Understanding Genetic Markers for Depression: A Medical Expert’s View

In recent years, significant strides have been made in uncovering the genetic underpinnings of mental health conditions like depression. While these breakthroughs offer fascinating insights, they don’t necessarily change the clinical approach to diagnosing or treating depression. Red Health spoke with two of our leading medical experts, Clinical Psychologist and Clinical Neuropsychologist Dr Simone Shaw and Clinical Psychologist Dr Grant Blake, to explore how these findings align with their practice.

Genetics and Depression: A Complex Relationship

Depression is far from a uniform experience. As Dr Simone Shaw points out, “Depression manifests differently in each person, with a complex interplay of biopsychosocial factors.” For some, it’s the cognitive challenges—like trouble concentrating—that dominate. For others, it may be the emotional toll, such as persistent sadness or irritability.

The research recently highlighted by The Conversation touches on genetic predispositions, but for our experts, this isn’t groundbreaking. While the presence of genetic markers for depression may be novel for some, Dr Shaw stresses that mental health professionals have long recognised the role of genetics, alongside environmental factors.

Epigenetics: A Bridge Between Genes and Environment

Dr Shaw explains that epigenetics—how environmental factors influence gene expression—sits at the heart of the biopsychosocial model. “Epigenetic modifications can affect how genes related to mental health are expressed,” she says. This explains why two people with similar genetic risk factors may experience very different mental health outcomes, depending on their life experiences.

From childhood adversity to ongoing stress, the environment shapes the brain’s response to challenges. And, importantly, these changes are modifiable, giving us hope for interventions that could alter a person’s mental health trajectory.

Clinical Implications: Does This Change Treatment?

Despite these genetic insights, Dr Grant Blake emphasises that this research does not alter how mental health professionals diagnose or treat depression. “It is not standard practice to genetically test patients,” says Dr Blake. “While these findings support existing models of depression, they don’t shift the clinical process.”

Instead, he continues to use a comprehensive evaluation of a patient’s thoughts, behaviours, and emotional reactions. “The findings reinforce that depression is about more than genetics. It’s how someone thinks, feels, and interacts with the world around them,” says Dr Blake.

Looking Ahead: Where Does This Research Take Us?

While genetic markers for depression offer a new layer of understanding, it’s clear that clinicians continue to rely on a broader picture. Dr Shaw and Dr Blake agree that the future of mental health treatment will likely involve more personalised care. This includes considering genetic, psychological, and social factors to provide the most effective interventions.

As research continues, one thing remains clear: depression is a multifaceted condition that requires a nuanced approach. Genetic markers may help explain predispositions, but the environment, personal experiences, and the support we receive are equally crucial in shaping mental health outcomes.

Check out the full article on The Conversation.

What Does Red Health Think?

We spoke to Vanessa Herrmann, Red Health CEO, and Mark Hayes, Red Health QA Manager, for their thoughts on the research and how it might change how they work in the medico-legal industry.

Mark Hayes on Genetic Markers for Mental Health

Q: Does this information change your department’s usual advice?

MH: “No, not really. In most law/compensation arenas, there’s a requirement to “take the person as they were” when determining causation.  Predisposition (either genetic or socioeconomic) is largely removed from the equation, because a predisposition doesn’t fatalistically determine an outcome.  For example, I have a predisposition to diabetes based on genetic risk, but I’m not diabetic.  There are other people that have a genetic predisposition to depression, but don’t ever experience it – this might be due to overriding socioeconomic protection, or any number of other reasons.

Further, ongoing treatment of psychological conditions is generally adaptive, in that the first treatment performed rarely provides for total cessation of symptoms. Treatments are normally titrated/increased/changed based on the results of the individual. Because the Medical Expert providing an IME doesn’t have the ongoing treatment relationship with the Examinee, the Medical Expert can only provide more common and generalised treatment recommendations, with the understanding that at all times, the treating practitioner should be responsible for adapting treatment regimes if/as required.”

Q: Is this common knowledge in the legal industry?

MH: “Not really, but there isn’t a strong need for it to be.”

Q: What outcomes could arise from this information?

MH: “In the short term, I don’t foresee any real change here.  As this field of study progresses and more information is readily available, and in combination with increased genetic marker testing, there may be precedent set where a predisposition has an impact on the eligibility for compensation of an individual, but I think this will be some time away, and opens a big can of worms in terms of employability of an individual in general. To me it creates a slippery slope where genetic testing could eventually be used for exclusion – i.e you have a predisposition to XX, therefore you can’t be employed as YY.”

Mark’s final thoughts

“A fascinating read, but there’s not enough concrete evidence yet to drive meaningful change.”

Vanessa Herrmann on Genetic Markers for Mental Health

Q: Does this information change your department’s usual advice?

VH: “No, the insights from the article reinforce the biopsychosocial approach, which is adopted by our medical experts, who are both clinically active and aligned with up-to-date guidelines. As appropriate to their speciality, they consider a comprehensive range of factors when forming their independent medical opinions – which may include genetic predispositions.”

Q: Is this common knowledge in the legal industry?

VH: “In my opinion and experience, the biopsychosocial model is well understood in the legal industry. However, the role of genetics, particularly given the recent changes to life insurance and TPD policies, is less familiar. The recent ban on insurers using genetic tests for risk assessments highlights a growing awareness of genetic factors (Life insurers banned from using genetic tests to deny cover or hike premiums – ABC News). As always, the medico-legal industry will adapt, especially once key players like insurers and government bodies begin integrating such advancements into their practices.”

Q: What outcomes could arise from this information?

VH: “While genetic testing isn’t currently a regular feature in our assessments, the insurance ban example illustrates how genetics may gradually become more relevant. We may see clients increasingly ask for our medical experts to comment on the role of pre-existing genetic factors. However, widespread integration of genetic testing into medico-legal contexts will take time and not one that I predict anytime soon.”

Vanessa’s Final Thoughts

The legislative changes around genetic testing and insurance offer a glimpse of how external shifts can impact our industry. Although genetics is not central to our current evaluations, this may evolve as more clients recognise its relevance in TPD and personal injury claims. Red Health remains committed to staying ahead of these discussions, ensuring our medical experts provide independent, up-to-date assessments grounded in medical and legal standards.

In my opinion, individuals should not be discouraged from genetic testing, as it serves as a crucial tool for early risk identification. Unfortunately, we see a similar issue in mental health, where seeking professional support is often met with stigma, implying something is wrong, rather than viewing it as part of a proactive wellness routine. If people could visit a mental health professional regularly without fear of judgment or repercussions, the benefits would be immense. From reducing chronic illness, suicide rates, and reliance on prescription medications to easing pressure on the healthcare system, lowering crime, and improving overall well-being, the positive impact is far-reaching.

Similarly, genetic testing can empower individuals to take preventive action, such as those carrying the BRCA gene, who are more likely to undergo screening and catch potential issues early. This benefits not only the individual through better health outcomes but also insurers by reducing the long-term costs of treating advanced illnesses. The potential upside of genetic testing is clear, both for healthcare and the insurance industry.

Dr Grant Blake’s CV Extract

This is a short extract, correct as of 6/10/2024. For Dr Grant Blake’s full CV, please contact us.

Dr Simone Shaw’s CV Extract

This is a short extract, correct as of 6/10/2024. For Dr Simone Shaw’s full CV, please contact us.

Article updated 10 Jan 2025