to become predisposed to depression—severe negative experiences such as parental loss may be sufficient (see, e.g., Kendler et al., 2005; Kendler, Neale, Kessler, Heath, & Eaves, 1992). Furthermore, it is important to note that genetic and environmental risk factors are by no means independent of one another—rather, there is emerging recognition that they mutually influence one another in important ways.” –Beck and Bredemeier, 2016: “A Unified Model of Depression
  • When It Comes to Depression, Serotonin Isn’t the Whole Story (NPR)
  • What Has Serotonin to Do with Depression? (World Psychiatry)
  • If Low Serotonin Levels Aren’t Responsible for Depression, What Is? (The Guardian)
  • Randy Blakely’s Publication Record: PubMed

List of Known Treatment Options

  • Psychotherapy, including cognitive behavioral therapy, family-focused therapy and interpersonal therapy
  • Medication including SSRIs (selective serotonin reuptake inhibitors), SNRIs (serotonin and norepinephrine reuptake inhibitors), TCAs (Tricyclic antidepressants), and MAOIs (monoamine oxidase inhibitors)
  • Ketamine for suicidal patients
  • Brain stimulation therapies including electroconvulsive therapy (ECT) or repetitive transcranial magnetic stimulation (rTMS)
  • Light therapy, which uses a light box to expose a person to full spectrum light and regulate the hormone melatonin
  • Exercise
  • Alternative therapies including acupuncture, meditation, and nutrition
  • Self-management strategies and education
  • Mind/body/spirit approaches such as meditation, faith, and prayer

Factoids about Treatment Rates

  • Nearly 60% of adults with a mental illness didn’t receive mental health services in the previous year. (Substance Abuse and Mental Health Services Administration)
  • African American & Hispanic Americans used mental health services at about 1/2 the rate of whites in the past year and Asian Americans at about 1/3 the rate. (NIMH)

MUSIC IN THIS EPISODE

  • Original theme music: “Catharsis,” written and performed by Matt Phillips
  • “Stigmata,” performed by Davis Absolute
  • “Getting Inside,” performed by Alon Ohana
  • “Clarity,” performed by Ian Post
  • “Light Crossing,” performed by Patches
  • “Value,” performed by G-Yerro
  • “Downstream,” performed by Muted
  • “Winter’s Edge,” performed by When Mountains Move
  • “Wolves,” performed by Davis Absolute
  • “To Edinburgh,” performed by The Highlands
  • “Endless Fields,” performed by Eminence Landscapes
  • “Delicate Frost,” performed by Winter Solstice
  • “So Far,” performed by Nadav Remez
  • “You and Me,” performed by Eldar Kedem

HOW TO GET HELP

National Suicide Prevention Lifeline: 1-800-273-8255

What to do if you think you might be depressed (healthfinder.gov)

Common reasons people avoid treatment and expert advice on how to get past them (WebMD)

How Can I Get Help for Depression? (Healthline.com)

Finding Help (Anxiety and Depression Association of America)

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