Why you should care
Knowing your odds of developing depression, or even committing suicide, could help. Or not.
“Which would you choose — love or science?”
Lab technician Zachary Kaminsky trailed behind his boss through the windowed, marble-floored halls of Johns Hopkins University’s psychiatry building, stopping every few offices to poll the doctors inside. Kaminsky had fallen in love — with a Canadian. So in love, in fact, that he wanted his colleagues’ opinions on whether he should move to Toronto to live closer to her. Nervously, he awaited each psychiatrist’s response. Each time, they answered, “Love.”
Soon afterward, with help from his boss, he managed to land a lab gig in the University of Toronto’s neurogenetics department — which meant he got the girl (now his wife) and would also develop a fascination with chemical changes, mood disorders and how genes might affect people’s long-term risks for mental issues. Now the scientist who chose love is helping the alienated and mentally distressed find their footing, identifying chemical markers of psychiatric disorders in our genes. He plans to use these insights to create controversial tools that could revolutionize mental health: tests to predict whether someone will develop mood disorders — or even commit suicide.
Vivid stories of life on the ward left an impression — as did watching both grandfathers struggle with Alzheimer’s disease.
And he’s barely started his career. A 37-year-old assistant professor of psychiatry and behavioral sciences at Johns Hopkins, Kaminsky regularly publishes in top journals and has already won a $1.5 million National Institutes of Health grant, typically awarded to more seasoned scientists and harder than ever to earn in today’s funding environment. And despite his newness to the field, “he is already quite well-known,” says Art Petronis, a professor at the University of Toronto and head of the Krembil Family Epigenetics Laboratory, one of Kaminsky’s mentors.
Kaminsky studies psychiatric epigenetics, a young, burgeoning field that looks at how the environment can tag genes involved in mental illness with chemical structures that switch them on and off, without changing their DNA sequence. Why all the fuss? Research suggests these changes can be passed down to future generations — but can also be reversed, offering hope for treatment. Kaminsky’s work is part of a broader effort to identify biological signals, or biomarkers, of these disorders. Other researchers are using them to design tests that predict alcoholism and, yes, suicide.
Kaminsky has a dimpled, cherubic face and a willowy teenage frame. Leaning back in his office chair, he speaks fluidly and with almost meditative insight. He lives outside Baltimore with his wife and two kids, and makes it a point not to bring work home. His father was the clinical director of psychiatry at Johns Hopkins, whose vivid stories of life on the ward left an impression — as did watching both grandfathers struggle with Alzheimer’s disease.
A blood test like Kaminsky’s could identify at-risk patients, even those without warning signs, allowing more time to intervene.
Initially intent on medical school, Kaminsky reconsidered amid the intense stress of applications. A black belt in karate and aikido with a penchant for Zen philosophy, he instead taught English in Japan for a year after graduation. While scaling Mount Daisen, he fell in love with the Canadian girl who was ringing the giant bell at the temple along the volcano’s slope. After he was hooked up with Petronis, the smitten scientist applied to the University of Toronto’s doctoral program, at Petronis’ urging not to “waste his talent.” He conducted his Ph.D. research in Petronis’ lab, comparing chemical changes in the genomes of twins, published in the prestigious Nature Genetics.
In 2010, Kaminsky started his own lab at Johns Hopkins. When his team gained access to brain tissue from patients who had committed suicide, they analyzed their DNA and found they were more likely to have chemical changes that switched off a gene called SKA2, which Kaminsky suspects might act “like a brake pad” to regulate stress — turning it off could make stress careen out of control. He then examined blood samples from three sets of patients and designed a test to predict which had experienced suicidal thoughts or attempted suicide based upon their SKA2 status. It predicted correctly 80 percent of the time. Today, psychiatrists look for red flags, like previous suicide attempts — but patients don’t always share that information. A blood test like Kaminsky’s could identify at-risk patients, even those without visible warning signs, allowing more time to intervene.
Kaminsky’s lab has also identified chemical changes that could predict postpartum depression. Since some researchers think that the moods of women with postpartum depression are more sensitive to estrogen levels, they examined blood samples from about 50 pregnant women with a history of mood disorders, focusing on genes that estrogen had chemically altered in a mouse study. Chemical changes to two such genes, HP1BP3 and TTC9B, were more common in these women. Based on these findings, they designed a test that predicted which women would develop the disorder — with 85 percent accuracy.
But researchers need to repeat Kaminsky’s experiments before these tests appear in the clinic — which could take up to a decade. Even then, they would still pose ethical quandaries. Those meant to predict suicide risk might create “a self-fulfilling prophecy,” says Mark Rothstein, director of the Institute for Bioethics, Health Policy and Law at the University of Louisville School of Medicine. And employers might use test results in discriminatory ways.
But Kaminsky remains as Zen as ever. Although he acknowledges the thorny issues surrounding his research, he chooses to let go, allowing the data to “lead to something new that may translate to helping people,” he says. “It’s a blast.”