Archive for February, 2013

Silver Linings, epigenetics and our environment

Tuesday, February 26th, 2013

After watching ‘Silver Linings Playbook‘ based on a book with the same title (the movie received eight Academy Award nominations and Jennifer Lawrence got one Oscar for her amazing performance as Tiffany) I just figured: Whom can we call as a normal person? I think that to a level we are all screwed up in the mind. We all tweak our mind to live in society; we all have our little “OCDness” and bipolarity. ‘Silver Linings Playbook’ touches something that society prefers to keep in a safe; it is ugly to say that you or a family member has any kind of mental illness. However, the world today is somehow bipolar. We all need to handle a “wired” world and be successful in all tasks at work, at home, etc. We all are scrutinized by society in a daily basis.  Who can handle that? I really liked the way the director of the movie approached mental illness, showing how family support is very important and anybody can be happy (yes, it is a love story with a happy ending) even with lots of “ups” and “downs”. Well, the environment can play a significant role in metal illness such as schizophrenia, bipolar disorders and other mood disorders. In the movie, the character played by Bradley Cooper (also nominated for an Oscar) “Pat” would always have a nervous breakdown in stressful situations or when hearing a song that reminded him of bad experiences in his life. These are all “environmental triggers”, and medication can indeed help to keep these symptoms dormant. A recent essay by Elyn R. Saks in the NYTimes (see the article “Successful and Schizophrenic”) shows that anybody with mental disorders could be happy, married and successful. Elyn writes that when she was diagnosed with schizophrenia her prognosis was “grave” and she would never live independently, hold a job, find a loving partner, or get married. Well, guess what?! She is married now, holds a Ph.D. and is a successful tenured Law Professor at the University of Southern California. She has also written books about her illness. Of course in her essay she mentions that it was never easy, with lots of treatment and medication during the course of her life. Scientifically, two fields of study – epigenetics and how the environment affects genetic profiles – have been trying to understand and study people with mental illness; cases such as Elyn that somehow control her illness and also people that have very grave symptoms without a “normal” life. Epigenetics is a field that deals with how changes in our environment could modify our molecular profiles based on our lifestyle, what we eat, where we live, if we smoke or not, etc. Studies have been showing that genetic or epigenetic differences cause discordance between monozygotic twins as a clue to a molecular basis for mental disorders (for more details check the article by Kato et al Genetic or epigenetic difference causing discordance between monozygotic twins as a clue to molecular basis of mental disorders”). This study points that genetics is not enough to cause and/or maintain a “mental illness state”. Interestingly, the environment can modify our genetic profile in different ways, which is mainly through epigenetics – gene expression control and phenotypic changes in our brain cells. For bipolar disorders, for example, epigenetic mechanisms might be relevant to the pathophysiology based on several lines of evidence such as the relatively high degree of discordance in monozygotic twins, characteristic age at onset, parent-of-origin effects, and fluctuation of the disease course (see the article “Epigenetics and bipolar disorder: New opportunities and challenges”). Even though there are lots of complexity involved in understanding mental illness, since all of them are classified as complex diseases and have multiple factors involved, research from the last decade pointed towards epigenetic mechanisms and the environment as factors to explain the differences in the symptoms that people have during their lifetime. Coming back to the movie ‘Silver Linings Playbook’, it is clear that mental illness is a serious condition and can have extreme impacts in a person’s life, but it is not a death sentence or a way for society to exclude these individuals completely. The take home message of the movie is that everybody during their lives will have to deal with bad and good situations and the big difference is the attitude that these individuals will have towards these events. Thus, as “Pat” says in the movie, “this is what I believe to be true; you have to do everything you can, you have to work your hardest and if you stay positive, you have a shot at a silver lining…”I see silver linings and happiness as environmental triggers that could change anybody’s life in a good way. The truth is that we all want to have the big shot at a silver lining! (Image Source: Wired Magazine)