Brain Disease Editorial by Rep. Myrick

About twice as many people kill themselves each year than die from AIDS in the United States.  But to look around, you wouldn’t know it.  We don’t like to talk about that.  It’s painful and embarrassing for family and friends to discuss suicide.  It’s not easy to explain, and most of us just can’t understand why people with so much potential can abandon all hope for the future. 

At least 90% of people who commit suicide have a diagnosable mental illness.  The stigma of severe mental illness is such that we don’t even realize how many people in our social groups, families, and workplaces struggle with diseases that most of us can’t understand.  These aren’t conditions where people can pull themselves up by the bootstraps and get better.  Diseases like bipolar disorder, schizophrenia, and major depression are biologically legitimate illnesses—research shows this time and time again. Severe mental illnesses aren’t about personality defects.  They’re about underlying biological ailments.  Schizophrenics don’t choose to have hallucinations, just as arthritics don’t choose to struggle with chronic pain. 

Brain disease is the ‘new’ cancer.  Decades ago, we didn’t all talk about how we had cancer.  We didn’t publicly discuss getting mammograms, preventing colon cancer, and enduring chemotherapy.  It used to be embarrassing.  People worried about what would happen to their job, or their image, if they spoke openly about what was perceived as a weakness.  Too often, a cancer diagnosis was basically a death sentence.  It was caught too late, and medical advances that would have helped were too far away.  Even so, countless cancers that could have been detected and removed were allowed to metastasize because people didn’t know or didn’t want to know that they were sick.

Severe bipolar disorder, major depression, or similarly disabling conditions can be just as lethal as cancer.  Sometimes even more so.  The stigma surrounding brain disease might be somewhat more difficult to eliminate, because these illnesses are just plain complicated.  When we discuss mental illness anecdotally, we tend to forget that the brain is an organ of the body that can be prohibited from functioning properly—just like the heart, or the kidneys, or the lungs.  With Parkinson’s disease, Alzheimer’s, and ALS, we all acknowledge that they’re biological, neurological diseases.  They affect a particular part of the brain, and we can easily recognize physical manifestations.  Mental illnesses affect a person’s behavior, productivity, personality, mood, and actions—and we can’t explain why or how they developed.

There’s no doubt that environmental factors can affect the onset of disease symptoms and the severity of an individual’s illness.  A recent study supported by the National Institute of Mental Health found that the children of severely depressed mothers were 11% less likely to develop depression if their moms were effectively treated.  We can’t separate the biological basis of these illnesses from the landscape where they occur. 

But there’s hope.  Despite denial and resistance to treatment, there are ways to get help.  When it comes to brain diseases, we don’t have the full picture yet.  We don’t know exactly how specific genes interact to produce the conditions that we call schizophrenia and bipolar disorder.  But scientists are closer than they’ve ever been.  In January, an Australian scientist identified a gene that may cause 10 percent of bipolar cases.  In March, NIMH-supported scientists found that a person’s response to anti-depressant medication depends on the version of a gene that the patient inherits.  The next month, a new report was released detailing a schizophrenia-linked gene, and how it affects the brain.  In May, a study was published indicating that severe bipolar disorder in children may stem from impaired development of certain emotion-related brain circuits. 

At a hearing of House Energy and Commerce Committee’s Subcommittee on Health, Dr. Thomas Insel of the NIMH spoke to the fact that some of the most promising studies on the biology of mental illness have been released in the last nine to twelve months.  We’re a long way from a reliable, widespread screening test, or a ‘cure’ for mental illness.  But we’re on the cusp of great discoveries that are bound to have a ripple effect in other medical fields. 

Already, greatly improved treatments are widely available.  Millions of people have found medicines and therapies that help tremendously.  Medicine doesn’t cure major depression, but it manages the disease.  Just like many of us live with arthritis and diabetes, greater numbers of Americans can live with mental illness as medical research finds more answers.  In fact, it’s estimated that 70 to 90 percent of those with serious mental illnesses can be treated successfully.  Raising awareness is step number one. 

