Aug 05

“What can I do, it’s in my genes!” In recent years, this has become a standard explanation for many of the health problems we have to face in our lives. Indeed, there are few human diseases without scientific studies trying to pinpoint ‘genetical causes’ as the root. Consequently, there are efforts to find genetic roots of mental problems as well. But 150 years after Mendel (the ‘father of modern genetics’) had outlined his ‘Laws of Inheritance’, we have still to see significant therapies that could wipe out major human burdens like cancer, addictions, diabetes or violence by purely genetical means. This is not to say that genetic science doesn’t have potential; but all the other influential factors should not be forgotten.

One of the weirdest aspects of the notion that all things human are genetically predetermined is that it takes everyone completely out of the context of their environment. We might as well not put personal or societal energies into trying to improve ourselves or others, because it’s inevitable and unchangeable anyway… But in fact there is just a very small number of very rare diseases that are truly genetically determined. Most complex conditions like ADHD, schizophrenia, a tendency to violence or addiction might have a predisposition that has a genetic component, but a predisposition is not the same as a predetermination. Genes just seem to give us different ways of responding to our environment. Some of the childhood influences and the method of child rearing in turn also affect gene expression; they can actually turn on or off various genes to put us on a different developmental track which may suit the kind of world we’ve got to deal with.

For example, a study done in Montreal with suicide victims looked at autopsies of the brains of these people and it turned out that if a suicide victim had been abused as a child, the abuse actually caused a genetic change in the brain that was absent in the brains of people who had not been abused. That’s an epigenetic effect: an environmental impact that is capable to either activate or deactivate certain genes.

So, in adaptation to the famous quote of Shakespeare, “There are more things in heaven and earth than are dreamt of in our scientific world.” And there are more things we can do to change ourselves than we might imagine.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011)

Jun 29

You’re psychotic!‘ That’s supposed to be the ‘polite’ form of the phrase ‘You’re insane!’, used by some when they can’t explain the actions of a person.

In deeply nature-bound cultures, people whose behavior strongly deviated from what was perceived as ‘normal’, were treated by magicians and shamans. In the West, however, they were locked up in so-called ‘insane asylums’ where they often received cruel treatment. Only in the 1930s, psychiatrist Karl Birnbaum introduced a first definition of the medical term ‘psychosis’: according to his theory, biological roots defined the form of the disease, while its severity, beginning and course would be strongly influenced by psychological factors, so new ways of treatment were experimented with.

The importance of the factors involved in psychiatric diseases was subjected to historical changes: while the ‘mentally ill’ were considered as uncurable before psychiatry became a medical science, after Birnbaum and Freud, psychotherapy had its heyday. Currently, we are again in a phase with an emphasis on physical (neurological) theories and treatments. Sometimes, treatment is so focused on pharmacological prescriptions that even patients feel that ‘something is missing’. The most successfull concepts in modern therapy therefore involve a multi-strategic approach of pharmacological, psychotherapeutic and social therapeutic aid.

People experiencing psychosis or psychotic episodes may report hallucinations or delusional beliefs, and exhibit personality changes and confusion. Depending on its severity, this may be accompanied by unusual or bizarre behavior, as well as difficulty with social interaction and impairment in carrying out every day activities due to feelings of anxiety, irritation, moodiness, and passive or indifferent behavior.

As patients are often intimidated about having to fight mental problems or might perceive their own situation in a distorted way, it is essential that friends or relatives do their best to help them get a proper diagnosis and therapy. If treatment starts early, the chances of stabilization and returning to a balanced and stable life increase significantly.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)

Dec 11

For mental illness, pretty much the same rules apply as for the body: the sooner you treat it, the better the prognosis. Researchers at the Department of Psychiatry of the RUB clinic in Bochum, Germany developed a concept for early detection and treatment of schizophrenia that already “clicks” at the first signs of the disease. An early treatment of schizophrenia patients in preliminary stages of the disease also reduces the risk of the disorder turning chronic.

For early detection, delusional symptoms, fleeting hallucinations, cognitive flexibility and general intelligence are analyzed. But until recently, one important factor often remained unconsidered according to the researchers: ‘social cognition’. The ability to empathize with others and to process emotional stimuli is often significantly impaired in the early stages of schizophrenia, regardless of other symptoms. Accordingly, psychoeducative methods are often more effective for treatment that antipsychotic drugs. Imaging studies demonstrate that the brain areas responsible for social cognition also show reduced activity in schizophrenic patients. It is the first time such research has been done for patients in the early stages of psychoses.

Source: MedAustria, Ruhr-Universitätsklinik Bochum (

More on the topic: Literaturtipps zum Thema “Psychosen” (german language)