Is Chronic Depression a Genetic Disorder?

Chronic depression, also known as Major Depressive Disorder (MDD), is a widespread mental health issue that impacts millions across the globe. It seriously affects both personal happiness and how societies work. 

The primary symptoms of MDD are:

• Persistent Low Mood: Constant feelings of sadness, hopelessness, and emptiness, which can drain your sense of optimism and purpose.
• Anhedonia: Loss of pleasure in activities once enjoyed, with goals and hobbies becoming unappealing, replaced by a sense of apathy and indifference.
• Suicidal Thoughts: Intrusive thoughts about harming yourself or others may surface, adding another layer of fear and distress. These thoughts, however unwanted, can feel overwhelming, emphasising the importance of seeking immediate help.

Researchers have been looking into whether chronic depression has roots in our genes, and this has been a big topic of research and discussion. This article dives into the genetic aspects of chronic depression, looking at evidence from around the world and specifically focusing on India.

Genetic Basis of Chronic Depression

The mix of our genes and the environment around us plays a big part in causing chronic depression. Studies on families and twins keep pointing to a family link in how likely someone is to have depression. A groundbreaking study by Sullivan and team in the year 2000 found that if someone's close family, like parents or siblings, has depression, that person is two to three times more likely to have it too. The results suggest that there is a strong connection within families, indicating that certain things we inherit might make us more prone to experiencing chronic depression.

Furthermore, it is essential to mention that when scientists look at twins, they find that about 30% to 40% of why someone might have depression comes from their genes. This means that a good part of the reason why someone might feel this way is because of their family background (Sullivan et al., 2000; Kendler et al., 2006). These studies show strong evidence that genes are a big part of why someone might deal with depression. However, at the same time, it is crucial to recognise the role of the environment around us in causing chronic depression. The interaction between our genes and the things happening in our environment, like stress, is really important in how this condition develops. This intermix of our genes and what is going on around us plays a big part in how depression shows up.

Global Perspective

Looking at chronic depression worldwide, research keeps showing that our genes play a role in making us more likely to have it. In a big review done by Power et al. in 2016, they looked at studies from different places. They found that the chances of having chronic depression because of our genes are similar across different ethnic groups. This similarity globally suggests that our genes are a big part of why chronic depression happens. The idea here is that, no matter where somebody is from, the influence of genes on chronic depression stays quite steady.

It is important to mention that although genes have a big role, how depression shows up can be different based on culture, society, and the person. For example, how common chronic depression is changes from one country to another because of cultural habits, differences in socio-economic status and access to healthcare. Seeing these variations is important to create solutions that fit each place, considering both genes and what is happening around us. Understanding these differences helps us make specific plans that consider both our genes and what is going on in our surroundings.

Indian Perspective

In India, things are different from Western countries in terms of culture and how people interact. When we look at the genetic side of chronic depression here, it takes on a unique meaning. A study by Patel and others in 2018 checked out the genes related to depression in people from India. Researchers discovered specific genetic markers associated with an increased likelihood of depression among individuals with Indian ancestry. This discovery hints at a genetic link to depression in this specific group of people.

Nevertheless, when we think about chronic depression in India, it is not just about genes. It also includes things related to how society and culture work together. In India, there is a lot of shame connected to mental health problems, and there are not enough resources to help. According to a recent news report, India needs three clinical psychiatrists for every 1,00,000 people, but it only has 0.7. This is even less than one-third of the recommended amount, which makes it immensely difficult for both individuals to find help and the medical professionals to provide the assistance needed. This often leads to people not talking about or getting help for depression. So, it is not only about genes but also about the cultural and social surroundings when we talk about chronic depression in India. Understanding these aspects becomes crucial in addressing the issue effectively.

Genetic Research in India: Opportunities and Challenges

Even though researchers are making progress in studying the genes related to chronic depression in India, there are still many difficulties. There are not enough resources, people do not know much about mental health, and there are many different cultural practices. Insufficient resources, limited public knowledge about mental health, and the presence of diverse cultural preferences contribute to challenges in addressing mental health issues. For instance, some cultures may rely on herbal remedies, spiritual rituals, or communal support networks as traditional approaches to coping with mental health challenges. These challenges make it tough to do detailed genetic studies. To deal with these problems, it is crucial for researchers, people who make decisions, and those who provide healthcare to work together. By teaming up, they can tackle these challenges and get a better, more detailed understanding of how genes play a role in chronic depression among Indians. Collaborating in research allows scientists to explore how genes contribute to chronic depression in individuals with Indian roots. Depression may vary between the West and India and also between urban and rural areas.

In Western societies, people tend to discuss their emotions openly, turn to professional help, and focus on individual solutions. Conversely, in India, societal stigma often leads to less open conversations about depression, with individuals relying more on family and traditional practices for support.

