The impact of depression
Take a moment to reflect on your daily life. Consider your major stressors: work deadlines, bills, perhaps a messy house, family and friends demanding your time and attention.Too much to do and too little time. It’s easy to let these stressors and negative thoughts consume you to the point that you’re swamped and struggling to function.
For 93 percent of adults in the United States, these feelings pass. Overwhelming feelings of doubt, sadness and pain are overcome or dissipate, and the affected people are able to find joy in their lives and understand that the stress and sadness are temporary.
For the other 7 percent — nearly 15 million people who are affected by the disease of depression — these feelings persist.
That’s at the heart of what makes depression and other mental illnesses so difficult to understand. Those with depression can’t simply set it aside, work through it or get over it. Depression isn’t merely a negative state of mind. It is a disease with a biological basis that is coming into sharper focus.
Billie Kubly and her husband, Dr. Michael Kubly, understand well the devastating effects of depression.
Their son, Charlie, the youngest of their seven children, struggled with it from an early age. Despite the disease, he put on a brave face, especially in front of friends. Billie says he was embarrassed and didn’t want people to know what he was going through. His family, however, saw his pain and agony.
Charlie admitted he needed treatment after college and, despite trying several treatment options, couldn’t find relief from the disease, which he described as incapacitating. After battling the disease for years, Charlie took his life at age 28. He wrote that if he hadn’t had depression, he believed he would have led a happy life.
The Kublys vowed to help others with the disease and formed the
Charles E. Kubly Foundation, a public charity devoted to improving the lives of those affected by depression. One of the foundation’s key tenets is that it’s important for people not to be ashamed: “Depression is a disease like any other for which one should seek help.”
Billie says it’s about reducing the stigma. “Charlie was private about his disease, but I know he’d be proud to have his name associated with this foundation that strives to help people overcome it,” she says.
In addition to overwhelming feelings of sadness, stress and loss of interest, people with depression often suffer from physical symptoms like nausea, fatigue, insomnia and chronic pain. Treating depressed individuals is difficult, often involving much trial and error. Approaches can include pharmacological treatment with antidepressant medications, as well as cognitive behavioral therapy, some combination of which provides at least partial relief for 70–80 percent of patients.
“Though currently approved antidepressants work in a subset of patients, their effectiveness is often limited and many depressed individuals don’t respond to them at all,” says Dr. John Mantsch, chair of Marquette’s biomedical sciences program and co-founder of Promentis Pharmaceuticals Inc., a company that develops treatments for several central nervous system disorders. “The result of treatment failures in these cases can be catastrophic. Suicide rates are very high in treatment- resistant depression.”
It can also take up to six weeks for a medication to reach its full effect, and if the dosage or drug isn’t a good fit, a person can lose six weeks of treatment time. After repeating this cycle three or four times with no success
and no relief, depressed individuals can become so frustrated that they quit
treatment altogether.
Even if a person does find relief, antidepressants can have side effects, including anxiety, weight gain and headaches, many of which mirror symptoms of the actual disease. And people who need to stop taking medication for any reason could experience severe and serious withdrawal symptoms.
“Cognitive behavioral therapy and counseling are often key components of successful treatment, and a subset of patients may respond sufficiently well to these approaches so medication isn’t necessary,” Mantsch says. “However, this is not usually the case with most depressed individuals.”
The Kublys believe there is a better solution. So does Dr. William Cullinan, dean of the College of Health Sciences and director of the Integrative Neuroscience Research Center.
Cullinan and Mantsch assembled a team of neuroscience researchers whose talents and work complement each other and who collaborate to tackle issues from multiple angles.
“We’re focused on finding the underlying causes of mental illness and discovering new, faster-acting, more effective ways to treat these disorders,” Cullinan says.
The Kublys have long sought to find a more effective pharmacological option for treatment. When they saw the innovative work being done in the college, they knew the potential for a breakthrough existed within its collaborative neuroscience model. To foster that work, they made a personal gift of $5 million to the college to establish the Charles E. Kubly Mental Health Research Center.
Their goal for the center is to accelerate the pace of discovery toward better medications for depression and related mental illnesses and to remove the stigma that can be a barrier to treatment.
“People don’t often fund diseases like depression,” Billie says. “I hope our gift will inspire others to give. It’s an important area of study and one that needs more attention.”
“Progress in treating these conditions requires the identification of new targets for medications,” adds Mantsch. “Unfortunately, drug companies are unable and insufficiently motivated to conduct the basic research necessary to accomplish this, leaving much of the burden on academic researchers.”
According to Mantsch, real progress requires a research environment that can meet three key criteria. The environment must value and foster basic science that can be translated into new treatments. It must encourage scientists to creatively pursue quality science beyond chasing grant funding and publication numbers. And it must be strategically constructed of talented neuroscientists with complementary research interests and technical expertise capable of working closely as an interactive team.
It’s no accident that this is precisely the kind of research environment that exists in the college’s biomedical sciences department, currently comprised of a dozen neuroscientists. Dr. Peter Lake, medical director of Rogers Memorial Hospital and board-certified psychiatrist, calls the Marquette model “inspirational to all of us on the front lines who help patients and families in their daily battle with mental illness and psychiatric disorders.”
“When we talk about depression and other related illnesses, we are talking about conditions that have a neurobiological origin,” Mantsch says. “We often think of depression as a single entity, when it is likely a collection of conditions with common symptoms, each of which has a slightly different neurobiological distinction. It’s not surprising then that there’s so much variability in the severity of the disease and how differently patients respond to available treatments.”
The Kublys’ gift will directly address treatment development by bolstering the college’s research infrastructure by providing new tools to help answer research questions that couldn’t be asked because of technological constraints. The gift also will fund the hiring of additional research faculty members while placing neuroscience researchers in the college at the leading edge of the depression and mental health research landscape.
Cullinan points to the strategic addition of faculty scientists as a major reason for progress. “The principal innovation here is the complementary approach. We believe a key to making progress in understanding mental illness is to simultaneously assess the brain’s motivational/reward system, its emotion-related circuitry, and the cognitive circuitries that guide executive function and impulse inhibition. Importantly, these three systems overlap significantly, and by focusing our efforts at their interface we hope to develop more effective biologically based treatment strategies,” he says.
To date, this innovative approach has resulted in several breakthroughs, including discovery of a novel mechanism controlling the release of the brain’s principal excitatory transmitter, glutamate, and the discovery and analysis of a novel brain protein that regulates re-uptake of monoamine
neurotransmitters like serotonin and norepinephrine.
“These discoveries and others made within the group have implications for development of new anti-depressant treatments and are proving to be important in understanding additional neuropsychiatric conditions such as addiction, PTSD and schizophrenia,” Cullinan says.
To help support depression research at Marquette, contact Kathleen Ludington at 414.288.1410 or visit marquette.edu/giveonline
