Getting SAD in the winter – Why do we have emotions?

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It creeps up on you in the mornings.

First, it’s the cold.

Then the dark.

And finally, the snow.

Winter is here.

For many of us, winter represents a slowing down of things. The days are shorter, suddenly you’re less inclined to go to the gym after work. Vacations have settled for the most part, and energies are redirected towards class or work or whatever it is you do.

It can also kind of suck.

Why is it that our moods are affected by this change of season? What is it about humans that makes us so sensitive to these changes? Does this have an evolutionary benefit? What if we get too sad?

To think about why the human mood (in general) changes during the season, we must first think about what mood is. Where did mood come from? One of the earliest forms of “mood,” is hunger. When in a hungry mood, even the most primitive animals will change their behaviour, and begin food-seeking behaviours. Their cytoplasmic cilia might undulate towards a chemical stimulus. They may swim to a shallower depth towards the scent of a school of fish. If you are a hunter, and encounter a bear in the woods, hope that it’s not hungry. It may not eat you. If it’s looking for a meal? Good luck! The point is the moods, in animals, represent a set of behaviours suited to a particular circumstance.

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Does this apply to humans? Of course. We gorge the cupboards when we’re hungry. On a macro level, countries and nations suffering from famine and starvation have orders-of-magnitude more unrest and civil war than their well-fed counterparts.

While hunger is a relatively easy “mood” to understand the benefits of, the behaviours and utility provided by more traditional moods like happiness, sadness, and anger, are more subtle, yet equally significant.

Anger can be considered synonymous with threat. People who are angry often feel threatened, and many of the behaviours associated with anger are involved with defense and mitigating a threat. Yelling, like the growling bear, is making yourself “big,” to intimidate an enemy. Elevated heart rate (tachycardia) occurs when you’re angry, in case the most extreme manifestation of anger, violence, is necessary. Sadness can be a little less clear. After all, what could be the evolutionary benefit of something often so painful?

Sadness is afforded power by virtue of the pain it causes. If we are sad about something, our brains want us to avoid that same circumstance from happening again. Losing a job, a messy break up, losing a loved one, these are all circumstances that our brain is telling us we should avoid again, and our behaviours begin to modify in hopes to avoid triggering the sadness again. If you’ve lost your job because you continually showed up late to work, the sadness afforded by the job loss may motivate you to be on time for the train more often in the future. While wallowing over a messy break up, you may find yourself reflecting on the relationship in search of “what went wrong,” and using this information to improve your relationships in the future.

The pain caused by the loss of a loved one is a little more nuanced. What change could sadness drive? There are a few answers. Historically, most deaths were preventable, and the result of a sabretooth tiger attack, or tribal warfare. Sorrow caused by deaths in these circumstances were clearly cause people to be more weary of protecting against tigers, and may either question the benefit of their war or double down and fight even harder. Today, many deaths have a component of lifestyle contributions, and grief after a loved ones death from lung cancer, who smoked, may cause us to question our own habits. The point is, even grief, sadness, and sorrow drive change, and have clear utility on an evolutionary, population level.

So what happens when you get too much of this? Well, depression, for one. A disruption of the normal mood cycle, by any number of factors, can contribute to the development of depression. In the case of anger and happiness, they can contribute to the development of mania. And the fact is, all of us are vulnerable to alterations in our moods when the environment changes, even if it doesn’t represent a frank depressive or manic episode. One of these factors is the season, as we discussed above. For most of us, it’s just the way things are. For some of us, it’s the winter blues. In extreme cases, it’s seasonal affective disorder (SAD).

What is SAD? How is it caused? What about the seasons impacts our moods? Can we use this information to inform SAD treatment? Tune in to part 2 to see!

Dr. Travis Barron is a resident physician in Toronto, Ontario.

Why does anxiety make me tense?

It’s mid-July, and that means vacation. You’ve been waiting for this all year. You can’t wait to have a few weeks to just sit, relax, maybe take in a few books. And don’t forget the wine.

You arrive home and see your husband. He’s beaming as he gets off the phone. You kiss him hello and for a moment, everything is still.

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“Guess what?” he says.

