Genes, depression and the link to disease – Dr Nina Bailey

It’s a universal rule that when things get a little heavy in conversation, some one will always offer, at some point, to ‘put the kettle on’. In fact a ‘nice cup of tea’ has, for decades, been associated with healing, for making things better or just as an excuse to sit down and talk. In fact, ‘tea and talk’ is the theme for this year’s awareness of World Mental Health Day, an international event, held annually on 10th October. The event aims to bring general awareness to and about mental health issues, and this year’s focus surrounds the association between mental health disorders and chronic illness.

For those individuals suffering from depression, life itself is a daily onslaught of both emotional and physical challenges; ensuring that the right treatment is both sought and offered early is essential to the recovery process. A good GP is therefore central to ensuring that individuals receive the best, and most appropriate, mental health care possible. There is increasing recognition that pharmaceutical intervention is not necessarily the key to all treatments – diet, as well as alternative therapies, can be key players in recovery, and should therefore be openly discussed with patients. With more and more people actively seeking non-pharmaceutical treatments for their depression, it is reasonable to hope that a good, open-minded GP should be knowledgeable about the use of complementary and alternative therapies, not only to give their patients accurate and up-to-date information, but also to take into account the benefits of such treatments on other health areas.

Indeed, with depression comes an increased risk of a myriad of other health issues: metabolic syndrome, diabetes, cardiovascular disease and even early onset dementia, to name but a few. Interestingly, however, there is a common link between all of these illnesses, in the form of omega-3 fatty acids.

Long chain omega-3s, with particular reference to eicosapentaenoic acid (EPA), are integral to normal cell membrane structure and function; low levels of this important fatty acid are linked with many chronic diseases and inflammatory disorders, either through low dietary intake, or through an increase in utilisation, which is not then replaced. The direct intake of EPA, in order to retain a constant supply ready for utilisation within the body, is becoming increasingly recognised as a method of reducing the risk of developing depression, as well as a variety of chronic illnesses that occur with or without the associated depression.

As such, the effectiveness of EPA as an antidepressant, anti-inflammatory and chemo protective agent is rapidly gathering data. Key findings published recently in the Journal of Affective Disorders suggest that individuals who suffer from major depressive disorder are associated with central and peripheral deficits in omega-3 fatty acids, and that these deficits are, in part, due to a reduced capacity to endogenously synthesise these important fats because of genetic differences in the enzymes responsible for their manufacture. The consequences of these genetic differences could also reflect on the susceptibility to develop further health issues, against which long chain omega-3s play a major protective role. The author suggests that intervention with preformed long chain omega-3 offers a therapeutic method that bypasses potentially defective pathways1. Furthermore, these findings offer a possible explanation towards the therapeutic actions that are experienced by individuals who opt to use Vegepa known for its high EPA content, as an alternative to using common anti-depressant drugs.

McNamara RK, Liu Y.Reduced expression of fatty acid biosynthesis genes in the prefrontal cortex of patients with major depressive disorder. J Affect Disord. 2010 Sep 20. [Epub ahead of print]

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