Ending stigma through research - Q&A with Wataru Inoue, PhD

Wataru Inoue, PhD, is an assistant professor with the Department of Physiology and Pharmacology and a scientist at Robarts Research Institute. He studies the effect of chronic stress on the brain and the biological basis for depression. He recently received a New Investigator Fellowship from the Ontario Mental Health Foundation.

We spoke to him about ending stigma around mental health and how his research may help diagnose, treat and prevent clinical depression in the future.

What do you think contributes to the stigma around mental illness?

For clinical depression, as well as many other mental illnesses, we don’t understand the pathology behind the disease. This lack of understanding leads to confusion and misinformation.

We can blame tumour cells in cancer, or infection and inflammation in fever, but don’t have this sense of culpability with mental illness. The result is people are blamed, rather than disease.

And before modern science made the connection to biology, many mental illnesses were thought of with superstition and fear – feelings that are still pervasive today.

What can research do to help end the stigma?

Mental illness is a biological disease that is influenced by environmental factors, such as stress or trauma. Researchers around the world are rapidly uncovering the precise nature of these relationships.

How does your research help explain the connection between stress and clinical depression?

When you are in stressful situation, it is perfectly normal to be stressed out and show symptoms that are commonly described as depressive, such as anxiety, fear and lethargy. But in clinical depression, these symptoms of stress show up and persist even in the absence of stress (or disproportionate to the level of stress). In other words, the brain becomes hypersensitive to stress.

One prevailing idea is that this hypersensitivity is caused by dysregulation of neural plasticity – the changes in our neural pathways as we learn and memorize new information. This is something my lab is currently investigating.

Importantly, the relationship between stress and neural plasticity is reciprocal. This means that stress causes neural plasticity, and neural plasticity in turn changes the stress response. This relationship is used to modify our stress response, similar to the learning process, to make stress response more effective. But dysregulation of neural plasticity can make this dynamic process go awry and leads to pathology associated with clinical depression.

What are the potential impacts of your research on mental health?

Many researchers, including myself, are working to understand the exact nature of neural plasticity and the link to clinical depression in order to improve diagnosis, treatment and prevention of the disease.