In bustling urban environments, depression may manifest as stress and burnout due to the fast-paced lifestyle. In contrast, rural areas may face unique challenges such as economic struggles, limited access to mental health resources, and the impact of agricultural uncertainties on mental well-being.

Understanding and acknowledging these cultural and environmental differences are crucial for developing mental health treatments that are sensitive and effective across diverse populations and settings. By tailoring support systems accordingly, we can ensure that everyone, regardless of cultural background or location, receives appropriate assistance for their mental health needs.

The Role of Epigenetics

Recent advancements in epigenetics go beyond regular genetic studies, offering a new way to grasp how genes and the environment team up in chronic depression. Epigenetics explores how our actions and surroundings can influence how our genes work. Unlike changes in our actual genes, these epigenetic changes can be reversed and do not mess with our DNA sequence. However, they do impact how our body interprets that sequence.

Think of epigenetic changes like tiny switches that can turn genes on or off, without altering the main genetic code. In the context of chronic depression, research in epigenetics reveals that things like stress and trauma early in life can cause lasting changes. These changes, tied to how genes are interpreted, can heighten the risk of depression. Understanding this adds another layer to how we see the link between our genes, our experiences, and chronic depression.

Implications for Treatment and Prevention

Understanding why chronic depression happens at a genetic level is essential for how we treat and manage it. The specific genes linked to being more likely to have depression could be targets for creating personalised ways to help. Also, realising how our genes interact with what is around us stresses how crucial it is to deal with things in our environment to lower the risk of chronic depression. T. Knowing how genes and our surroundings work together highlights how important it is to tackle environmental factors to reduce the chances of chronic depression.

In India, mental health support is not as much as it should be. It is crucial to have a complete approach that mixes what we learn from genetics with ways that fit the culture. Bringing genetic discoveries into mental health plans can help make specific strategies for India's unique mix of genes and surroundings. This is necessary to deal with both the genes and the things around us that lead to chronic depression in India.

In summary, chronic depression is heavily connected to our genes, and this is clear from studies done all around the world, including in India. Figuring out how genes and the environment around us work together to cause depression is tricky and needs a complete understanding. While genes play a big part in making someone more likely to have chronic depression, the mix of culture, society, and personal differences is also super important, especially in places like India with a mix of people.

Dealing with chronic depression needs a mix of strategies that look at both our genes and the environment around us. This is where Mave Health comes in. With Therapy Club, one of our flagship initiatives, we understand that choosing the right therapist is extremely important for your mental well-being. That is why we have over 1500 therapists from across the nation, allowing you to find a mental health practitioner that works the best for you. Understanding genes and their changes gives us helpful information for specific solutions. As we handle the challenges of chronic depression, it is crucial to see how it shows up differently worldwide and in specific regions. This helps us create plans that fit each place, ensuring people get complete and culturally aware help for their mental health. Recognising these differences is vital as we work on ways to support people dealing with chronic depression.

References:

1. Therapy Club. Types of Depression. Mave Health. Retrieved from https://therapyclub.mavehealth.com/blogs/types-of-depression
2. Sullivan PF, Neale MC, Kendler KS. (2000). Genetic epidemiology of major depression: review and meta-analysis. The American Journal of Psychiatry, 157(10), 1552–1562. doi:10.1176/appi.ajp.157.10.1552
3. Kendler KS, Gatz M, Gardner CO, Pedersen NL. (2006). A Swedish national twin study of lifetime major depression. American Journal of Psychiatry, 163(1), 109–114. doi:10.1176/appi.ajp.163.1.109
4. Power RA, Tansey KE, Buttenschøn HN, Cohen-Woods S, Bigdeli T, Hall LS, ... & Craddock N. (2017). Genome-wide association for major depression through age at onset stratification: Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium. Biological Psychiatry, 81(4), 325-335. doi:10.1016/j.biopsych.2016.05.010
5. Patel V, Chisholm D, Parikh R, Charlson FJ, Degenhardt L, Dua T, ... & Whiteford H. (2018). Addressing the burden of mental, neurological, and substance use disorders: Key messages from Disease Control Priorities, 3rd edition. The Lancet, 393(10121), 27–35. doi:10.1016/S0140-6736(18)31612-X
6. Labonté B, Engmann O, Purushothaman I, Menard C, Wang J, Tan C, ... & Nestler EJ. (2017). Sex-specific transcriptional signatures in human depression. Nature Medicine, 23(9), 1102–1111. doi:10.1038/nm.4386
7. Times of India. (2022, February 12). India needs 3 psychiatrists per lakh population, has only 0.7. Retrieved from https://timesofindia.indiatimes.com/india/india-needs-3-psychiatrists-per-lakh-population-has-only-0-7/articleshow/104327049.cms?from=mdr