“I don’t know, you bought good steaks for the weekend?”

“Well also that, but something else… my mother is coming to stay with us for a week!”

The calm serenity melts out of your hands and you instantly feel tight. Your muscles start to ache and your teeth are grinding. You notice your heart rate is picking up as your husband asks, “are you OK honey?”

It’s an uncomfortable feeling.

I think we can see why our fictional character may be anxious in this case. A surprise visit by the in-laws on her vacation. Yikes! (If you’re reading this my in-laws, totally love you guys!)

So she’s anxious – but why does anxiety make us feel this way?

Like I’ve spoken about time and time again, anxiety is not a mental illness. It is a personality trait. Like all personality traits, anxiety can both serve us and hurt us. Anxiety makes us not forget our wives’ birthdays, and makes us turn off the stove. On the other end, anxiety can be the root of some mental illnesses, such as Generalized Anxiety Disorder.

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Anxiety originally involved in humans as part of the adrenaline nervous system, called the sympathetic nervous system. It’s function? To help us stay safe in the jungle, and to help us fight off a predator – but doesn’t help us do much about it. Fortunately for us, we have evolved a way around this. As I’ve discussed previously, the brain operates through it’s connections, and those connections exist in very complicated but specific ways. This means the brain likes patterns. Anxiety is no exception. The anxious nervous system directly connects to the adrenaline nervous system, and turns it on when we are feeling anxious. What does the adrenaline nervous system do? Well it’s also called the fight-or-flight nervous system. This nervous system prepares our bodies and allows us to either fight off a predator such as a boar, or flight/run like crazy from something like a tiger. To allow us to do these things, the adrenaline system dilates our pupils, to improve our vision in the dark. It raises our heart rate and blood pressure to get blood to our organs and muscles, and tightens our muscles, in anticipation of a great battle or a long sprint. It freezes our digestion to preserve resources. The benefits of this connection-based system are obvious when we examine someone like a caveman.

Not so much with anxiety.

The brain doesn’t always distinguish one situation entirely from another, a symptom of it’s pattern-based operation. These same connections are activated when anxiety is caused by a seemingly harmless threat, such as news your in-laws are visiting. Increased heart rate and blood pressure can feel overwhelming and make it impossible to sleep. Muscle tightness turns into uncomfortable chronic tension. Frozen digestion becomes abdominal pain.

But there’s an end. As these things go, the physical symptoms of anxiety typically burn out over the course of a few hours. There may always be more mild chronic symptoms in the background but in general, anxious people are not always in relative crisis. Funny enough, the duration of the average panic attack (about fifteen minutes) last about as long as our adrenaline stores last.

And we can retrain these connections. Through cognitive behaviour therapy (CBT) you and a therapist work together to identify the thinking patterns that lead to a number of mental illnesses, including anxiety. Once you identify those patterns you can begin to change them, and “train” your brain to not always turn on your fight-and-flight response, at least so intensely, when you feel anxious.

Dr. Travis Barron is a resident physician in Toronto, Canada.

How being in crowds (may have) caused psychosis

It’s Canada Day, and boy are you hungry. You have a hankering for sticky meats and while the drool begins to pool in your mouth, you remember. The Mandarin Chinese Buffet is having a free Canada Day buffet!

You hop on the subway and go to your nearest Mandarin. When you arrive at your stop, you wonder, “what’s that noise?” You exit the station and then it hits you. The noise was the massive crowd of hundreds of people who had the exact same idea as you. Just a few hours earlier.

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For me, those crowds were outside of my home, and man what a spectacle. Hundreds – maybe a thousand? – of people lined up to stuff their faces. This crowd is one thing at ten in the morning after a nice breakfast. It’s an entirely different beast at two in the afternoon with a rumbling stomach. Tensions start to build (indicated by the police presence that has slowly built up over time), and it’s easy to imagine how something could go wrong.

But it doesn’t. Against what seems tremendous odds, these events, as most do, go by without a major hitch or injury.  It leads one to wonder, what exactly allows us to do accomplish this as humans?

