More than two-thirds of Australian study participants have had to rely upon multiple antidepressants to treat their clinical depression – a trial and error approach that remains a major challenge in delivering more effective mental health care. 

This interim data from the Australian Genetics of Depression Study – the world’s largest genetic investigation into clinical depression – published in MJA InSight today (August 21, 2017), reveals we’ve reached the limit of our current knowledge of treating clinical depression, and require far more personalised, and targeted approaches to optimise outcomes.

Research author, Study Co-Investigator and Co-Director for Health and Policy, Brain and Mind Centre, The University of Sydney, Prof Ian Hickie AM, is joining forces with fellow researchers, study participants and high profile Australian mental health advocates today, including Osher Günsberg, Dan Hunt, Julie McDonald and Mitch Wallis, to call for the enrolment of another 10,000 adults into the groundbreaking Australian Genetics of Depression Study.

“We require a total of 20,000 Australian study volunteers aged 18 and over, who are undergoing, or have been treated for clinical depression,” said Prof Hickie.

“In just over three months, we’ve enrolled 10,000 Australians into our transformative study.1 This remarkable response demonstrates the general public’s willingness to partner with the research community, through the sharing of personal experiences digitally, to advance scientific understanding into clinical depression.

“Now we urgently need another 10,000 volunteers to help us crack the genetic code of our nation’s third most burdensome disease,” Prof Hickie said.

One in seven Australians will experience clinical depression during their lifetime.3 The mental illness represents the top cause of non-fatal disability in Australia.4 Moreover, our nation has one of the highest antidepressant prescribing rates per head of all OECD countries – behaviour that delivers considerable benefits, but also forces many people to contend with ongoing, disabling and potentially life-threatening medication-related side-effects.

“Our interim data reveals better targeting of existing treatments through individual genetic profiling before commencing medication, would drive a major advance in clinical therapy.

“Given our lack of diagnostic methods to predict different responses to antidepressants, or forecast the potential for intolerable side-effects, we are exposing those battling clinical depression, to trial and error, which is often slow to deliver significant benefits,”1 said Prof Hickie.

“To date, we have failed to move effectively from the general principles of treating clinical depression, to much more personalised and targeted approaches that minimise risk to maximise benefit.”

TV and radio personality and Director of SANE Australia, Osher Günsberg, Sydney, is no stranger to mental illness. He battles social anxiety, Obsessive Compulsive Disorder (OCD), has lived with Post Traumatic Stress Disorder (PTSD), and harbours a family history of mental illness. Over time, Osher’s doctors have worked hard to fine-tune his medication, so that the benefits outweigh the associated side-effects.

“It took quite a long time, meeting with lots of different doctors, and trialling multiple different medications and listening to different hypotheses about my illness, before we found a treatment that worked for me.

“I’ve tried life without being on medication for my mental illness, but it didn’t work for me,” Osher said.

Osher is continuing his road to recovery today and supporting the Australian Genetics of Depression Study to help researchers “identify ways to better treat people living with clinical depression individually, to more finely-tune the treatment possibilities, and to give people a chance to act before things get out of hand.”           

Genetics is key to solving clinical depression, according to geneticist, Lead Study Investigator, and Head of the Genetic Epidemiology Laboratory, QIMR Berghofer Medical Research Institute, Prof Nick Martin, Brisbane.                                                  

“The link between genetics and clinical depression is very clear. Approximately 20,000 genes make up the human genome.5 Alterations in some genes cause clinical depression. But right now, we don’t know what they are. What we do know, however, is how to find them. We just need a large enough study, performed the right way, to identify them,” said Prof Martin.

“Our groundbreaking research should allow us to identify between 50-to-100 genes that influence a person’s risk of developing clinical depression. Only then, through cracking the genetic code of clinical depression, will we be able to develop new, and more effective, personalised treatments that target the problem directly.”

The interim study data also revealed the overwhelming majority of respondents taking antidepressants discussed their mental health problems with friends (90 per cent) and family (86 per cent).1 This is an important finding, for many of the risks associated with clinical depression, and the sense of isolation that ensues, can be reduced by sharing this information with trusted others. Open discussion however, did not always fix the problem, as dialogue with family members and friends was reportedly unhelpful, in 20 per cent, and 10 per cent of cases, respectively.

Fitness model, health and lifestyle coach, Jane, 50, Sydney, battled clinical depression for years, and on two occasions, attempted suicide. She attributes her mental illness to an “unhappy childhood” and the insecurity she felt in failing to live up to her parents’, and society’s expectations, of being a blonde, slim, attractive woman. Her turning point came in 2013, when, at 46 years of age, she decided to compete as a fitness model.

“Bodybuilding literally saved my life. Having been clinically depressed for my 30th, and beyond depressed for my 40th, I was determined my 50th would be symbolic of my journey toward recovery.

“I’m sure it’s not for everyone, but for me, fitness and the disciplined lifestyle was such a positive and affirming environment,” Jane said.

Today, Jane is participating in the Australian Genetics of Depression Study and genuinely hopes her contribution will allow experts to unravel more answers to help combat depression.

“This study is necessary, particularly for young people. I wish I’d had a school curriculum to deal with real-life situations, such as divorce, death, heartbreak, and was armed with a tool box of mental health techniques to help deal with, and move past, these difficult life events,” said Jane.                                           

Participating in the Australian Genetics of Depression Study is simple and free. Volunteers complete a 15 minute online survey, and, depending upon their responses, may be asked to donate a saliva sample. Study researchers will then analyse the saliva (DNA) samples to investigate and pinpoint specific genes that may be associated with clinical depression.

To volunteer for the Australian Genetics of Depression Study, or to learn more:
Head to: www.geneticsofdepression.org.au
Email: gendep@qimrberghofer.edu.au

The Australian Genetics of Depression Study is being conducted internationally, with 200,000 participant samples required. Australia is aiming to contribute 10 per cent of the total study population.

About QIMR Berghofer Medical Research Institute (QIMR Berghofer)
QIMR Berghofer is a world-leading, translational research institute specialising in cancer, infectious diseases, mental health and a range of complex diseases. Working in close collaboration with clinicians and other research institutes, QIMR Berghofer aims to improve health by developing new diagnostics, better treatments and prevention strategies.                

For more information, head to www.qimrberghofer.edu.au. QIMR Berghofer recognises the NHMRC (National Health and Medical Research Council) for its involvement in funding this research study.