The Director Discusses:
Your help is crucial in the search for answers!
John Greden, M.D., is the executive director of the University of Michigan Comprehensive Depression Center. His research focuses on the long-term course of depression and bipolar disorders, stress biomarkers, and clinical strategies to prevent recurrences and help people attain and maintain wellness. We asked him to discuss the many ways that participants in research are true difference-makers in improving the lives of people with depression, bipolar disorder, and related conditions.
Why do depression and bipolar research advances rely on people to participate?
To start with a few axioms, “knowledge heals,” and “all depressions and bipolar disorders are not the same.” Each person has different genes, different stresses, and different precipitating factors and medical variables. This dictates a “personalized” approach, rather than believing that “one treatment fits all,” or repetitively exploring “let’s try this treatment.” Depression investigators are working hard to generate the knowledge that will enable us to diagnose and treat with this personalized approach. It is so important, but, sadly, such knowledge is not yet available. And it won’t appear at all without the participation of people who want to improve the situation for themselves and for their generations of children and grandchildren to come. Why people? These important clinical questions can’t be answered in test tubes, laboratories, with microscopes, or with neuroimaging techniques unless people are involved. Basic science studies admittedly guide all of our studies with people, but without the latter, we won’t ever achieve the breakthroughs we need.
What do people mean when they say “translational” clinical research?
A simple answer is that it is a relatively structured approach to asking questions, developing studies to evaluate important basic science questions in laboratory settings, answering them, making sense out of what we find, comparing our results to prior reported research studies, recognizing promising new approaches, and then translating the overall picture into clinical programs and guidelines for use in treating people. The translational approach is really what I feel should be the core of everything we emphasize. The key translational question? How do we translate what we learn into clinical programs that make a difference for you and me?
At one point, we didn’t know how to treat many cases of heart disease, cancers, or diabetes. Research has given us better answers to enable us to do that, and even for these and other medical disorders, we still have so much more to learn. We have also learned that knowledge about other disorders is important in better understanding depression and bipolar illnesses. When we learn from each other, we speed up the road trip to better answers.
Why do people choose to participate in research?
I think the major motivation might be that they actually are doing something that will help themselves, others they love, or future generations. It is a very noble motivation.
I’ve often heard participants say, “I am so honored to have done this. Maybe we’ll learn enough so that my children or grandchildren won’t have to struggle with the same things that I have experienced. If we learn rapidly, maybe I will even benefit.” I smile when I think of this. They are often convinced that their personal efforts might be responsible for accelerating a breakthrough – and I believe they are often right!
What kinds of questions should someone ask before participating in a research study?
The logical first question is – what are the benefits that this may produce? For me? For others? What are the risks? Will I have to stop other treatments that I may be taking? Am I going to have to spend meaningful time away from work, or will this take an hour of my time? Is it a survey, or do I have to give blood or go through other kinds of tests? Might it be something that will help us learn about new treatments that will potentially help me or others in the long run?
In short, ask all the questions that you consider. And have your family join in the “asking” process – and expect good answers.
We must work together if we are to find better diagnostic and treatment approaches, and people—research participants—are essential team members. Hopefully, if you are comfortable with what you’ve heard, you’ll say, “Count me in.”
John F. Greden, M.D.Read other messages from our director.