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A Gene Link to Depression? - An Examination - by M. Bowden

THE RESEARCH

Recent research (Science 18 July 2003) [1] has found a link between a gene (5-HTTPLPR) and a tendency to depression. New Scientist [26 July 2003 p.15] referred to this article and it was reviewed in newspapers [2]. Based on such reviews, there was a general impression that at long last a definite link between genes and depression had been found, and one Christian organisation concluded that we "mustn't simply tell them to pull themselves together." This certainly reflects the general consensus of opinion regarding this research.

The article reports on tests carried out on 845 people, all aged about 26, who were divided into three groups. The gene, which affects serotonin reuptake at brain synapses, has two forms, short and long and as it is duplicated, a person may have two short versions [SS], a long and short [SL] or two long versions [LL]. There were 146 with SS, 435 SL and 264 LL. They were then assessed for how they reacted to 1, 2, 3 or 4+ "stressful life events that involved threat, loss, humiliation or defeat.." that can cause depression and/or suicide - both considered and attempted - between the ages of 21 and 26. It was claimed that there was a correlation between those with SS and a higher incidence of depression/suicide compared to those with LL.

One can almost hear the sigh of relief from those with depression at this confirmation of what they have been told by their specialists; that they are depressed because they are "ill" due to a medical condition. That medical cause has now been found - a genetic defect over which they obviously have no control. Clearly, they cannot be held responsible for their unfortunate state and that drugs should be prescribed to correct this condition and alleviate their suffering to a bearable level.

But are these opinions, based as they so often are on second and even third hand reviews, really supported by the original research?

I have read many papers and comments, by both Christians and non-Christians, often based not upon the original article but upon reviews written by a selective secular commentator, that seem to contradict certain basic principles in the Bible. Even before I have read the original article, I can virtually guarantee that there will be one or more little publicised yet fundamental flaws or features in it that have been carefully filtered out before they reach the general public.

This article is yet another.

Although the biblical approach to depression is the most important aspect of any discussion [3], we will examine this after we have dealt with the scientific/medical aspects raised by this article.

THE EXAMINATION

The first thing that strikes the reader of the article is the cautious terms used by the writers. They consistently refer to the gene as "moderating" the reaction to events that cause depression, not "controlling"; i.e. it has some effect but is not a fully controlling factor. They also say "Much genetic research has been guided by the assumption that genes cause diseases, but the expectation that direct paths will be found from gene to disease has not proven fruitful for complex psychiatric disorders... to date, few linkage studies detect genes, many candidate gene studies fail consistent replication, and genes that replicate account for little variation in the phenotype. IF [emphasis MB] replicated, our G x E [Genes and Environment] findings will have implications for improving research in psychiatric genetics." In other words, no proven links have been found between genes and non-organic "mental illnesses", any links found have been minor and even their research should be replicated before it is relied upon.

It is when their figures 1A, B, C, D and 2 are examined that some strange features can be seen. If having SS makes a person noticeably more prone to depression etc. then one would expect to see at all numbers of stressfull events the SS always having a greater reaction than for a person with LL, but this is not the case. Every chart in Fig. 1 shows the LL having a greater reaction at lower incidence of stress - the lines cross over near 1 incident of stress (or 2.3 in 1C). Therefore, the SS factor does NOT correlate at these low levels. The most glaring example is 1C, where with NO events, 2.9% of LL were "suicidal" compared with only 0.5% of SS! At one event, 3.2% of LL were suicidal compared with 1% of SS, and even at 2 events, LL were 3.8% whilst SS were 2.9%.

Thus, at low event levels, THE CORRELATION IS REVERSED. Why should there be such a reversal? This is surely unexpected and should have been carefully considered by the researchers, yet this important paper completely ignores this result. Was it because it would have upset the nice, tidy clear-cut correlation between genes and depression that they were wanting to promote?

Let us face it, psychiatrists have been searching long and hard for such a connection that links "mental illnesses" with any evidence that can shift the responsibility from their clients to some factor in life over which they have no control. Have they (and commentators) highlighted only that part of the research that supports this link and deliberately ignored that which contradicts it? It would not be the first paper that has received such treatment.

ONLY PARTIAL CORRELATION

Another major feature of the article is the large percentage that do NOT have a reaction at all the event numbers - even the highest of 4+. Consider 1B; 40% of SS became seriously depressed, and 20% of LL. Thus having the SS, doubled your chances of becoming depressed. BUT, if only 40% became depressed, why did the remaining 60% NOT have any major depression? Here again, the correlation is far from being as clear cut as the researchers - and commentators even more so - might have preferred to see.

