In an article published in the current issue of Psychotherapy and Psychosomatic Dr. Bruce McEwen (Rockefeller University) analyzes promising outlooks that interventions that affect brain may have on health.
In this article, Dr. McEwen argues if the effects of stress, lifestyle, and adverse early life experiences on the brain and body can be treated and compensated without 'magic bullets' like penicillin for stress-related disorders. For psychiatric illnesses, such as depression and anxiety disorders, including PTSD, it is necessary to complement and even replace existing drugs and adopt strategies that center around the use of targeted behavioral therapies along with treatments, including pharmaceutical agents, that open up windows of plasticity in the brain and facilitate the efficacy of the behavioral interventions. To that extent, meeting the demands imposed by stressful experiences via various coping resources can lead to growth, adaptation, and learning to promote resilience and improved mental health.
Epigenetics refers to events 'above the genome' that regulate the expression of genetic information without altering the DNA sequence. Even in adulthood, gene expression in the brain continually changes with experience, and there is loss of resilience of neural architecture with aging that can be redirected by exercise and, to some extent, by pharmacological intervention. More generally, there are new approaches to opening windows of plasticity and redirecting the brain towards a more health-promoting state.
Even 'personalized medicine' is presently cast as genomics-based knowledge and fails to acknowledge the individual person's personality and experiences across the life course and their influence on brain plasticity and ultimately health. Dr. McEwen concludes stating that ignoring this is depersonalizing and may fail to treat the problem.