Depression & Genetics

Please note: I don’t often write about the technical side of my treatment because I know that it is a very personal thing and what works for one person may not work for another.  I do not want to appear to be endorsing a specific path for anyone else because I am not a medical professional by any means.  What I am sharing is not a recommendation for anyone else but rather my own personal experiences.  Please talk to your doctor before making any changes in your mental health routine.

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I have had a lifelong struggle with depression, anxiety and ptsd.  Not too long ago, I was asked to write a piece about when I first realized I was suffering from a mental illness.  I honestly just laughed because I cannot remember a time I have not.  Throughout the years, I have tried prescription medications on and off to help balance my moods and alleviate the symptoms.  Again and again, it felt like the doctors were playing whack a mole with my health, randomly trying different drugs in varying strengths and combinations until I was a drugged up mess.  I had pills to wake myself up, pills to drag me throughout the day and pills to put me to sleep.  Each time, I felt like I was becoming a mindless zombie.  Each time, I would take myself off the medications because I would rather endure all my pain than to lose myself completely.

When I recently reached out for help again, I was adamant about my stance on drugs.  I never again wanted to return to that state with horrible side effects and a comatose-type demeanor where every day blended into the next in a drug-induced stupor.  Looking over my medical history, my new doctor could find no rhyme or reason to my long list of past medications prescribed by others.  Instead of prescribing something purely on a hit or miss basis, he opted to send me out for genetic testing.

Apparently, there are genetic tests now that can determine which drugs your body will be able to metabolize based on your genes.  This test can also determine which medications are likely to cause side effects and even rank the severity from mild to moderate to severe.  When the test results came back, ironically the majority of the medications previous doctors have put me on were listed under moderate to severe side effects.  No matter how much they increased the dose, they were never going to help me because my body had always been unable to break them down.  My new doctor had done a full panel so now I knew what medications would and would not work in my body.

The most exciting result, however, was not among the medication listings, but on the cover of the packet itself.  According to the lab:

This individual is homozygous for the T allele of the C677T polymorphism in the MTHFR gene.  This genotype is associated with significantly reduced folic acid metabolism, significantly decreased serum folate levels, and significantly increased homocysteine levels.

In layman’s terms, it means I have a gene abnormality that makes my liver almost completely incapable of breaking down folic acid.  In normal, healthy livers, folic acid is broken down into a compound called L-methylfolate.  L-methylfolate is used by the brain to regulate the hormones associated with emotions.  Without that compound present in my brain, it would be near impossible to treat my depression and my own body was incapable of producing it in any meaningful quantity.

It turns out that genetic test was a godsend.  Normal lab tests would not pick this up.  A blood test would show the levels of folic acid in my blood and doctors would infer my levels must be fine, not realizing that my liver was incapable of processing it.  Only by looking at the genetic level could they see that my liver was not able to convert any of that folic acid into anything useful.

What makes this an even bigger deal is that a pharmaceutical company has found a way to break down folic acid into L-methylfolate and put it in pill form.  Getting what my brain needs and my body has never been able to provide will be as simple as having a prescription written.  I honestly felt excited.

My doctor was very clear that this is just a big first step, not a cure-all.  This prescription is by no means a panacea.  It, however, is a stepping stone.  It means that antidepressants will finally be able to work because the L-methylfolate will be able to help get them where they are needed.  It means that if my brain actually attempts to regulate my own moods, there is at least a very real possibility of success where previously there was absolutely none.

I took my first pill yesterday and admittedly felt a noticeable difference right out of the gate.  I had more energy and a greater sense of calm.  The depression is by no means gone or even diminished but the fact that I felt anything noteworthy at all on the very first day was enormous for me.  For the first time in a long time, I truthfully am hopeful when it comes to my medication.

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One thought on “Depression & Genetics

  1. Pingback: The New York State Appeals Process: Apparently Not Everyone Who The State Certifies To Prescribe Medication Is Considered ‘Educated Enough’ To Defend Their Patients’ Prescriptions During An Appeal | unlovable

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