Research for good mental health

Text: Trio MedienService Bonn

Jürgen Margraf is one of the leading German-speaking experts in clinical psychology. The internationally reputed research pioneer into the causes and therapy of depression, panic and anxiety disorders will establish a new mental health research and treatment centre in Bochum.

Anorexic models, depressive football stars and panic-ridden managers: psychological disorders are constantly in the media focus. But does that make them as socially accepted as physical illnesses? Definitely not: “These illnesses are still extremely stigmatised. They’re seen as weaknesses, and those affected are considered ‘not normal’,” concludes Jürgen Margraf as a result of his studies. For over twenty years he has been investigating anxiety disorders and depression, and he knows that almost every second German will suffer some kind of mental illness during their lifetime, to a varying degree of severity. The clinical psychologist is convinced: “It’s not a question of whether we acquire such a disorder, but how we deal with it. Psychological illnesses are one of the major causes of premature death or a severely impaired life. That’s why we have to explain far more about them.”

Jürgen Margraf set new standards in research into anxiety disorders when he discovered a recurring structure of symptoms in panic attacks from which he developed his psycho-physiological model. During such an attack, which usually lasts for about 28 minutes, the person affected first experiences a physical symptom: he or she may break out in sweat or have severe palpitations. Whilst healthy people rationally attribute such phenomena to their present everyday situation, for instance an exam or being in love, a person suffering from panic senses imminent danger. “It’s a question of fear, indeed mortal fear, and this is all that is felt,” explains Margraf. This panic leads to an intensification of the physical symptom or to additional symptoms, such as breathing difficulties. People’s perception is focused exclusively on the potential danger, their assessment of the situation becomes more drastic and the fear increases. Margraf tested this “vicious circle” at Stanford University. When panic patients perceived a faster heartbeat, which the researchers had simulated acoustically, their pulse rate increased and the attack took its course. Nothing happened in the healthy control group.

Who gets ill and who stays healthy?

At Ruhr-Universität Bochum (RUB) Jürgen Margraf now wants to investigate which conditions are responsible for determining whether a person becomes depressive or suffers from panic attacks. “As a therapist I now know how I can help, because we can recognise certain dispositions, such as responses to stress or distressing life events.” But therapists always come too late: “Patients already have a long history of illness before we start treating them. In addition to this, the memory is unreliable: people confuse the order of events and create constructs of reality,” says Margraf. For this reason his research will focus on complex constellations of causes to investigate the interplay of psychological, biological and social factors as well as genetic-environmental interactions. “Until now we have concentrated solely on the effects of the genes on a person’s behaviour. However, the fact that the environment can also influence the gene pool or epigenetic structures has tended to be neglected so far,” the Humboldt Professor explains.

The distinguished research scientist and therapist says the triad in the development of mental illnesses consists of predisposing, triggering and maintaining factors. Health promoting factors have been neglected, yet all human beings have these protective, health promoting factors at their disposal. Until now they have hardly been investigated or adequately defined. “Our way of thinking is absolutely fixated on disease, but we hardly know anything about the protective factors influencing mental health,” declares Margraf. He wants to define mental health in positive terms rather than just differentiating it from illness. Protective factors can include such things as stable social support and robust emotional relationships, which for many people are not necessarily foregone conclusions in an age of rising divorce rates and declining births.

Prevention is the best cure

Together with his wife Silvia Schneider, who has also been appointed as Professor of Child and Adolescent Psychology at Ruhr-Universität, Jürgen Margraf wants to develop a holistic approach at the new Mental Health Research and Treatment Centre. “In the area of prevention the results have not been particularly good so far. Prevention is the test of our theories and is extremely important,” says Margraf. The two scientists will be examining not only adults but also very young children in the context of their whole environment, their genetic predispositions and family factors. Their work will also benefit from RUB’s research network, including collaboration planned with the neuroscientists and some 18 clinics in the region. “At our outpatients department for research and training we treat 300 patients every quarter on the basis of the latest research,” says Margraf. The Humboldt Professor is very enthusiastic about the speed at which scientific results are being translated into therapies at RUB. It is creating the foundations for effective prevention.