If we could pinpoint with fair accuracy neurotransmitter levels of key neurotransmitters, at any given point, that would be a breakthrough to begin with. Depression hits the hardest in the early morning hours. Perhaps metabolism of electrolytes monitored on a 24 hour basis could also provide a clue.
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A Biology of Mental Disorder
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The most convincing scientific progress in psychiatry in the past decade has had little to do with genomics. It is the rigorous, scientific verification that certain forms of psychotherapy are effective. This is perhaps not surprising. One of the major insights in the modern biology of learning and memory is that education, experience, and social interactions affect the brain. When you learn something and then remember it for a long time, it's because genes are being turned on and off in certain brain cells, leading to the growth of new synaptic contacts between the nerve cells of the brain. Insofar as psychotherapy works and produces stable, learned changes in behavior, it can cause stable anatomical changes in the brain. We are now beginning to measure such changes with brain imaging. If a person with obsessive-compulsive neurosis or depression undergoes psychotherapy—and if the treatment is successful in changing behavior—the treatment will cause a reversal in the biological markers of these disorders.
Taken together, these advances could open up new approaches to the treatment of depression, bipolar disorders, and schizophrenia, areas that have been at a pharmacological standstill for decades. Along the way we may also learn something about who we are.
Kandel, professor of biochemistry and biophysics at Columbia University, won a Nobel Prize in 2000 for his work on the molecular basis of memory. He is the author of In Search of Memory.
© 2009
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