Can Pharmacogenetics Improve Mental Health?
How personalized medicine can benefit mental health patients
Link to the Original Essay
The COVID-19 pandemic has brought with it a lot of consequences that are distinct from the virus itself. One such consequence has been a dramatic rise in mental health problems. Despite this devastating rise, hope should not be lost. Pharmacogenetics can help aid the process of treating mental illness.
Rising Mental Health Problems
Society, in general, did a great job with social distancing and quarantine during the pandemic. Without these efforts, millions of more people would have gotten sick, and therefore, many more deaths would have been more likely to occur. However, these measures came at a cost.
Human beings are intrinsically social animals. This can be demonstrated in a few ways. A salient way is the fact that, without sufficient human contact, newborn infants can either have irrecoverable health complications for the rest of their life, or they can even die. Another salient example is punishment via solitary confinement: being totally cut off from human contact is actually considered less tolerable for inmates generally, than being socially in proximity to dangerous criminals. So being around each other is crucial for our development and psychological well-being.
The pandemic has forced us away from each other. Many of us went through the holidays without seeing anyone, and many of us haven’t seen our loved ones in a long time. That is to say, due to the pandemic, to some degree, what it is to be a human –namely, to be socially in the world– has been severely interrupted.
Largely because of this, we have seen a significant rise in mental health issues in the general population. We have seen this rise take many forms. For instance, it has been reported that four out of ten adults in the United States have reported experiencing symptoms of anxiety or depression during the pandemic. To put this into context, prior to the pandemic only one out of ten adults in the United States reported experiencing symptoms of anxiety or depression. These measures are quite consistent with the data we have on the psychological effects of quarantine: namely, that someone who is quarantined is much more likely to develop mental health problems than someone who is not quarantined.
Another worrying statistic regarding mental health is a rise in substance abuse. There is emerging evidence that heavily suggests that alcohol abuse has increased significantly during the pandemic. Similarly, there is evidence now that suggests that general drug abuse is also on the rise because of the pandemic. On top of this, the rate at which drug overdoses have been occurring skyrocketed during the pandemic. Specifically, according to the CDC, in 2019 there were 70,000 drug overdose deaths in the United States 2019; in 2020, this number went up to over 88,000 deaths.
Finally, COVID-19 and post-traumatic stress disorder (PTSD) have an inter-related relationship. On the one hand, it has been reported that about one-third of COVID survivors who had severe cases may have or could develop PTSD. On the other hand, along with feelings of anxiety and depression, reports of PTSD have been on the rise since the beginning of the pandemic. Healthcare workers are particularly vulnerable to these effects. The stress of this entire pandemic is getting too many of us, which is one of the ultimate sources of this rise in mental health problems.
Pharmacogenetics
The healthcare system –including the part of it that pertains to mental health– has attempted to adapt in light of the pandemic. Telehealth allows us to see our providers with zero risk of getting infected with the virus. However, an age-old problem remains and has gotten potentially worse due to the pandemic: psychiatry is notorious for its “trial and error” method of treatment. For the most part, when you go to a psychiatrist, they will prescribe a medication to you depending upon your symptoms and/or diagnosis. The idea here is that you will try out the medicine to see if it works. If it doesn’t –which is quite common– the doctor will prescribe you a different medication to see if that works. This process will continue until you and your doctor find the right medication for you. Unfortunately, sometimes people never find the right medicine for them, leaving them feeling more hopeless than before they started seeking treatment. In a world with increasing mental health issues, this way of going about treatment may need to be re-envisioned with something new and more accurate.
Pharmacogenetics is the solution to the trial and error method of psychiatry. pharmacogenetics, in layman’s terms, is when a doctor orders a genetic test for a patient for the purpose of accurate and effective medical prescriptions. So, instead of testing out all of the SSRI’s when you are depressed, pharmacogenetics can bypass this process, by telling the patient which SSRI will have an increased likelihood of a positive response for them with less adverse reactions based upon their genetic profile. The purpose of pharmacogenetics is to individualize treatment for patients and in doing so, ameliorate any of the unnecessary suffering that goes along with the trial and error method of psychiatry. There is already a large body of research substantiating the effectiveness of pharmacogenetics’ ability to do this in the domain of psychiatry.
Therefore, it is imperative in any effective psychiatric treatment plan to include pharmacogenetic methods of prescribing medications. As mental health issues rise, the hope is that access to pharmacogenetic methods becomes more accessible to more patients. In some sense, such increased access is essential to ending our current mental health crisis –the trial and error method, if anything, continues to exacerbate it. It is possible that, with the removal of the trial and error method and the initiation of pharmacogenetics within a treatment plan, the reduction in stress by getting streamlined treatment could potentially reduce rates of self-medication, and put patients on the road to recovery much quicker.