If you’ve grown up in a rural community like myself, you’re probably familiar with ant hills. If, like me, you essentially lived in a forest, there might be a few different ant hills around. Inevitably, as kids do, you take an ant from two different colonies and leave them together.

Spoiler: they fight to the death.

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This obviously doesn’t happen with humans. In fact, you can take two humans who couldn’t be from more different walks of life, and often times, a relationship will form. Why have we evolved this way? Well, it helps us! Humans are social animals at their very core, and our human society is the only society (think meercats, honey bees, other social animals), that have built a civilization. Civilization has allowed us as a species to thrive and master the planet like none before us. What does it take to build a civilization?

Trust, for one. Humans have needed to evolve trust of one another so that we can take full advantage of the world’s resources. We need to trust that by doing our jobs (which often times have absolutely nothing to do with the basic necessities of life), we get paid, and we need to trust that by getting paid, we are able to buy food and resources to sustain ourselves. It would be difficult to wake up every morning and be an insurance broker if that didn’t translate into food, shelter, and security for your family.

Trust, however, can only go so far. There are inevitably people among us who would violate that trust, and who would harm us, were our defenses so low. This problem has been increasingly important as humans live in denser and denser cities. It has required us to develop suspicion, to complement our trust of each other. In big cities, a mild level of paranoia keeps us safe. It makes us lock our doors at night, avoid the dark alley, and be aware of people acting strangely or dangerously around us. To simplify things, you could say all of us have inherited a little suspicion from our parents.

Sometimes, people can inherit too much suspicion. We may call this paranoia, or psychosis. This might make you believe people want to harm you, or that you are being monitored. You might begin to take meaning from completely innocuous things, due to hyperviligance. Think of psychosis as our natural suspicion in overdrive, suspicious traits that have become too concentrated. This perhaps lends to the fact that living in an urban environment significantly increases your risk of developing psychosis.

This theory is one of many behind the question, why does psychosis exist? We may never know for sure. What I do know, is that the human mind is fascinating, and we can often under appreciate the profound significance behind something as apparently simple as being in a crowd.

Like more on psychosis? Try this out!

Dr. Travis Barron is a resident physician in Toronto, Canada.

Mental illness exists for a reason (part 4)

Thanks for reading and keeping up with this series – Mental illness exists for a reason! In part 1, part 2, and part 3, we discussed the evidence for genetic control of behaviour in primates, and found that variability within a species’ genome allows that species to be adaptable. Humans are an example of a species with a variation in genes within  their genome, allowing us to become one of the most successful species on the planet! We discussed that because of this variability, some of us succeed in cities, rural areas, at high elevations, or thrive working underground. It also means that not all of us will succeed – at least in every environment.

So how do we guide treatment and recovery, with this understanding of mental illness?

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When I was in grade school, as there tends to be, there was always the one problem child. Teachers would scorn this child, parents would be caught whispering about the kid in hushed after-dinner conversations as they dispersed the latest rumors coming from the school. This child had bad grades, would act out in class, and was the regular example of how not to act when your parents warned you about the repercussions not studying. “Do you want to end up like Johnny? No future?!” You could say that in the eyes of the masses, this child was struggling.

Johnny felt he was struggling too. He didn’t seem to jive with the classroom environment. He had a lot of pent-up energy he felt he had nothing to do with. He intended well, but ultimately was ambivalent regarding his grades. ‘What will I ever need that for, anyway?”

I eventually moved on from grade school, and high school, and university, and medical school. Years later, on a short trip home to Newfoundland, I saw Johnny in the supermarket, He was with his beautiful family, and had three kids. We got to talking and it turned out he entered trade school after high school, was at work a few years later, and now actually owned a home. The thing that stuck out the most was he was glowing. Absolutely glowing., I couldn’t help but feel, this guys got it all figured out.

But Johnny was struggling. So what happened?

Not everybody will thrive everywhere. I could think of lots of examples from my office, but I thought that this example was more down to earth and a great example of how things are not always as they seem.

Johnny was never meant to sit in a classroom, and was intended to use his hands. When given the wide open expanse of a work day and a welders hat, he found his niche, and owned it. The reality is, the filtration system this is our school system didn’t work for him, and he struggled.

