Everyone experiences periods of heightened emotions: stress, anger, fear or even grief. It is a natural human response. Typically, these feelings are temporary. But, what if those feelings simply won’t go away?
“It is completely natural to be sad due to the death of a loved one,” said D. Isum Ward, M.D., a medical geneticist at Sanford Health. “But that feeling should resolve on its own over time. Yet, sometimes, for some patients, it doesn’t. It can persist, consuming all aspects of life — from motivation to mood and passions.
“Understanding psychiatric disease is a huge health care need for our population, but it is also an area of genetics where a lot is still unknown. Genetics has helped reveal the cause of thousands of hereditary conditions, but we still don’t know the exact cause of many psychiatric conditions.”
Family history and brain chemistry
While psychiatric diseases do tend to run in families, there is not always a single identifiable genetic change occurring. And for many conditions, there can be multiple factors, such as family history, genetics, lifestyle, brain chemistry and environmental exposures, that together result in a psychiatric condition.
“Some individuals have portions of the brain that are not functioning correctly, and those portions are the areas typically causing psychiatric diseases,” he said.
While many physician specialties look at a patient’s many symptoms and attribute them to one diagnosis to identify the problem, medical genetics is different. It explores all of the potential causes of the symptoms to try to identify the individual underlying cause or causes.
“When patients come to see me, I am trying to look at why those feelings are happening, how those feelings are affecting them and what is happening in the brain that is causing, aiding or adding to the issue,” Dr. Ward said.
How genetics helps patients
To make it more complicated, there are up to 7,000 known genetic conditions, and many can have the same or similar symptoms. Psychiatric conditions are especially challenging to identify and diagnose because the doctor is most frequently relying on the patients to describe what they are feeling.
“It can be difficult to align a patient’s described symptom or symptoms with a known physiological disorder,” Dr. Ward said. “If someone tells you they cannot move their arm, you can test that. However, if someone has an unusual thought, there is no way to test that. There is no screening, scan or blood test to confirm what is going on in the brain.”
When new patients come into the clinic, they will first meet with the genetic counselor to complete a family history. Then, the medical geneticist meets with them for a medical exam and patient interview.
“Because I work in precision medicine, I can take the time to get to know my patients, better understand the cause of their problem, and use that knowledge to improve their treatment options and hopefully quality of life,” Dr. Ward said.
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