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“Depression is an insidious thing, it has the habit of closing down life and making the world smaller.” – Research participant

The experience of this research participant is not rare. Major depressive disorder (MDD), often called clinical depression, is the most common mental illness and is the single leading cause of years lived with disability. It is the top cause globally of disability in adolescents and young adults.

But this individual, and hundreds of others, are taking part in a research study co-led by Professor Frances Rice (PhD 2003), that is trying to change this trend.

Professor Frances Rice is a researcher at Cardiff University who has been studying depression since her PhD.

"I’m interested in science that can improve people’s lives and try and deal with issues that are facing society - I think this is a hugely important issue. It’s something that’s incredibly common.

"So many people have a family member or someone close to them who’s been affected by depression. Specifically, we are focusing on the transition between adolescence and young adulthood because most new episodes of depression begin at this time."

Frances is researching the causes of depression by tracking mental health, physical health, social circumstances, and genetics over time.

"I’m part of a big study that started in 2007 involving around 350 families from across South Wales. We meet adolescents who are children of parents with recurrent depressive disorders and we meet the parents too. These young people were at a high familial risk of developing mental health problems, but some people stay well and others get ill. We want to find out why. Not all individuals with a depressed parent will go on to develop depression themselves so we need methods of predicting who is at highest risk so that those at very high risk can quickly receive the help they need."

''The questions...made me think about my life and the way I felt. I’m glad to have helped, because I’m still working through those questions in my head.'' – An adolescent participant

Frances is working with researchers whose expertise spans psychology, psychiatry, neuroscience, with some even specialising in immunology.

"Cardiff is a centre for excellence in mental health research. We are very cohesive in the way we work together towards a shared goal – we are a multidisciplinary team of researchers who are trying to reach similar end points where we understand more about the basic causes of a range of common mental health conditions.

"Diversity strengthens the research and it is necessary, because these are really complex conditions and they involve complicated webs of causation. Ignore the biological or social, or focus on one bit, you’re never going to see the whole picture."

"Complex problems like depression require lots of different perspectives and minds working from different angles. We’re not trying to separate factors but consider them all at the same time to see how they interact.

"We’re working with groups across the world who are doing similar studies, setting up collaborations with researchers internationally doing similar sorts of studies and trying to pool all our resources and work on some of the same questions together."

Professor Rice's team take a holistic approach to their research.

''Taking part in this survey took away the shame I was experiencing from living with chronic low mood.'' – A parent participant

Identifying the causes will help to develop practical solutions.

"By understanding some of the causes, the idea is that you can then try to work out how better to treat an episode of depression when it arises and prevent it from escalating into something even more serious.

"We’re trying to identify which factors increase someone’s likelihood of much later on developing a depressive illness so that we can then use that information in clinical practice to develop ways of better monitoring and identifying who is going to need help, and who needs to be targeted for intervention.

"We’re hoping to develop a tool that GPs and clinicians can use to predict risk of depression and to ensure that those individuals most in need receive the support and care they require. Such tools are used routinely in general practice for predicting physical health problems such as cardiovascular disease but are not currently available for monitoring mental health.

"Depending on the patient, prevention is likely to involve psychological approaches (such as practicing recognising and challenging negative ways of thinking) as well as other lifestyle factors such as connecting with people and getting enough sleep."

Donors supporting Neuroscience and Mental Health are part of this research. In Frances’ case, donations have allowed her to include insights into the immune system’s role in depression.

"Evidence suggests that immune responses may be involved in mental health conditions. We want to investigate this further and see how the immune system is linked to stress and mental health.

"Without donor support we wouldn’t be able to include this vital layer of the latest study."

The researchers have already met the adolescents and their parents three times and are now doing a follow up study, ten years after the first interaction, to see what’s going on in their mid-20s.

It's clear to see from these testimonials that merely participating in the study has had a profound impact. Rather than allowing depression to close down life, and make the world smaller, the study has opened up new possibilities and new dialogues.

And whilst it may be easy to look at those successes and form a mental picture of a job well done, the real story is that this study is still underway. If the outcomes for participants are so profound at this stage, it inspires hope that, with continued support, Frances' research could provide better and earlier identification of those at risk, more effective treatment, and ultimately improve people's lives.

''This study was the forerunner in taking mental health seriously, investigating its life span and its impact on families. As the rest of society gets on board with promoting well-being and wellness, I am proud to have been here at the start.'' – A parent

"Because of you, we're getting closer to the whole picture on depression."