The conclusion? Sometimes, a change in environment is the most important intervention when you are struggling with a mental illness. If you live away from your family and friends, and are struggling, my pill will have limited benefit. Until jobs can stop requiring people to work 50, 60 hours a week for next-to=nothing, people will suffer.

Editor’s note: As if it wasn’t complicated enough, I’ll add an asterisk! Often times, when you are in the throes of a mental illness, your judgement can be distorted. In general, I recommend people do not make life-altering decisions while severely unwell. A discussion with your doctor on how to best approach this scenario is my recommendation.

Not all mental illness is a result of person-environment incompatibility. There are true, organic mental illnesses out there. Often times, a combination of medication, therapy, and life changes, is required.

I would like to credit Dr. Albert Wong at the Centre for Addiction and Mental Health for inspiring most of the content of parts 1-3 of this blog series.

Dr. Travis Barron is a resident physician in Toronto, Canada.

Mental illness exists for a reason (part 3)

In part 1 of Mental illness exists for a reason, we discussed the evidence behind genetic control of temperament in two different primate species, Chimpanzees and Bonobos.

In part 2, we discussed how having a variation of behaviours within a species makes that species adaptable to a broad range of environments. Voles were a great case study on how polymorphic genes lead to a variety of behaviours within a species, allowing voles to thrive in a wide range of habitats on the planet.

In part 3, we will be discussing the role of the gene we have been examining, vasopressin 1a receptor, in human behaviour, and extrapolating from that why mental illness may exist.

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Humans are not voles. Before we get started, I want to reiterate that there are thousands of genes which interact to have an effect on human behaviour. No one gene is responsible for the beauty that is the human mind. When we examine human behaviours in studies, like the one I will be discussing today, we are observing trends in behaviour, and not absolute rules. Remember, personality is thought to be at most 50% genetic, and each one of those thousand genes are in direct interaction with each other, and our ever changing environment, at any given moment, to produce the “climate” of traits that becomes our personality.

So what’s the deal with vasopressin 1a receptor? What is it anyway?

In the human body, brain function is dependent on something called neurotransmission. In a nut shell, neurotransmission is when two different nerve cells, called neurons, communicate with each other. Neurons are constantly communicating with each other at any given time to produce consciousness, vision, hearing, touch, and just about any neurological function you can imagine.

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Credit: Nature

How does neurotransmission occur? Through chemicals called neurotransmitters. In a neuron “discussion,” the first neuron sends a neurotransmitter to the second neuron. There is a receptor on the second/receiving neuron that picks up the message. Vasopressin 1a is this kind of receptor. Depending on the shape or form of the receptor, different things will happen to the second/receiving neuron. This is how variation in the receptor produces variation in effects!

Why is this important? Vasopressin 1a receptor has been implicated in pair bonding behaviours, across a wide range of species, including humans, chimpanzees, bonobos, and voles. Consistently, a “longer” form of the gene has been associated with increased pair bonding and less aggressive behaviours. Think the lazy, horny Bonobo and the monogamous Prarie Vole’s. And some humans.

A group at John Hopkins set out in the mid-2000’s to investigate the role of vasopressin 1a receptor in humans. You can read their study here. To summarize, the group found that a number of variations of the vasopressin 1a receptor exist in humans. That makes this a polymorpic gene. As expected, certain forms of the gene correlated with certain behaviours in humans. Longer forms of the gene were associated with increased pair bonding, as determined by a questionnaire. Amazingly, not only did carriers of the longer gene tend to report happier marriages, their partners did as well. Carriers of the shorter gene were unhappier in their marriages on average and were considerably more likely to have had a threatened divorce within the last year.

So why can’t we all be married, well fed, and happy?

