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Advancing Mental Health by Reducing Stigma and Improving Treatment

08/09/2018 Author: Husseini K. Manji, M.D., Global Therapeutic Area Head for Neuroscience, Janssen
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Recently, the Centers for Disease Control and Prevention announced suicide rates in the U.S. increased by 25 percent over the last two decades, and more than half of those who died by the disease had not been diagnosed with a mental health condition. These new scientific findings bring data to what headlines tell us daily. More people are struggling with mental illnesses than we realize, and they include our mothers, fathers, brothers, sisters, friends and co-workers who have serious, often disabling illnesses.

The stigma around mental illness is still strong, and there is growing recognition that these diseases are growing in prevalence, sometimes, quite tragically, with fatal consequences. Biopharmaceutical researchers across the country are working to gain a greater understanding of the biological basis of the conditions that make up mental illness such as bipolar disorder, schizophrenia, severe depression and the circumstances that can lead to suicide.

 

While there is nothing more complex than the brain, we know more today about the biological mechanisms underlying disease than ever before. Today, we have more ability to intervene with different treatments, and we have new and different tools and technologies that make it possible to do things we would never have dreamt imaginable. A few examples include:

 

  • Induced Pluripotent Stem (iPS) cell discovery, which transforms skin cells or blood cells into different cell types in the body, allows us to research parts of the brain once thought impossible.
  • Advances in our understanding of synaptic and neural plasticity have continued to provide better ways to track how the brain processes information. Neuroplasticity describes how the brain continually regulates the strength of information processing in different synapses and circuits. This includes regulating thoughts, emotions, perceptions, learning and memory, in the short-term, medium-term and long-term.
  • Better neuroimaging technology helps increase our ability to pinpoint exactly where in the brain neuronal breakdown occurs. This allows us to better target treatments for patients.

Additionally, increased understanding of how the immune system regulates brain function, a biological research environment enriched by the digital technology revolution, and the promise of personalized treatment all sit at the cutting edge of progress today. This paradigm shift has opened up a new world of cell and gene therapies for neurodegenerative diseases including brain disorders, such as bipolar disorder and schizophrenia.

 

Today, rather than waiting until people are acutely ill, we are moving to a model of “predict and preempt.” Our research suggests that some illnesses such as schizophrenia and bipolar disorder include a prodromal period. In other words, patients will demonstrate symptoms before developing the full blown illness. There are reasons to believe that if we can intervene at the early stage, we have a real chance at changing a patient’s trajectory, just as we are trying to do in cancer, in pre-diabetes and heart disease. Additionally, relapse in these diseases is highly recurrent. When we can predict – and thus quickly treat or even ward off – a person’s relapse, we can have a much better outcome.

As we have seen with HIV, cancer, hepatitis and other diseases that now have far more treatment options compared to 30 years ago, the biggest impact on our ability to treat mental illness will come from research investment.

This investment will allow researchers, who are passionate and hopeful about their work, to continue to advance the science and make a real difference in the lives of millions of people. That dedicated work now allows doctors to treat the core symptoms of schizophrenia with just four injections a year and may soon bring advances for treatment-resistant depression and suicidality.

 

My team at Janssen and I take that promise with us to work every day. Our mission – to think up the next new thing, to persevere until we develop next breakthrough, to find the right treatments – is part of our commitment to move research from the laboratory into the real world. Mental illnesses are difficult illnesses, but with appropriate treatment, most people will see their conditions improve. As researchers, our goal is to help people get remarkably better so they can live their lives fully with every hope for the future.