Now consider the poor response to available medication (IIRC 30% remit and 60% respond, which leaves roughly 40% with a potential deadly disease without medication). Some symptoms of depression occur in other mental illnesses, like the similarity between bipolar and unipolar depression. Maybe the disease we currently call depression is acutally a cluster of diseases. That's the reason to look for biomarkers that separate those different diseases and the develop treatments specifically for one disease. Similar to the development of brexanolone for postpartum depression.
Right now we just try lots of drugs, one after another, on each patient until something works or the patient gives up. What if we could confidently predict the drugs that were the most likely to succeed for each group? It may cut treatment times and help people find relief faster.
Even if we don’t find new treatments or gain a better understanding of cause/effect it could still be useful.
I am one of the people with this deadly disease and frankly I want to die right now because I am homeless living with schizoaffective disorder and it its the 15 year anniversary of my nephews suicide and all anyone here does is downvote me because they cannot take the time to listen.
DO you know how many years I have heard of sht like this and then I go to the doctor and I am getting the same medications my mother got when she was sick 60 years ago?
Do me a favor, read my blog, look at what I know and what I have and am living with, then come back here and tell me I should be happy about this study that will do nothing for me and nothing for anyone in the next 20 years. Then tell me how not giving me that money to help me other people living with mental illness who are homeless to find housing is not better.
But nevertheless, if these studies don't happen, there will forever be people who have to suffer like you do.
Instead, there are many other places where money is being wasted on things that not only have 0 chance of helping, but are actively hurting people. The war budget is many times over all of the psychiatric research money ever spent - maybe we should target taking money from there to help people people struggling with mental illness or homelessness or both, before taking that money from research.
From the article:
> There is an urgent need to derive quantitative measures
> We need treatment, not more tests to tell us what we already know.
Testing for objective markers can/should lead to choosing the most adequate treatment faster than relying on self reported symptoms or subjective opinion from therapists (even if experienced or informed).
This need to measure everything is almost pathological.
Speaking as a patient myself.
I wish there was a way I could get an objective test that spits out exactly what's wrong with me and which treatments are most effective. I've been through several psychiatrists and treatments and am yet to find something effective.
I'm glad research like this is being done.
Neither can doctors, or researchers. They obviously see something wrong with you, as they did with me, so do we worry about their objectivity? No. Because bias and stigma.
And if you are looking for answers, like I have been for 20 year, you might want to look at the role the purine pathway plays in mood disorders. Here is an article I wrote about it.
https://christianbonanno.substack.com/p/what-caused-my-menta...
Best of luck because I objectively know the crap you are dealing with.
This article also makes me think of the neurologist that unknowingly analyzed his own brain scan only to discover he was a psychopath.
https://www.smithsonianmag.com/science-nature/the-neuroscien...
The doctors "objectively" thought I was on drugs.
And those tele-health centers are being shutdown because they do no legitimate screening and are pill farms.
https://thehill.com/policy/healthcare/4723163-cdc-disruption...
So I feel you are confusing mental health and mental illness and confusing compassion with a profit making operation.
What's pathological is the tendency to see everything in black or white, right or wrong. There are many different causes for fatigue and tiredness: the flu, atypical depression, chronic fatigue, etc. But those conditions can overlap with depression. Putting the symptoms through a sieve by eliminating some causes helps pinpoint the origin (I over-simplify of course).
edit: this complaint about measuring things is a bit surprising considering what needed to be measured so this article https://christianbonanno.substack.com/p/what-caused-my-menta... (edit: interesting reading btw) could be written ?
That is nothing close to what they are doing. Do you think they are going to be giving these scans to everyone that walk in with fatigue and/or depression? I cannot even get to see a rheumatologist and I am disabled with schizoaffective disorder.
If one becomes "depressed" when sick, why not investigate the immune dysregulation in depression?
The only way out of a mental illness is personalized medicine but that is something no one care enough to provide.
However, your post has a very "we don't need x-rays, we can just tell the bone is broken" vibe. It reads like you think better and more objective, quantitative diagnosis is not worth pursuing.
They diagnosed the patients to get them in the study and they they said "see, it matched out "objective" diagnosis based on the patients "subjective" complaints.
There is nothing quantitative about what they are doing. Take a look at figure 5. How quantitative is that?
depression with anxiety is dramatically more difficult to treat than either or.
Bipolar can come across as ADHD in certain parts of the cycle or just usually depression. In fact, you can even have uni-polar depression that does not respond to traditional anti-depressants and you don't necessarily exhibit hypomanic episodes.
Relying on patients to know and understand what they are experiencing other than "this is just normal I assume everyone else experiences this" is not reliable.
Having something that can reliably diagnose and find markers for these conditions would be _huge_.
I wade through whitepapers and books on this stuff because of my own issues. I don't expect the average person to even remotely know about all of this; it's a lot and very subtle.
To add on to all of this, people tend to not seek treatment until there IS a problem. Sometimes this can be really life alteringly bad, sometimes it's benign. But it would be helpful if people could just "take a test" and know or at least have an idea.
The issue with being "objective" is also that your doctor has to be "objective" and I've had a lot of friends that are clearly ADHD and end up with DRs that think they are just trying to get medication and don't have ADHD.
Worse yet; they do get medications and they have to cycle a few different ones because of the way they tolerate it. It would be really nice if we had an idea to correlate your ADHD, your body chemistry, and which drugs would be most effective for you rather than the 3-12 month ordeal of figuring that out.
"To enable more precise diagnosis and selection of the best treatment for each individual, we need to dissect the heterogeneity of depression and anxiety. The dominant ‘one-size-fits-all’ diagnostic approach in psychiatry leads to cycling through treatment options by trial and error, which is lengthy, expensive and frustrating, with 30–40% of patients not achieving remission after trying one treatment"