A small Australian biotech has drawn big-name backers — including swimming superstar Michael Phelps — to its audacious goal: to develop a quick, cheap, and objective way to diagnose an array of mental illnesses.
The tool would be a stunning breakthrough in the field of mental health — if it works.
And there’s the rub. Researchers have been trying for decades to find reliable biomarkers for mental illness — that is, tangible biological clues that conclusively indicate whether a person has a particular psychiatric disease. Effort after effort has failed, leaving doctors to diagnose such conditions mostly on the basis of screening checklists and conversations with their patients.
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Using biomarkers is fine, but there are a few things one needs to be cautious about:
(1). If we find biomarkers, we need to know that what the person is experiencing is not a “disease” like for example something like “liver disease” or a heart condition. A great deal of research has shown that the brain circuitry and biomarkers are constantly changing as a result of experience – for example, various psychological stresses show dendritic atrophy (accompanied by changes in biomarkers), and these are reversible through psychological means – for example: if someone is depressed due to the loss of a job, if the person gets a job again, this depression would stop, and the bio markers would return to normal again.
(2). Because of the above point #1, it is important not to give labels to people (you have this disease and that disease, etc., because of this biomarker, etc.) – all the fancy labeling that people are now given (based on DSM checklists) only increase their levels of stress – besides patients are currently often told what they have is a “long-term condition”- that itself can be extremely stressful to a patient. It also increases stigma (people avoiding the person because “he has that disease”). Imagine when a person is depressed as a result of losing a job, and if this person is additionally given a psychiatric label – that can be extremely stressful and can also affect all family members.
(3) The presence of biomarkers should not be an excuse for pharmaceutical companies to refer to mental illnesses as “biochemical abnormalities” and to come up with various medicines. Remember that it is the mind-states that change the brain and biomarkers. If a person is given medicine after losing his job – that could mess up his biochemical pathways in the long-term.
What patients who have elevated biomarkers need is hope, support and other interventions such as training in mind-calming activities – definitely not fancy psychiatric labels and medicines. A recent study has shown that mindfulness practices bring about changes in objectively measurable biomarkers – see: Hoge, E. et al. (2017). The effect of mindfulness meditation training on biological acute stress responses in generalized anxiety disorder. Psychiatry Research.