Category Archives: manic depressive illness

Love, Madness, Terrorism: Connected?

By Liah Greenfeld

In the 16^th century, in England, several remarkable things happened:

Social mobility, inconceivable before, became legitimate and common;

The ideal of Romantic love between a man and a woman emerged and “true love,” as we understand it today, was added to the human emotional range;

The word “people,” which earlier referred to the lower classes, became synonymous with “nation,” which at the time had the meaning of “an elite”;

Numerous new words appeared, among them “aspiration,” “happiness,” and “madness”;

The English society, previously a society of hierarchically arranged orders of nobility, clergy, and laborers under the sovereignty of God and his Vicar in Rome, was redefined as a sovereign community of equals;

The nature of violent crime, personal and political, changed, with crime that was not rational in the sense of self-interested becoming much more common;

The attitude to pets, especially dogs and cats, changed, transforming these animals in many cases from living multi-purpose tools to our friends and soul-mates;

The pursuit of growth — rather than survival, as was the case before – became the goal of the economy;

Mental diseases which were later to be named “schizophrenia,” “manic-depressive illness,” and “depression” were first observed, shifting the interest of the medical profession, in particular, from other, numerous, mental diseases that were known since the times of antiquity.

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On DSM-V and the Diagnosis of Mental Illness

Schizophrenia and Manic-Depressive Illness: What do We Know about Biological Causes?

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By David Phillipi

While the technological advancements of recent decades allow us to map the human genome and look at the brain on the molecular level, the enormous amount of data that has been amassed is virtually useless for psychiatrists trying to diagnose their sick patients because the assumed biological causes of schizophrenia and manic-depressive illness have not been found. No brain abnormalities that are specific to either illness or present in all cases have been identified. Nevertheless, the experts who study and treat schizophrenia and manic-depressive illness (MDI) keep the faith (quite literally) that a breakthrough is just around the corner.

For years, genetic research has appeared to be the most promising of the recently opened avenues, but the excitement seems unwarranted by the findings. The relatively large number of chromosomal regions which may be implicated in susceptibility for bipolar disorder means that hope of finding a specific bipolar gene or even a small number of genes must be given up. Some researchers think the way to go is to narrow the search by looking for genes associated with specific aspects of the disease. Of course, this further refinement is only possible because of the huge variation in symptoms and experiences of those who fall under the MDI/bipolar umbrella, and we are once again reminded of the difficulty of defining what this illness or group of illnesses even is. Furthermore, even the distinction between schizophrenia and MDI seems to collapse in light of the genetic linkage data. In Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression (2nd Edition), Drs. Frederick Goodwin and Kay Redfield Jamison write:

While the search for predisposing genes had traditionally tended to proceed under the assumption that schizophrenia and bipolar disorder are separate disease entities with different underlying etiologies, emerging findings from many fields of psychiatric research do not fit well with this model. Most notably, the pattern of findings emerging from genetic studies shows increasing evidence for an overlap in genetic susceptibility across the traditional classification categories. (49)

Genetic studies in the schizophrenia research community lead to pretty much the same hypothesis as with bipolar: genetic susceptibility is most likely polygenic, meaning dependent on the total number of certain genes which may contribute to vulnerability. It must be noted that genetic vulnerability is a condition, not a cause of schizophrenia and bipolar – something else must be acting on this vulnerability. In one way or another, this fact is usually noted in the literature that deals with genetic data, but it is often obscured by a tone of confidence which suggests the information may be more meaningful and explanatory than it truly is.

Even when a specific gene has been well studied across illnesses, its usefulness in understanding genetic susceptibility may be extremely limited. Some studies in both schizophrenia and MDI have found an increased risk of illness for those who possess the short form of the serotonin transporter promoter gene 5-HTT. The thing is, each of us has two copies of this gene, and over two-thirds of us have one long and one short form, meaning that having the normal variant of the gene is the risk factor! If most of us possess a gene which puts us at risk for an illness which only a small minority of people have, then this particular trait is obviously not much of a causal explanation.

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Psychiatric Disorders Linked Genetically

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By Gil Press

In the Wall Street Journal today, Shirley S. Wang reports on a new study published today in The Lancet, which “provides early evidence that several disorders thought to be distinct appear to have some genetic overlap, and it may help in one day diagnosing mental illness based on faulty biological processes, and not just on behavioral symptoms.”

The study compared the genes of some 33,000 people with schizophrenia, bipolar disorder, major depression, autism or attention-deficit hyperactivity disorder, and also compared them with a group of nearly 28,000 controls. It “identified several regions of the genome that were associated with all five diseases.”

In Mind, Modernity, Madness, Liah Greenfeld came to a similar conclusion that viewing manic-depressive illness and schizophrenia as distinct illnesses, each with its own biological causes, is wrong. Instead, she argues that they should be placed on a continuum of the complexity of the will-impairment caused by the anomie inherent in modern culture. This argument, linking mental illness to individuals’ (varied) response to the pressures of modern society, could also explain why “the findings don’t mean that an individual with one or more of these gene variants has or will develop the condition,” as the Wall Street Journal article–and the authors of the study–conclude.