Mental illness is often a scary phrase. It’s thought of in association with the words “disorder,” “sick,” or even worse, “crazy.” People often say “it’s all in your head.” Meaning a mental health diagnosis is somehow different, or less than any other physical health problem anywhere else in your body. Like it’s somehow your fault how your brain works, but not your fault how your heart, lungs, or kidneys work.
It’s a taboo subject, and avoided at dinner parties at all costs. Yet it’s very common to ask people, kids even, if they’ve ever broken a bone. Then someone will regale everyone with a tale about the time they were goofing around and fell out of their tree fort, but showed up to school the next day and everyone signed their cast. We share when we have the flu like we’re talking about the weather. Yet if someone shares that they’re having a tough mental health day, the room falls silent. No one knows what to say. Which is quite funny when you think about it. Because we all have mental health. Everyone has a brain, so everyone has mental health. So maybe it’s far past time to start calling it “brain health,” or at least acting like it’s no different than physical health.
Let’s take a look at schizophrenia…
We don’t really know exactly what causes it, but we do know it’s a neurodevelopmental disorder. This means there is something not working like it usually does in terms of brain development and neural connectivity. The Wnt signaling pathway is one of the key pathways associated with brain development, and has been found to play a role in schizophrenia [1].
Wnt and GSK signaling in schizophrenia [1].In people without schizophrenia, there is not enough GSK to phosphorylate β-catenin, an essential transcription factor. This means there is enough β-catenin to make it to the nucleus of the cell where gene transcription takes place that is essential to development[1].
However, in people with schizophrenia, there is generally less Wnt signaling activity, and more GSK activity. This increases the phosphorylation of β-catenin, and there is not enough to make it to the nucleus for gene transcription. An important piece of development is impacted [2]. This is connected to the dopaminergic system, which is overactive in schizophrenia. Dopamine plays a role in increasing GSK, which in turn decreases β-catenin and the resulting gene transcription process[3].
This is where the treatments come in…
Antipsychotics are dopamine receptor antagonists, they reduce dopaminergic activity by targeting D2 receptors. This increases Akt, decreases GSK, and increases β-catenin [1].
Lithium starts by decreasing GSK, and increasing β-catenin [1].
Medications that target glutamate increase Akt, which decreases GSK, and increases β-catenin[1].
Genetics
Further evidence linking the Wnt pathway to schizophrenia is found in animal model genetic research. The DISC1 and Akt genes both reduce GSK activity, which results in the same pattern we’ve seen before [1].
↓ Wnt & ↑ DA
↓ Akt
↑ GSK
↓ β-catenin
↓ gene transcription
Brain Health
Not everyone has a brain health diagnosis, just like not everyone has a physical health diagnosis. But there are some days we have to stay home from school or work because we’re sick with a cold or the flu. Because we are having a bad physical health day. The same can be said about having a bad brain health day. Just like an increase in germs impacts physical health, an increase in stressors impacts brain health.
Artstract created by Hadlie Dahlseid
And some people do have a mental health, or brain health, diagnosis. Just like some people have a heart condition, asthma, or diabetes. Except with brain health, it’s treated like the person’s fault. Maybe we should look at the science that proves it’s “in your head” only in the literal sense. That proves it’s really all about your brain health, and not a moral failing or anything to do with the kind of person you are.
References
[1] Singh, K. (2013). An emerging role for Wnt and GSK3 signaling pathways in schizophrenia. Clinical Genetics, 83(6), 511–517. https://doi.org/10.1111/cge.12111
[2] Panaccione, I., Napoletano, F., Forte, A., Kotzalidis, G., Casale, A., Rapinesi, C., Brugnoli, C., Serata, D., Caccia, F., Cuomo, I., Ambrosi, E., Simonetti, A., Savoja, V., Chiara, L., Danese, E., Manfredi, G., Janiri, D., Motolese, M., Nicoletti, F., … Sani, G. (2013). Neurodevelopment in schizophrenia: The role of the Wnt Pathways. Current Neuropharmacology, 11(5), 535–558. https://doi.org/10.2174/1570159×113119990037
[3] Brisch, R., Saniotis, A., Wolf, R., Bielau, H., Bernstein, H.-G., Steiner, J., Bogerts, B., Braun, A. K., Jankowski, Z., Kumaritlake, J., Henneberg, M., & Gos, T. (2014). The role of dopamine in schizophrenia from a neurobiological and evolutionary perspective: Old Fashioned, but still in vogue. Frontiers in Psychiatry, 5(47). https://doi.org/10.3389/fpsyt.2014.00047
