Genetic Testing Is a Helpful Tool
- A new global study, published the peer-reviewed journal Cell, has identified 697 variants and 308 genes linked to depression—a mental health condition actress Kirsten Dunst previously struggled with. She went to a rehabilitation facility in Utah during her 20s for help.
- The idea of tailoring medication for mental health issues based on genetics is already happening and this is the kind of study we need to have a better understanding of how our genetics play a role in the type of treatment one needs.
- Genetic testing can help determine the best course of mental health treatment for people struggling with issues like anxiety and depression.
- Genetic testing can give a profile of how a person is likely to respond to different types of psychiatric medications, Dr. Lori Plutchik explains. Testing is also available to create a profile of how patients will likely respond to different sorts of pain medications, which can be really beneficial for those going through some other sort of health issue.
Researchers ultimately found 697 variants and 308 genes linked to major depressive disorder (MDD), thanks to the findings from the unparalleled global study, the largest and most diverse of its kind, published this month in the peer-reviewed journal Cell.
Read MoreThe findings allow scientists to predict depression risk among patients, as it was found that each genetic variant had a minuscule effect on one’s depression risk and the more variants a person has, the higher the risk due to the compilation of the small effects.
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Dr. Brittany Mitchell, one of the study authors and researcher at Queensland Institute of Medical Research Berghofer, said in a statement, “While depression is a growing major health issue, we lack the insights needed to better treat and prevent it.
“Larger, more inclusive studies like this will help us develop better treatments and interventions, ultimately improving lives and reducing the global impact of the condition. It will also reinforce the evidence that mental health conditions are as biologically based as other conditions like heart disease.”
Dr Enda Byrne, a scientist at the University of Queensland (UQ) and co-lead analyst of the Australian Genetics of Depression Study (AGDS), which played a major role in the meta-analysis, told QIMR Berghofer Medical Research Institute, “Our research has identified numerous genetic factors that contribute to the condition, showing that it involves a complex mix of genes.
“These findings offer new opportunities to improve how we treat and support those with depression.”
The research team also pointed out how existing drugs, like pregabalin and modafinil, could be possibly repurposed in depression treatment, other than being used for pain, anxiety and fatigue.
How Can Genetic Testing Help Determine the Right Form of Mental Health Treatment?
According to Medscape Medical News, which also reported on the study, study investigator Andrew M. McIntosh, MD, said that although there’s so immediate clinical influence from the new findings, it offers a better understanding of what leads to depression.
McIntosh also explained how the meta-analysis included both European and non-European ancestry, including people from East Asia, South Asia, South America, and Africa.
Offering additional insight, McIntosh added, “Most of the world isn’t White, and most people suffering from depression don’t come from rich and high-income countries where people are mostly of European ancestry. We have begun to appreciate the need to include people who are of non-European ancestry.”
“Many of the 697 variants that we discovered, we only discovered because we included ancestrally diverse participants.”
Expert Resources On Mental Health
- How to Fix Relationships When Depression Hits – A Survivor’s Guide
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- SN & You Presents Mental Health: Coping With Emotions
- How Can Genetic Testing Help Determine the Right Form of Mental Health Treatment?
- Insomnia, Pain Tolerance, and Anxiety: Addressing Your Unmet Mental Health Needs
- Mental Health: A Guided Breathing Exercise to Help Manage Anxiety
- Mental Health: Coping With Feelings of Anger
- Mental Health: Understanding the Three Wellsprings of Vitality
Kirsten Dunst On Her Battle With Depression
In an earlier interview with The Sunday Times, the Spider-Man actress revealed she sought treatment for her depression at a rehabilitation facility in Utah during her 20s.
“I feel like most people around 27, the s— hits the fan,” she said. “Whatever is working in your brain, you can’t live like that anymore mentally.
“I feel like I was angry. You don’t know that you are repressing all this anger, it wasn’t a conscious thing.”
Dunst also noted that medication was a huge help in getting her to a better place.
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“It’s hard to talk about such a personal thing, but it is important to share too. All I’ll say is that medication is a great thing and can really help you come out of something,” Dunst said. “I was afraid to take something. and so I sat in it for too long.
“I would recommend getting help when you need it,” she urged.
