John Greden, MD
“What excites me most about working in the field of depression is the belief that we can make a difference, and that we are making a difference.”
For many, John Greden is the public face of the University of Michigan Depression Center, as its founder and executive director, and the driving force behind its broad mission to prevent, detect, and treat depression, bipolar, and related mood disorders earlier and more effectively, and educate and reduce stigma around depressive illnesses. Similarly, with an illness whose pervasive reach and immense public health, societal and economic burdens can sometimes be overwhelming to comprehend, it is Greden’s ability to keep the focus on the very human way that individuals experience this disease that makes him perfectly suited to lead the effort day in and day out in the search for answers that will lead people to wellness.
After establishing the U-M Depression Center in 2001, Greden’s vision compelled him to take the lead in establishing a nationwide network of Centers of Excellence devoted to research, prevention, and treatment of depression, bipolar disorder, and related illnesses. The National Network of Depression Centers, of which he is the founding chair, has now grown to over 20 member institutions, with the goal of making depression expertise and care available within 200 miles of every American. “We’re on our way towards doing that,” he says. “And then, we’ll really have a better opportunity to come up with the answers, the better diagnoses, and the better treatments that we all seek.”
“One of the visions was to say, ‘not only will we bring people together from all the different disciplines, from an array of schools, and from an array of specialties to work together to solve a complex problem, but we are going to see whether we can help others also do that throughout the country and even the world,’” Greden says.
“When you have disorders that are linked to genes, biology, chemical influences, alcohol, drug abuse, stresses, marital conflicts, rewarding things like love and affection – all of those things play a role. How do we then understand something so complex and how do we put it all together?” Greden asks. “ To do that, in my judgment, we need inputs from a vast array of people with various expertise. That’s what you get when you have an opportunity to establish a Center of Excellence, to bring people together who make their contributions toward various pieces” he says. “You bring these people together, they share their knowledge, they get excited, they jump into new ideas, they deliver that care. And that’s the real rationale for why we have Centers of Excellence to have such breakthroughs.”
Facilitating groundbreaking, interdisciplinary research is a key part of the U-M Depression Center’s mission to develop innovative education, treatment, and prevention strategies to improve the way psychiatric medicine is conducted and ultimately transforms lives. Translating those research discoveries into practical applications is the critical first step in disseminating innovations with the potential to improve clinical practice. “After we’ve tested what we’ve learned through research or in a clinical trial, we still need to ask, ‘Gosh, does it make people better? Have the outcomes been cost effective and affordable? Can people go back to work? Does it keep them out of the hospital? All those pieces are components that we’ve brought together in the Depression Center,” Greden, who also served as the chair of the Department of Psychiatry for more than 22 years, explains.
“How do you take what you’ve learned and move it into the world where it makes a difference? And the answer is, you translate it. You’ve got to put it into a framework that is usable by clinicians in Alpena, Michigan, or in Boise, Idaho. Only then is it truly translatable to the clinicians and to the families who live with these conditions and who hopefully get better.”
Early on, Greden’s own research focused on links between depression and abnormalities in the system that regulates stress hormones. More recently, his emphasis has shifted toward preventing recurrences of depressive episodes and finding better ways to detect, prevent, and manage depression that is particularly resistant to treatment.
“Recurrences are just a huge and not very well-understood aspect of what some people call mood disorders, what some would call affective disorders, what I call depression and bipolar,” he explains. “There is a pattern of getting better and then getting worse, and with each episode, if it’s untreated, the symptoms actually get more severe and harder to treat….The consequences not only in our life, our relationships, our jobs, and even in our biology and in our brain – are not good. So the goal is not just to get to wellness, but to keep wellness. It’s truly, truly one of the most important and neglected parts of the depression and bipolar story.”
Ever optimistic about the promises for improving the lives of people living with depressive illnesses, however, Greden finds much hope in the future for his ultimate goal of eradicating depression from the human experience. “What excites me most is the belief that we can make a difference, and that we are making a difference. When I sit and look at where we were even in the early days of my training, we didn’t have answers for a lot of things. I think we now have better answers, but there just aren’t enough.”