As it is with most issues, my husband and I didn’t focus on brain disease awareness until our granddaughter began struggling with bipolar disorder over a decade ago.  The impact on a patient’s family is tremendous, and finding a successful, consistent treatment is often harder than it seems.  We’re so proud of her for being willing to speak about her disease, and I hope that as a society, we continue to encourage the courageous folks who address the issue publicly.  These are real diseases that deserve our attention.

Myrick Opening Statement-- Energy and Commerce Health Subcommittee Hearing on Mental Health

(June 28, 2007)

Thank you Mr. Chairman, and thank you for giving me the opportunity to suggest that we hold this hearing today.  And thanks to all of our distinguished panelists for taking the time to be here.  My personal goal with this hearing is to bring Mental Illness out of the shadows, and emphasize that conceptually, these are really “Brain Diseases”—conditions that are biological, diagnosable, and treatable.  Though the title of this hearing describes Mental Illness AND Brain Disease, I want to emphasize that they’re really one and the same. 

Yesterday, after an article about this hearing appeared in our local paper, I was encouraged by the number of people who approached me at the airport and on the plane, to say thanks for being open and bringing awareness to the issue.  That confirms to me how widespread the problem is.

For today’s hearing, we decided to focus on three diagnoses that fall under the “Severe Mental Illness” category—Major Depression, Bipolar Disorder, and Schizophrenia.  These are some of the most serious mental illnesses.  Acknowledging these diseases is good for society as a whole—and not just for the individual patient or parent. 

Awareness provides a clearer path to treatment, and lessens the personal and societal “cost” of the disease.  That’s why all of us on this Subcommittee support various awareness hearings and programs for diabetes, breast cancer, arthritis, chronic pain, Alzheimer’s, and everything else.

If you think about it, it wasn’t that long ago when no one wanted to tell their colleagues, friends, and even family members that they had cancer.  Twenty to thirty years ago, people just didn’t talk about it.  It’s hard to remember that now, when we have walks, and screenings, and posters everywhere telling people to be proactive about their care. 

When I revealed publicly that I had breast cancer back in 2000, close friends and colleagues whom I’d known for years told me for the FIRST TIME that they’d battled cancer.  But it was common for them to keep it quiet-- for fear of losing their job, fear that others would think less of them, and for a host of other reasons I’m sure.  There was a stigma attached to cancer.

That’s where we are with brain disease now.  People don’t want to talk about it because they’re scared.  And oftentimes, they’re not sure that there’s a solution.  Well, there ARE ways to live with these diseases, and I hope that will be made clear today and in the future.

Although research continues to progress, and more public figures speak out about depression, bipolar disorder, and even schizophrenia-- it seems we have a long way to go.  As with so many diseases, I didn’t become personally involved until our granddaughter started suffering from severe bipolar disorder about 13 years ago.  It took several years to get a diagnosis.

This disease doesn’t just affect the patient.  It involves the entire family and beyond.  It’s a serious illness that’s difficult for many to discuss, and often much harder to resolve.  To this day, her diagnosis affects the daily life of our family.  My husband and I have spent countless hours worrying about her, reasoning with her, and doing our best to get her the best kind of treatment that she’ll accept.  As a lot of you probably know, it’s not easy. 

These are literally life threatening illnesses that deserve our attention.  As our panelists will show, suicide is an all too common risk that’s closely associated with conditions like bipolar disorder, depression, and schizophrenia.  And it’s a problem that has touched each of our lives at some point, because it’s widespread—In 2001, more Americans killed themselves than died of HIV and AIDS.  And while women struggle with depression in higher numbers than men, men are four times more likely to commit suicide.  We need to help Americans get at the root of this problem-- and so often that root is brain disease.

With the progress we’ve made in research, there’s no call for hopelessness.  We’re better at diagnosing, treating, and helping people recover from these illnesses than we’ve ever been.  We can see changes in the brain more clearly than ever before.  The experts in this field are making dramatic findings about how gene mutations and proteins contribute to brain disease.  We’ve got a long way to go, but there’s a lot for us to be hopeful about. 

I’m very glad to have our two panels here this morning, and I thank the Committee for holding this important hearing.