If you’re looking for more inspiring stories like that of Dunst’s, check out SurvivorNet’s page “Mental Health: Inspiring Stories from SNTV.”
Genetic Testing & Mental Health Treatment
These days, there is a form of genetic testing that has been shown to be able to match people with the best medication for mental health treatment. While genetic testing has been helpful when it comes to making treatment plans for other diseases such as certain types of cancer the ability to use it to help people who are suffering from things like anxiety and depression is relatively new.
“Doing the genetic testing has absolutely transformed the landscape of psycho-pharmacology,” psychiatrist Dr. Lori Plutchik tells SurvivorNet.
“It’s something that I highly recommend for anybody that is taking medication, whether they are being treated for cancer, or not … I recommend it for children who are taking medication. I recommend it for elderly people. Anybody who is taking medication, I think, can greatly benefit from genetic testing.”
Genetic testing can give a profile of how a person is likely to respond to different types of psychiatric medications, Dr. Plutchik explains. Testing is also available to create a profile of how patients will likely respond to various pain medications, which can benefit those going through some other sort of health issue.
Genetic testing “gives me information about which medications are likely to work without having problematic side effects. It also gives information about interactions between any of the psych medications that we choose,” and other medications a patient may be taking, Dr. Plutchik explains.
The genetic test Dr. Plutchik spoke to SurvivorNet about, Genomind, looks at multiple factors before determining which treatment will likely have successful results and minimal side effects. The test examines certain genes that are associated with responses to medications commonly prescribed for mental health issues and then looks into the patient’s ability to metabolize medication.
Cancer & Mental Health
While anyone can struggle with mental health, this is a particular hardship affecting those after a cancer diagnosis and while going through treatment. After being diagnosed with cancer, it’s common for people to experience feelings of grief, fear, anger, depression, and anxiety. Additionally, common treatments such as chemotherapy can cause side effects such as depression. While it’s often not clinical depression, if a cancer patient is struggling with mental health during and after their battle, genetic testing may be key in helping them take these struggles head-on.
“Depression and stress make it harder to treat cancer [and] make it harder to tolerate the treatments,” Dr. Scott Irwin, director of supportive care services at Cedars-Sinai Medical Center, previously told SurvivorNet. “Actually, there’s data that if you have extra stress or depression that you may not recover or you have a higher risk of recurrence, so in treating the depression, we’re actually impacting the cancer care outcomes.”
Dr. Scott Irwin explains how addressing depression can impact cancer treatment
Mental health is a subject that’s made huge strides over recent decades, but there’s still much more work to be done. However, this genetic test Genomind has proven to be a strong step in making sure each mental health patient is prioritized and individualized to ensure successful results on the first try.
“When you’re working with a population of people who are dealing with cancer and even family members who are involved in the care of patients dealing with cancer, they have so much going on that it’s so important to address their mental health needs,” Dr. Plutchik says. “It’s such a scary and stressful, and at times, depressing situation for some people and taking their mental health needs seriously is just as important as taking their physical health needs seriously…I think it just makes people feel so much more hopeful right from the beginning that they’re not going to have to go through this painful process of trial and error.”
As for Genomind, Dr. Plutchik told SurvivorNet in an earlier interview, “This test covers all of the psych medications, essentially, and it also covers pain medications. It’s such a great test.
“Depression affects about 20% of women at some point in their life and about 10% of men at some point in their life. That’s a very prevalent illness, and then when you’re working in the cancer population, which I’ve worked in extensively over the years, depression can be up to 50% in patients who are having impairments in their life due to their illness.”
The test that Dr. Plutchik uses, Genomind, tests for multiple factors before determining the medication that will both have successful results and minimal side effects. To do this, there are two parts the test examines. First, the doctor will test for certain genes that are associated with responses to medication commonly prescribed for mental health issues. Secondly, the patient’s ability to metabolize medication will be tested. Through this, it reduces the chance of negative side effects and allows patients to respond well to medication on the first try.
RELATED: Treating Depression After a Cancer Diagnosis
“About 95% of the time the first medication that I choose for them ends up being the right medication,” Dr. Plutchik explains. “In other words, we don’t have to switch it. They feel well on it. They’re having minimal to no side effects, and they just get to a place where they’re doing much better, much faster.”
