Understanding the brain and mental health

Dr. Lena Palaniyappan is a scientist at Robarts Research Institute and an associate professor with the Department of Psychiatry at Schulich Medicine & Dentistry. He studies the mechanisms behind symptoms in mental illness using state-of-the-art neuroimaging facilities at Robarts.

We spoke to him about ending stigma around mental health, and how his research may help early detection, diagnosis and treatment in the future.

What is the focus of your current research?
My current research focuses on improving the diagnostic process and treatment choices in psychosis and depression. In particular, our group's main aim is to translate the recent stellar advances in neuroscience to clinical psychiatric practice.

What are the potential impacts of your research on mental illness?
Studying the brain closely has provided several insights that challenge the conventional notions about mental illnesses. Firstly, it is becoming increasingly clear that there are certain organizing principles behind the structure and function of the human brain. You can call these the 'natural laws' of the brain's organization. When these principles are disturbed, unusual mental phenomenon can result. Brain imaging can uncover these changes even before clinical impairment sets in, thus providing us a valuable lead-time for early intervention.

What do you hope your research will mean for people's health in the future?
One in five of us will experience a mental illness in our lifetime. Despite this high frequency, our understanding of these illnesses continues to be minimal. I hope that in the not-so-distant future, we will be able to routinely use information from brain anatomy and physiology in mental health clinics. These measures could guide patients and clinicians in making treatment decisions, which at present, are made mostly on the basis of clinical intuition.

What do you think contributes to the stigma around mental illness?
A patient treated at a psychiatric clinic suffers more social stigma than one who sees a neurologist for a very similar presentation. There is a pervasive but often implicit view that mental illnesses are the result of one's own making or inadequacy. Our explanatory frameworks often invoke distal 'risk factors' but are inadequate to explain matters such as Choice and Will.

What can research do to help end the stigma?
Clarifying the mechanisms behind mental phenomenon is crucial, in my opinion. Without this, we will be falling back on untestable and broad notions regarding stress and trauma, weaving another layer of complexity that may take years to unpick.

What have you learned about mental health as a researcher and clinician that you'd like others to know?
For each person who suffers with a persistent mental health issue, there are hundreds who make a meaningful recovery. We often underestimate the resilience that is inherent to individuals and their families.

What motivates and inspires you to keep studying the brain?
We are living in interesting times where a large number of eminent researchers are studying the brain – my focus is to harness these efforts for the benefit of several million individuals that battle mental illnesses everyday. While there are other approaches that may deliver results in the short-term, I believe psychiatric neuroscience is the field where discoveries can have a huge, enduring impact.