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Like the Prarie Vole, humans live in a wide variety of environments. This is different than Chimpanzee’s and Bonobo’s, who are really good at living in the kinds of places they live, but not great at living elsewhere. Humans live in mountains, on swamps, the plains, the coasts. There’s hardly a terrestrial environment on this planet that we haven’t conquered. The point? Humans have had to be extremely adaptable to achieve this level of success across the wide range of environments we inhabit. This doesn’t only apply to geography. The massive differences between an urban metropolis and a rural village cannot be understated. The variation in cultures across the West and East is difficult to appreciate. These differences in the societies in which we lives requires a broad range of behaviours to be within our species to succeed.  We need people who thrive in a big city, among thousands of their peers, in cramped, noisy, stimulating environments. Without them, the economic engines of our nations would collapse. We need people that can’t stand the city, who need wide, open expanses, and tranquility to survive. Without them we wouldn’t be able to feed the masses. The point is that variation in our personalities allows some of us to succeed, and to excel, so that society and the species may go on.

But that doesn’t mean we are all meant to succeed. Or rather, that we are all meant to succeed in every environment.

Variation means exactly that – variety. For every person that thrives in a city there’s another who suffers. Sometimes, there is a fundamental mismatch between our personality, and our environment. Try as you may, a monogamous Vole ain’t gonna do well at a polygamous Vole frat party. A Bonobo chimp would be dead meat caught in a Chimpanzee civil war.

These mismatches occur in humans as well; sometimes, we may call that mismatch, a mental illness.

Join me in part 4 for a discussion of how we can use our understanding of why mental illnesses may exist to help guide treatment and recovery!

Editor’s note: I do not want to diminish the role of, “nurture,” in the nature vs nurture argument. By no means in personality 100% genetic (most studies show it’s around 50%)! This blog simply looks at the genetic side of things.

I would like to credit Dr. Albert Wong at the Centre for Addiction and Mental Health for inspiring most of the content of this blog post.

Dr. Travis Barron is a resident physician in Toronto, Canada.

Mental illness exists for a reason (part 2)

In part 1 we discussed the differences in behaviour between Bonobo chimp’s and their closest relatives, the Chimpanzee. Bonobo’s and Chimpanzee’s each have distinct temperaments between their two species and minimal variation in the these temperaments within their own species. What does this mean? Most Chimpanzee’s are territorial, aggressive, and violent, and most Bonobo’s are chill, horny, and non-violent.

And now, to the promised star of part 2, the Vole.

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Voles are a group of small rodents that reside in North America. Unlike the Chimpanzee and Bonobo, Vole’s occupy an extremely wide variety of habitats. If you recall, Bonobo’s live in one small part of Africa, in a very specific habitat, while Chimpanzee’s have a large range of similar habitats (to their own, not Bonobo’s) all across Africa. You can find Vole’s in prairies, meadows, mountains, and your basement. So what is it that make voles extremely adaptable?

Behaviour, for one.Voles, unlike Chimpanzee’s and Bonobo’s, have a wide variety of behaviours within their species. Some voles are monogamous, and some are not. Some are territorial, and some are not. By having a wide range of available behaviours within their population, the Vole species always ensures that there’s somebody (somevole?) around who are able to handle the demands of the environment. Prairie Vole’s, for example, are monogamous, while Meadow Vole’s are not. Maybe this means that a gentle, monogamous Vole may not survive in the meadow, but it ensures, on a population level, the survival of the species across a wide range of environments.

What’s responsible for the variations in behaviour seen across the Vole’s? If you recall, in part 1 we discussed the role of a gene, vasopression 1a receptor, in the different behaviours observed in Chimpanzee’s and Bonobo’s. Well, as it turns out, the vasopression 1a receptor gene is also responsible for the different behaviours among the Vole’s.

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Credit: Science Magazine

As you can read in this study, genetic testing has shown a variety of vasopression 1a receptor mutations within the Vole genome. We would call this a polymorphic gene, meaning that many different forms of the gene exist within the same species. Humans have polymorphic genes for hair, eye, and skin colour, for example. Monogamous Vole’s appear to have a higher density of vasopressin 1a receptor and, similar to Bonobo’s, a “longer” version of the gene.

The take away? It’s not that vasopressin 1a receptor is the God-gene controlling our every instinct. The reality is there are thousands of genes that play a role in behaviour, and each one is more nuanced than the next. This should however stand as an example of how variation of a gene within the same species produces a variety of behaviours!

In part 3, we examine the role of vasopressin 1a receptor in human behaviour in an effort to extrapolate why mental illness exists!