In addition to the test, Dr. Plutchik also takes into account ethnicity and family history as these can contribute to struggling with depression, anxiety, and other conditions. While this test is simple for the patient to go through, don’t let that fool you. This comprehensive genetic test explores specific genes, such as the SLC6A4 gene variants, which can determine how the patient will react to antidepressants such as selective serotonin reuptake inhibitors (SSRIs).
“If somebody has [a certain variant] that means they’re in a category where they have the highest likelihood of response, a good clinical response, and the lowest likelihood of side effects,” Dr. Plutchik says. “If you don’t do genetic testing and you just give the medication, the overall rate of response to the SSRIs is somewhere in the high 60’s. When someone has this variant in this SLC6A4 gene, then we know that the likelihood of them responding from the genetic standpoint is about 80%. There’s a big increase in the likelihood of somebody responding well to an SSRI and that’s important information.”
Understanding Biomarker Testing
Biomarker testing — which involves identifying specific aspects of how cancer behaves — has rapidly become a cornerstone of modern cancer care, reshaping the way doctors diagnose, treat, and monitor various cancer pathologies. By identifying specific genetic, molecular, or protein markers linked to cancer growth, biomarker testing allows oncologists to tailor treatments to the specific characteristics of each patient’s tumor — potentially creating treatment plans that work better and cause fewer side effects.
Not too long ago, cancer treatments were limited primarily to one-size-fits-all regimens such as chemotherapy and radiation. As researchers gained more profound insights into the biological underpinnings of tumors, new opportunities emerged to develop therapies that target cancer’s specific weak spots. This is where biomarkers come in. When physicians test for these biomarkers, they can determine which targeted therapy — or, in some cases, immunotherapy — will be most effective.
Biomarker Testing — A Path to Better Outcomes for Cancer Patients
Dr. David Hyman, Chief Medical Officer at Eli Lilly and Company, previously told SurvivorNet that getting more patients access to biomarker testing is key.
“We really need to undertake a comprehensive, broad strategy to ensure patients have access to high-quality testing and that physicians are educated about how to act on the results. This way, patients won’t miss the tremendous benefits that biomarker-selected therapies can offer,” he says.
Cancer centers worldwide regularly adopt new testing methods to detect emerging markers, such as actionable mutations, gene fusions, or even the level of certain proteins that can predict response to immunotherapies. This continuous evolution not only expands treatment options but also paves the way for innovative research and future breakthroughs.
“Biomarker testing is increasingly relevant for many of the medicines that we and others are developing. These are medicines that have a very specific way of acting, and we also need to select our patients specifically. It’s not enough to know sometimes that they have lung cancer or breast cancer. We need to know exactly what makes that cancer tick. That involves what we call biomarker testing, which is an analysis of the cancer to understand what its specific drivers are,” Dr. Hyman adds.
Where Can I Get Genetic Testing?
Meanwhile, genetic sequencing of your tumor is available across the country, even if you don’t live near an academic hospital. A piece of your tumor can be sent to a hospital that does the sequencing, so having access to a genetic test of your cancer is not restricted by where you live.
Genetic sequencing is valuable for patients diagnosed with metastatic cancer as it allows oncologists to understand the mutations that may have evolved in the tumor.
Should I Meet With a Genetic Counselor?
If you’re thinking about getting genetic testing to assess your cancer risk, you may want to consider meeting with a counselor. But what is a genetic counselor, and what can they do for you?
Rachel Webster, a genetic counselor at MD Anderson Cancer Center, explains that her job is to figure out what type of genetic testing may be most useful for the person she is meeting with and their family members. However, genetic counselors are not always easily accessible. “You may find them in your larger cities or at major medical centers,” Webster says. “They are popping up in more and more community hospitals across the country.”
For those who do not have access to a medical center or hospital that offers genetic counseling services, tele-health counseling may be available. If you’re considering meeting with a genetic counselor and are unsure where to find one, the National Society of Genetic Counselors has resources on its website for locating a counselor.
Questions to Ask Your Doctor
- Should I consider going on medication to help with mental health struggles?
- Would genetic testing be helpful in determining the best treatment for me?
- What is the likelihood that the test will recommend the right treatment?
- What can we do if I don’t find success with the recommended treatment?
Contributing: SurvivorNet Staff
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