Cindy’s Story: How genomics helped personalise my mental health treatment

Please note: This story covers sensitive mental health issues, including suicide.

Cindy Black, an equine coach from WA, says her life has changed significantly with the information gathered from a DNA test.

“Over my years struggling with depression and complex posttraumatic stress disorder I tried countless medications,” says Cindy.

“If I’d been offered the test at the beginning, I could have started my road to recovery much sooner.”

Anxiety and depression are the most common mental health conditions diagnosed in Australia.¹

But finding the right medication and dose for each person can be challenging and may result in side effects and prolonged periods of untreated symptoms.

A type of genetic test is offering GPs and their patients’ greater insights into the medications that will work best for them based on their DNA.

Royal Australian College of General Practitioners (RACGP) clinical guidelines suggest that pharmacogenomics testing can help GPs access information about what medications may or may not work for them.²

Cindy was 17 years old when she was given her first antidepressant medication following a hospitalisation.

“I’d been struggling with depression and suicidal thoughts since my mid-teens but hadn’t told anyone,” says Cindy. “I was working in Sydney with no support when I went into a bit of a hole. I started to hyperventilate during a hockey game and was sent to hospital.”

After relocating back to WA, Cindy was admitted to a psychiatric facility.

“I was given different types of medication, some to help me sleep, some to help with the depression. It felt like the doctors were just throwing everything at me, hoping something would work. But nothing did.”

Over the years, Cindy spent up to 7 months at a time as an in-patient and attempted to end her life many times. Following one attempt, she was left in a coma for 4 weeks.

“I couldn’t hold down a job. I couldn’t look after myself or function in the world. I needed someone to be with me all the time. There was no relief despite all the medications I tried.”

Cindy’s story isn’t uncommon.

A study looking at 240,000 Australians began antidepressant treatment between 2013 and 2019 showed that around 1 in 5 needed a second medication, while 6% tried a third.³

If the antidepressants doesn’t work or causes side effects, it can be weeks before someone can try a new medication as it’s important to gradually reduce the dose under a doctor’s supervision.

Often, a short period without any medication, called a ‘washout’ period, is recommended before starting a new antidepressant to avoid side effects or interactions.⁴

A type of genetic science called pharmacogenomics is the study of how a person’s unique DNA can impact how they respond to certain medications.

A simple cheek swab test can provide a report for GPs to help design an appropriate treatment plan.

“When I was told about the test, I just thought why not?” says Cindy.

“I was also diagnosed as medication and treatment-resistant, meaning I needed much higher doses than I’d been getting.”

5 years later, Cindy says taking the test has given both her and her treating doctor a clearer map to navigate her journey with depression

“I still have dips in my mood, but they don’t end up with me in hospital. With the medication that I’m on now, plus the help I get from my psychologist and other support workers, we can manage it.”

Cindy, now 35, and her partner Tom have been together for 6 years and have a 5-year-old daughter, Olivia. Cindy works with horses, coaching adults and children, something that would have been unthinkable in the past.

“The medications I’m on now have given me a functioning life.”

While this type of testing isn’t new, knowledge of specific genetic tests is still growing in Australia’s medical community.

If you are interested in finding out more about genetic testing for medications, speak to your GP.