Fig. 2 also provides some interesting information. 30% of LL would have a major depression, whatever maltreatment they may have experienced as a child. So, in their case, maltreatment had absolutely no effect upon them regarding any depressive events. This is interesting because the statistic often bandied around is that 60% of those who had a deprived childhood finish up on drugs, become criminals etc. But the question that remains is why did the other 40% not also follow the same path? This particular genetic factor which gives 63% reacting to severe maltreatment raises the question of why the other 37% did NOT react. Did they exert more self control?

HOW THESE RESULTS ARE "USED"

There is an additional aspect of being classified as "mentally ill" that is rarely referred to in our present society. Theodore Dalrymple worked in a British slum and a local prison and in his "Life at the Bottom" [See Ref. 4] he gives a penetrating description of people's attitudes and motivations. His conclusions from what he saw is best summarised in his introduction in which he says that people consistently blamed their circumstances for their problems that "plainly serve an exculpatory function and therefore of personal responsibility [MB emphasis].... I have come to see the uncovering of this dishonesty and self-deception as an essential part of my work.... Nevertheless, patterns of behaviour emerge - in the case of the underclass, almost entirely self-destructive ones."

A friend has also related incidents where young work-shy people "play the system" by adopting the very behaviour that their psychiatrists expect of them, and then boasting how easy they can fool the experts by acting in a bizarre manner just before they are due for another "assessment" meeting.

It does not take much imagination to look at life through the eyes of someone classed as a severe case of depression or other "mental illness". He is excused working for his living and is paid sufficient for a reasonable lifestyle. As anger is a known component of depression, what are his reactions likely to be when faced with the view that his depression in mainly of his own making, and that he should find work to feed and support himself [2 Thess. 3:10]?

Thus, our present society encourages the blaming of depression and other similar "illnesses" upon external factors. Indeed, it is in the interest of both the patient and his professional advisor to maintain this situation; both gain so much from it that any intrusion will be vigorously resisted.

This is not to say that depressives are deliberately feigning their symptoms, but they do not realise that they are the result of introverted self-centred thinking that blocks out real concern for others that the Bible calls us to [3].

This article will be acclaimed as at long last providing the "scientific" evidence to support their point of view. That it does not provide any such concrete evidence, only tells us what we already knew and leaves major questions unanswered will be completely ignored. Some commentators however, have, like this author, also noted that the link is not strong, and that this research will provide an excuse for bad behaviour [2].

THE CHRISTIAN VIEW

How, then, should the evangelical Christian handle these results from a biblical point of view?

It is beyond dispute that we are all born with widely differing personalities. Some are strong and bold, others are weak and timid. However, when we study the Bible, we find that all these differences in personality ARE NEVER REFERRED TO. All the instructions, both in the OT and NT are stressing the fact that the people of God MUST behave in a mature, blameless and godly fashion. No other level of conduct is permitted, and indeed Christ stipulated "Be ye perfect, as your heavenly Father is perfect." [Matt. 5:48]. He does not exonerate anyone from this by adding ".. provided your genes are suitable for such a standard."

No allowance is ever made for those who are timid, and Paul encourages the young Timothy by saying "For God has not given us a spirit of fear, but of power and of love and of a sound mind." [2 Tim. 1:7]. The Bible and particularly the establishment of the church are for making us all "fully mature Christians" as given in Eph. 4:11-16.

This is not to treat the naturally timid harshly, but to point them to that full Christian life that can only be enjoyed when all our faculties are usefully employed in the service of God and others, and not hoarded for fear that they may be wounded by those who oppose them.

Similarly, those who are strong are not to ride roughshod over the feelings of others.

It is the Christian's constant challenge to hold all things in the right balance.

Malcolm Bowden.

September 2003.

REFERENCES

[1] Caspi, A. et al. "Influence of Life Stress on Depression: Moderation by a Polymorphism in the 5-HTT Gene" Science v302 p386-389 18 July 2003.

[2] McFadden, Johnjoe "The Long and short of depression" The Guardian. McFadden is professor or molecular genetics at the university of Surrey.

[3] Law, Rev. Dr. R.J.K and Bowden, M. "Breakdowns are good for you" Sovereign Publications, Box 88, Bromley BR2 9PF. This deals with counselling from a purely biblical perspective.

[4] Dalrymple, T. "Life at the Bottom: The Worldview that makes the Underclass." Pub; Ivan R. Dee Chicago 2001. This book is one of the most eye-opening I have read for many years, and should be read by everyone interested in social work of any nature. It can be ordered from Waterman's (who have to get it from America) for about £15. It is well worth it. It exposes the working of the Welfare State, police and social services that are geared to maintaining such people in their present appalling situation. No wonder it was published in America!


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