This post is about science, but it’s not for scientists. I have been studying some evolutionary biology, and naturally came across the freshly-blossoming field of epigenetics. As someone new and uncredentialled writing about a new and changing scientific paradigm, all I can offer is a gentle introduction to the subject for those who have heard little or nothing about it.
My main hope is to share a takeaway from my studies: Epigenetics opens up brand new possibilities for helping people who need the most help. Epigenetic medicine is the scientific advancement of love.
Imagine the genes in your body not as switches which can be “on” or “off”, but as tiny musicians who play certain instruments. Epigenetics is the study of the Conductor of this microscopic orchestra. Once the Conductor instructs a specific musician to start playing, or to play quieter or louder, the change is persistent. The musician will go on playing in the manner instructed by the Conductor until a new instruction is given. This is what is meant by an epigenetic modification—your genome is not changing, but rather the way it is expressed; the instruments stay the same and the music changes. Nessa Carey writes:
“So back in 1996 there was a nice simple story. DNA methylation turned genes off and histone acetylation turned genes on. But gene expression is much more subtle than genes being either on or off. Gene expression is rarely an on-off toggle switch; it’s much more like the volume dial on a traditional radio. So perhaps it was unsurprising that there turned out to be more than one histone modification. In fact, more than 50 different epigenetic modifications to histone proteins have been identified since David Allis’s initial work, both by him and by a large number of other laboratories. These modifications all alter gene expression but not always in the same way. Some histone modifications push gene expression up, others drive it down. The pattern of modifications is referred to as a histone code.”
This means that epigenetic changes (like methylation or acetylation) can determine things like your body’s reaction to stressful situations. If the “volume” of the “musician”, on a scale from one to ten, is at baseline of five, and during certain moments can get as loud as ten, we could say the gene is functioning normally. But what if the Conductor instructs this musician to play at ten, and then forgets to send a new signal to bring it back down? Then the musician has a new baseline of ten, and during intense moments will crank it up to eleven. This is clearly a problem, but what’s the solution?
Life and health
Epigenetics has the potential to radically reshape our overall wellbeing, healthspan, and lifespan.
An article in Nature reads:
“Given the importance of epigenetics in influencing cell functions, a better understanding of both normal and abnormal epigenetic processes can help to understand the development and potential treatment of different types of diseases, including cancer.”
More broadly, this calls into question the most common methods for dealing with problems like anxiety, post-traumatic stress, or depression.
Children exposed to childhood trauma are permanently (or at least enduringly) changed, epigenetically, by this experience. The epigenetic “volume” responsible for the child’s response to stress was over-activated by the Conductor. Then, as adults, they are “at a ten” to begin with — which may be ok for a rock concert, but not for emotions. Quoting Dorothee M. Gescher et al.:
“Epigenetic mechanisms have been described in several mental disorders, such as mood disorders, anxiety disorders and schizophrenia. However, less is known about the influence of epigenetic mechanisms with regard to personality disorders (PD). Therefore, we conducted a literature review on existing original data with regards to epigenetic peculiarities in connection with personality disorders... 23 original publications fulfilled the intended search criteria and were included. Those are 13 studies on gene methylation pattern with aggressive, antisocial and impulsive traits, 9 with borderline personality disorder (BPD), and 2 with antisocial personality disorder (ASPD). The results of these studies showed significant associations of PD with methylation aberrances in system-wide genes and suggest evidence for epigenetic processes in the development of personality traits and personality disorders. Environmental factors, of which childhood trauma showed a high impact, interfered with many neurofunctional genes. Methylation alterations in ASPD and BPD repeatedly affected HTR2A, HTR3A, NR3C1, and MAOA genes.”
Our current class of drugs act directly on the chemical imbalances associated with these conditions. They help regulate your serotonin, dopamine, cortisol, and so on. But why are your body’s “musicians” playing at the wrong volume to begin with? Epigenetics may hold the answer, and shows us that current drugs are like putting in earplugs instead of actually balancing the sounds of the orchestra.
This could be a medical paradigm shift which gets at the roots of physiological and psychological disorders, rather than applying post hoc fixes. Children who experienced trauma will not be left with lifelong epigenetic scars. Adults can find hope in treatments which “re-orchestrate” through epigenetic histone modifications.
Leaving the past
Epigenetics teaches us new facts about childhood experiences and the persistent effects which last through adulthood. Epigenetic changes can even begin during pregnancy. In “The Epigenetics Revolution”, Nessa Carey gives examples of epigenetic changes in the fetuses of women who lived through periods of famine or malnutrition, and subsequently gave birth to children who were more likely to be overweight:
“A major metabolic disturbance during early pregnancy, such as the dramatically decreased availability of food during the Dutch Hunger Winter, would significantly alter the epigenetic processes occurring in the fetal cells. The cells would change metabolically, in an attempt to keep the fetus growing as healthily as possible despite the decreased nutrient supply. The cells would change their gene expression to compensate for the poor nutrition, and the patterns of expression would be set for the future because of epigenetic modifications to the genes. It’s probably no surprise that it was the children whose mothers had been malnourished during the very early stages of pregnancy, when developmental programming is at its peak, who went on to be at higher risk of adult obesity. Their cells had become epigenetically programmed to make the most of limited food supply. This programming remained in place even when the environmental condition that had prompted it—famine—was long over.”
But my mind goes particularly to the intersection of epigenetics, trauma, and mental health disorders. For example, prisoners, by and large, are some of the most traumatized people in society—beginning with their Adverse Childhood Experiences, and later exacerbated by an overly-punitive system. One could argue that the epigenetic modifications associated with this trauma makes them prisoners in their own bodies before they ever step foot in a real prison cell.
A similar train of thought could apply to war veterans with PTSD, or to any number of psychological/mood/personality disorders whose risk factors include childhood trauma. By expressing love and sympathy throughout the future trajectory of our epigenetics revolution, the Conductor of your past can be left in the past, and a newly-balanced symphony may take the place of that one dissonant song playing on repeat.
Perhaps, along with other significant changes to the criminal justice system, epigenetic medicine can offer hope to people who want to move beyond their past and live a better future. Epigenetics is a powerful new tool for a justice system that is more restorative. I hope “epigenetic justice” receives proper attention in the course of the epigenetics revolution.
Conclusion: Epigenomes and beyond
Quoting former President Obama:
“Every dollar we invested to map the human genome returned $140 to our economy.”
This figure may be off, but it is not in doubt that the benefits to our society from the Human Genome Project have been greater than the costs. It will be money that gets the epigenetics revolution off the ground, but love will keep it flying in the right direction. And I think we can look forward to a future in which we have a better understanding of how epigenetics alters the course of our lives, and gain some control over it.
This fills me with joy, because I think about the kinds of people I’ve written about today—they need our love, and this is one of compassion’s newest frontiers. An epigenetic “re-orchestration” is medicine for a soul out of balance.