Researchers at the Indiana University School of Medicine developed a blood test that would be able to diagnose depression based on markers present in the patient’s RNA.
This test could also diagnose bipolar disorder. Dr. Alexander Nicolescu, who led the scientific team, said that this test can potentially distinguish between the two psychiatric disorders, and help avoid the lengthy “trial and error” that a patient must go through until depression is diagnosed.
The test is based on the analysis of a molecule known as brain-derived neurotrophic factor, which plays a central role in healthy nerve cell growth and in learning, memory, and maintenance of brain flexibility. Low levels of this molecule are associated with depression.
The scientists studied molecular changes in 300 individuals with severe depression over time, and identified 26 biomarkers related to the disorder.
Although the test is already available to order and is produced by a company created by Dr. Nicolescu, the opinions of the scientific community on the effectiveness of this diagnostic tool are divided.
The critical question in the discussion is whether a single test can be applied to the diagnosis of a disorder that has been shown to have very strong individual mental and chemical characteristics.
In an article in the Journal of Psychiatric Research, researchers from Australia and China said that doctors should use the blood test to diagnose depression and monitor drug treatment.
Alexander Talkovsky, program director in the Division of Translational Research of the National Institute of Mental Health (NIMH) of the United States, recognized that the new test is an advance in the study of ways to detect this condition, but stressed that they should be performed more research, in larger groups of patients, to validate the efficacy of the test.
The scientists who developed the test estimate that a diagnostic test based on their assay, with a cut-off point of 12.4 nanograms per milliliter of serum, would have a sensitivity of 82.2% and a specificity of 83.3%. But this could mean that the test will miss about 1 in 5 people who have depression.
The study of blood tests to detect mental disorders is not new. For example, a 2012 study looked at a substance, ethanolamine phosphate, that people with depression appear to have at lower levels. But this and other studies encountered barriers when investigating tests that could diagnose different types of depression.
Although there is controversy, experts assure that this field of research must continue and deepen, to achieve an accurate test that accompanies the clinical eye of the psychiatrist.
What is depression
Depression is a complex disorder that can have many causes: child abuse, having suffered domestic violence, the death of a loved one, even a failed relationship are the most common scenarios that usually trigger the disorder.
But the spectrum is much broader: an accident, low self-esteem, wounds that do not heal, medications that the person is taking for other conditions (such as beta-blockers, statins, corticosteroids, hormonal medications), family history of depression, the possibilities are so many that only a specialist will be able to get to the source and recommend appropriate treatments.
It is a mood disorder that causes a constant or cyclical feeling of desolation and loss of interest, in almost all aspects of a person’s life.
It is not easy to detect because it is “camouflaged” in a state of temporary sadness, or even stress.
Surely during your annual medical check-up, your GP will ask you about your mood, can detect warning signs, and take the first step in what will be a chain of help.
The American Psychiatric Association suggests that combining antidepressants with psychological treatment works well for most patients. Combining strategies has an explanation: people tend to abandon pills more easily than psychologists. If this occurs, the therapist will balance to get the treatment back on track.
It is not a fleeting sadness
Sadness is a normal human emotion, depression is a state of mind that is not. Many times, the two words are confused or used synonymously, especially in the Hispanic community, when saying that a person “is sad”, when in fact they may be suffering from depression, and need help.
The SOL Study (Study of Latinos), which was carried out for a decade in different Latino communities in the United States, found that 27% of Latinos living in the country have symptoms of depression.
Of all the Latino communities, the one with the most symptoms of depression was the Puerto Rican, followed by the Cuban.
An interesting distinction explained by Dr. Guy Winch, author of “Emotional First Aid: Healing Rejection, Guilt, Failure and Other Everyday Hurts,” is that we are generally sad about something. There are triggers of sadness, such as a difficult event, a loss, a breakup. It is a temporary feeling, and in a short period of time, it fades, it is overcome, and suddenly we are no longer sad.
On the other hand, depression invades all aspects of life, it is as if life were suddenly painted gray. And the word “less” begins to rule: everything is less interesting, less attractive, less important. Nothing worth. Anger and frustration tame, and it takes longer and longer to rearm.
Many times, the same person is not able to recognize himself in that emotional swamp, and it is a friend, a partner, a loved one, who begins to see the warning signs. It is time to ask for help.
Depression is one of the most common mental health conditions globally, with about 350 million people suffering from it.
In Latin America, 5% of the population suffers from it, although the percentage of people who receive treatment is very low, indicates the Pan American Health Organization (WHO).
The National Institute of Mental Health estimates that about 16 million people live with depression in the United States.
The entity identifies the following symptoms as the most notorious warning signs, although they may not be the only ones:
- A state of permanent irritability
- Changes in appetite and weight
- Sleep disorders (can be insomnia or sleeping a lot)
- Feeling tired or sluggish during the day
- Have very low energy
- Have feelings of guilt, or feel like nothing makes sense
- Problems with the ability to focus on an activity, or easily losing concentration.
- Losing the ability to make decisions
- Having thoughts of death or suicide
There are “smiling depressives”
In the collective imagination, the depressed person is one who has a sad, hopeless face, who locks himself in his house and who can barely function. However, not everyone with depression fits that stereotype.
An article in Psychology Today explains that there is a form of depression masked behind a facade of happiness that is defined as “smiling depression.”
The person with “smiling depression” seems happy, but internally has depressive symptoms. This form of depression often goes unnoticed. Those who suffer from it discard it, and put aside their own feelings. They may be unaware of their depression, or want to hide it for fear of being seen as weak.
Why is it so dangerous?
Experts agree that it is very difficult to detect “smiling depression” (its technical term is atypical depression) and therefore treat it.
The hallmark of the “smiling depression”, some also call it the sadness of the clown, is precisely the sadness. The smile and the external facade is a defense mechanism, an attempt to hide the true feelings that are sapping the soul of the person.
The “smiling depression” shares symptoms with the traditional form: feelings of anxiety, fear, anger, fatigue, irritability, hopelessness and despair. Those who suffer from this and other forms of depression may also experience trouble sleeping, an inability to enjoy previously enjoyable activities, and a loss of libido.
Of course, everyone’s experience is different. You may feel just one or more of these symptoms.
People who suffer from this form of depression often do not offer any indication of their problem to the outside world. You can even be the funny friend, the life of the party.
They often hold a full-time job, have a home, participate in sports, and have a fairly active social life. With her mask on, everything looks great, even perfect. However, under the mask they suffer sadness, panic attacks, low self-esteem, insomnia and, in some cases, they may have suicidal thoughts.
And this can be particularly dangerous. In classic depression, the person simply does not have the strength to act. But the patient with “smiling depression” has more energy to make his thoughts come true.
The following are resources that the person with depression, or a loved one, can use to ask for help and start the path back to normal life:
- Suicide Prevention Line: 1-800-273-8255
- Text line to talk about a crisis: Text HOME to 741741.
- Depression Support Group: 1-800-826-3632
- Teen Violence-Helpline: 1-800-992-2600
- Runaway Hotline (calls are confidential): 1-800-231-6946
- Sexual Assault Line: 1-800-223-5001
- National Domestic Violence Hotline: 1-800-799-SAFE
Sources: FDA, NDMDA, American Psyquiatric Association, CDC, Psychology Today, Mayo Clinic, PAHO.