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One of the difficulties for helping those with poor mental health is recognising the symptoms. The masterly masquerade artfully achieved by so many, means that the majority of us will not pause to question the pretence and we take the statement “I’m fine” at face value.

This week is Mental Health Awareness Week, and the Mental Health Foundation hopes to improve the wellbeing and mental health of Britain, after their survey revealed that the nation’s state of mental health is poor and appears to be deteriorating.

As the Foundation is investigating ways to prevent mental health and enhance society’s mental state, I thought I would investigate some of the research that has been recommended by our F1000Prime Faculty Members on the suggested influences and causes of mental illness, as well as possible treatments.

Moon phases

A review by James Murrough and colleagues published in Nature Reviews Drugs Discovery discusses the role of glutamate signaling in depression and progress made in the development of receptors that could act as antidepressants. It examines the safety and tolerability of glutatamate-targeting antidepressants, as well as the efficiency and dose-response relationship.

Faculty Member, John Lowe, from JL3Pharma LLC, said: “They conclude with several important questions about the potential for this type of approach in treating depression in the clinic. Overall, they provide a thorough review of this emerging area of treatment for depression.”

A link between bipolar mood cycles and lunar tidal cycles

Thomas Wehr, performed a longitudinal study using 17 patients with rapid cycling bipolar disorders  published in Molecular Psychiatry and suggests that there is a link between bipolar mood cycles and lunar tidal cycles, proposing that human behaviour, as has been observed in animals, is influenced by lunar cycles. Faculty Member, Charalambos Kyriacou, University of Leicester, was interested in the proposed correlations between the patients’ moods and various geophysical lunar cycles, such as the 14.8-day spring tide/neap tide, and the 206-day ‘supermoon’ cycles.

Kyriacou comments: “The results suggest that humans may be sensitive to changes in the gravitational pull of the moon with the 12.4-hour tidal cycle interacting with the 24-hour circadian oscillator to generate longer period switches between depression and mania.”

Transferring the blues

Research published in Journal of Psychiatric Research has proposed that our gut and its microbiota can influence our quality of mental health. A team of researchers from University College Cork, Ireland provide further evidence that depression could be caused by the gut’s microbiota and offer a new perspective.

The gut microbiota – mental health connection remains a challenge

Using a rat model, they found that depression was associated with a less rich and diverse gut microbiota. They also found that transplanting faecal microbiota from depressed patients to microbiota-depleted rats induced behavioural and physiological features characteristic of depression in the recipient rats. If the causal link can be proven, this could possibly be a route to explore for treatment and prevention of depression.

Peter Hozer, Medical University of Graz, Austria, from our Faculty explained: “The elucidation of causality and mechanisms in the gut microbiota – mental health connection remains a challenge. Microbiota disturbances have an impact on the gastrointestinal, immune and metabolic condition of the body, which all may indirectly impact on mental health. In a translational perspective, it will be important to find out which specific members or clusters of the gut microbial community are of relevance to mental health, information on which targeted therapeutic interventions could be built.

It’s complicated

I went to a yoga class the other night, and the teacher ended the session with “Depression is thinking about the past, anxiety is worrying about the future, so stay only in the present and that will bring you peace.” Although an ever so eloquent piece of advice, the audacious oversimplification troubled me, because unfortunately, it is not so easy, as was suggested, to determine the cause nor to ‘heal’ one’s mental wellbeing.

Complexity of the genetic architecture of major depression

The abundance of research shows that there is not a definable cause or influence, as shown by an analysis of the genetic architecture of major depressive disorder (MDD) in Han Chinese Women published in Jama Psychiatry. There has been limited success in identifying the genetic risks to estimate the heritability of MDD due to the difficulty in establishing the cause of the disorder. However, Faculty Member, Victor Reus of University of California, US, remains optimistic: “The results confirm the complexity of the genetic architecture of major depression, but they also provide a potential pathophysiologic pathway for more focused investigation.”

While researchers delve into our bodies and minds looking for answers and proposing new therapies or drug treatments to improve our quality of mental health, how many of us are actually fine, not just fine on the outside?