Editor’s note: I do not want to diminish the role of, “nurture,” in the nature vs nurture argument. By no means in personality 100% genetic (most studies show it’s around 50%)! This blog simply looks at the genetic side of things.

I would like to credit Dr. Albert Wong at the Centre for Addiction and Mental Health for inspiring most of the content of this blog post.

Dr. Travis Barron is a resident physician in Toronto, Canada.

Mental illness exists for a reason (part 1)

Damn you, Mother Nature!

It’s complicated.

Deep in the Democratic Republic of the Congo, near the South Congo River, lives the rarest species of great ape in the world – Bonobo chimpanzees. Why are the great apes important? They are the animals most closely related to humans on the planet! And they’re also the next most intelligent animals on the planet. These animals exhibit complex social behaviours and relationships, and members include chimpanzees, bonobos, orangutans, and gorillas.

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Bonobo – Credit: Wikipedia

Bonobos are particularly interesting because they only live in one place in all of the world – the South Congo River. This is in contrast to traditional Chimpanzees, who have ranges all across the African continent. This has resulted in Bonobos being the last discovered great ape and have therefore been the least studied! Until recently, that is.

Chimpanzees are notoriously aggressive. Jane Goodall infamously documented a brutal chimpanzee civil war when she lived among the apes in 1974-1978. Chimpanzees have a complex social structure, with rank and sexual capital determined by violence. Bonobos, on the other hand, are like your cool uncle. They do not appear to compete for rank, males are often subordinate to the females, sex is often homosexual and not for the purposes of procreation, they are considerably more sexually active than Chimpanzees, and importantly, are non-violent!

Scientists have been trying to understand the basis for the differences in behaviour for some time, in hopes that this can lead to a better understanding of the operation of the human mind. Genetic studies have begun to uncover key differences in the genomes of both apes. It turns out Bonobos are the second most related ape to us, after the chimpanzee, and Bonobos appeared to diverge genetically from Chimpanzees between 2 and 2.5 million years ago.

So what happened?

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Credit: Nature

Geological studies show that 2.5 million years ago, in the Zaire river, there was a large drought, which pushed the previous chimpanzee-bonobo ancestor out of that area. The group diverged, with the river being a dividing line. Those apes that went South of the river, found food plentiful. They were able to continue the fibre, plant-based diet the apes always had eaten. These apes are what we now call Bonobos. This was not the case for the apes which moved North. These apes had to compete with African Gorillas for scarce food resources, and due to competition and food scarcity, had to shift their diet to an omnivorous one, and include meat. These apes have evolved into Chimpanzees. You can read more about that here!

So what explains the stark difference in their behaviour? If you recall, I mentioned earlier that Bonobos and Chimps are our two closest relatives; both Bonobos and Chimpanzees are more related to each other than we are related to them. That provides a pretty interesting opportunity. Because Bonobos and Chimps are so closely related, it should be relatively easy to find differences in their genome, which provides an opportunity to find the gene, if there is one, responsible for this change in behaviour.

I won’t get into the technical stuff here, but it turns out that is the case. This study identified a key mutation in a gene (vasopressin 1a receptor gene) which occurred in Chimpazees and has been associated with lower sociability and increased anxiety. It makes sense why these traits are helpful when you are forced into competition with one another, and Gorillas, and have to hunt meat. Bonobos on the other hand carry the non-deleted form of the gene, which has been associated with increased openness to each other. You can read more in the previous link (it’s technically heavy) but the researchers argue pretty convincingly that this is the genetic basis for the differences in personality!

It turns out humans, and… prarie voles? also contain the gene for vasopressin 1a receptor. In part 2, we can use our understanding of this gene in humans to extrapolate why mental illness may exist!

 

Editor’s note: I do not want to diminish the role of, “nurture,” in the nature vs nurture argument. By no means in personality 100% genetic (most studies show it’s around 50%)! This blog simply looks at the genetic side of things.

I would like to credit Dr. Albert Wong at the Centre for Addiction and Mental Health for inspiring most of the content of this blog post.

Dr. Travis Barron is a resident physician in Toronto, Canada.