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Chapter 12:  Putting it all together

Knowing, at a biological level, that a big part of the problem is "not your fault", might be at least part of the toolset you can use to get better -- or at least suffer less with what you've got.  Perhaps it will help, at least somewhat, to keep your own mind from making things worse.  I hope that turns out to be true for you.  

Here are the key concepts for each chapter, all in a row, so you can review what you've learned, with a link for each if you'd like to review.  After that I'll offer a few thoughts on the whole picture, and link you to more resources, which I'll add here over time as this story changes -- which it surely will, perhaps faster than any other mental story, thanks to the efforts of the many researchers whose work is displayed here. 

Chapter 1: 

Chapter 2: 

Chapter 3: 

Chapter 4: 

Chapter 5: 
Although it might seem like knowing which allele lengths you have would be a great thing, there are some reasons to be cautious.  Here are some pros and cons.  

Chapter 6: 

Chapter 7:  
Stress causes the normal production of new neurons in the hippocampus ("neurogenesis") to slow or stop; and it may be that antidepressants work by accelerating that process.  

Chapter 8: 

Chapter 9: 

Chapter 10: 

Chapter 11: 

Antidepressant treatments and lithium lead to mprovements in structure (before lithium above, after lithium below) 

and in function (perhaps directly related to the structural changes, but welcome in any case) : 

Concuding Thoughts

Under construction Feb 2005 

(I'm going to take a breather before returning to muse on all this), including things like: 

• Which has more impact, the stressful event (e.g. in Chapter 1), or the way the person looks at that event? You probably know this line of thought from "cognitive-behavioral therapy" (CBT).  But doesn't the Serotonin Transporter data, particularly Chapter 4, make you wonder about some of the determinants of the kinds of thoughts people have?  Have we seen here factors that lie behind how people look at the world, independent of techniques like CBT?  We might be looking here at factors quite outside their own personal control which determine their degree of pessimism, or optimism -- over which they never had any influence. Might some people be built in such a way as to find CBT very difficult, a continual uphill climb? 

Meanwhile, for more details from Dr. Manji's work, here he is in person in a long interview he granted to a great support group: his interview with CABF (The Child and Adolescent Bipolar Foundation).