Harvard Psychiatrist Finds Mental Illness Starts in Your Cells

This shift in understanding moves beyond the long-held focus on chemical imbalances, pointing instead to the mitochondria and other energy systems that keep brain cells alive and connected, the journal Genomic Psychiatry reported.

Scientists have found that even before symptoms appear, these metabolic weaknesses can set the stage for conditions such as depression, bipolar disorder, and schizophrenia. The findings open the door to treatments that repair cellular function rather than simply adjusting neurotransmitters, marking a potential turning point in the prevention and management of psychiatric disorders worldwide.

In a recent Genomic Press interview featured in Genomic Psychiatry, Dr. Bruce M. Cohen discusses groundbreaking discoveries that are transforming how psychiatry understands and treats complex brain disorders. As the Robertson-Steele Professor of Psychiatry at Harvard Medical School and Director of the Program for Neuropsychiatric Research at McLean Hospital, Dr. Cohen reflects on nearly fifty years of research and places his work within a growing body of evidence that is redefining approaches to mental health care worldwide.

Dr. Cohen’s laboratory has led the development of advanced methods for cultivating brain cells from patient samples through induced pluripotent stem cell technology, an innovation he describes as “giving us leads we did not have forty years ago.” These tools have uncovered crucial abnormalities in how neurons produce energy and communicate—insights that are shedding light on the biological roots of psychiatric illness affecting millions across the globe. With more than 400 peer-reviewed publications and five patents, Dr. Cohen’s research is paving the way for therapies that may prove more effective and precisely targeted than current treatments.

The interview details how Dr. Cohen’s team has identified fundamental disruptions in cellular energy metabolism that appear to underlie major psychiatric conditions. These discoveries offer major promise for developing targeted treatments that could be applied across diverse populations. His studies demonstrate that brain cells derived from people with schizophrenia, bipolar disorder, and Alzheimer’s disease show intrinsic metabolic dysfunctions that may be corrected before illness symptoms develop.

This metabolic perspective represents a fundamental shift from the neurotransmitter-based theories that have dominated psychiatry for decades. Dr. Cohen emphasizes that the brain depends more than any other organ on precise energy generation and cell-to-cell communication. His findings suggest that stabilizing these essential processes could help prevent or reduce psychiatric symptoms in at-risk individuals around the world.

Dr. Cohen’s multidisciplinary research strategy integrates genomics, brain imaging, and cellular modeling to create a comprehensive view of mental illness. This unified framework is giving scientists new tools to better understand the biology of mood, psychotic, and cognitive disorders that affect people across cultures and continents.

Instead of the status quo expert-consensus diagnostic systems, which place people in categories, Dr. Cohen advocates implementation of an evidence-based dimensional approach for describing patients. He argues that terms like “schizophrenia” should be retired in favor of scientifically accurate alternatives that reduce stigma while better capturing illness complexity. His proposed dimensional model focuses on symptom profiles rather than categorical labels, offering clinicians more nuanced tools for patient assessment and treatment planning.

This diagnostic revolution extends beyond mere terminology. Dr. Cohen’s research demonstrates that traditional categorical systems fail to reflect underlying biological realities or clinical presentations adequately. His dimensional approach aligns with how clinicians actually evaluate patients, globally, providing richer individual descriptions while enabling formation of more homogeneous research cohorts. Such reforms could transform psychiatric practice internationally, improving diagnostic precision and treatment outcomes across diverse healthcare systems.

The interview explores how these new models could particularly benefit regions where Western diagnostic frameworks have proven problematic. By emphasizing observable symptoms and illness trajectories rather than culturally bound categories, dimensional approaches offer universal applicability while respecting local contexts and experiences.

Dr. Cohen’s impact extends beyond research laboratories. As McLean Hospital President and Psychiatrist-in-Chief from 1997 to 2005, he reversed financial decline while establishing over 30 new programs advancing both clinical care and scientific investigation. His leadership philosophy emphasized supporting frontline staff and reducing bureaucracy, principles applicable to healthcare institutions worldwide facing similar challenges.

Under his guidance, McLean achieved record levels of patient care, research funding, and educational training. These accomplishments demonstrate how scientific rigor combined with compassionate leadership can transform struggling institutions into thriving centers of excellence. His experience offers valuable lessons for hospital administrators globally confronting resource constraints while striving to maintain quality care and research productivity.

Particularly noteworthy was his establishment of Waverley Place, a peer-run center supporting individuals with mental illness living in communities. This innovative model, prioritizing mission over revenue generation, demonstrates how psychiatric institutions can serve broader societal needs while maintaining financial viability.

The interview reveals personal experiences shaping Dr. Cohen’s scientific trajectory. From early fascination with physics and mathematics to transformative encounters with psychiatric patients during medical training, his journey illustrates how diverse intellectual interests can converge to advance medical understanding. His first psychiatric patient, a young woman whose dramatic improvement on medication left lasting impressions, exemplifies psychiatry’s potential to restore lives devastated by mental illness.

Dr. Cohen acknowledges anxieties and shyness that limited some professional opportunities, offering honest reflections rarely shared by prominent researchers. These admissions humanize scientific achievement while encouraging young investigators worldwide who may face similar personal challenges. His perseverance despite such obstacles demonstrates that scientific excellence emerges through dedication rather than the absence of struggle.

Family influences feature prominently throughout the narrative. His father, a prominent internist, provided early models of medical dedication and research collaboration. Now married for over 55 years, Dr. Cohen credits family support as fundamental to sustained career achievements. These personal dimensions remind readers that transformative science emerges from human experiences transcending laboratory walls.

Looking forward, Dr. Cohen expresses optimism about psychiatric research trajectories while acknowledging societal challenges. His current investigations focus on identifying targetable mechanisms determining illness risk, with particular emphasis on prevention strategies. Since psychotic disorders rarely manifest before adolescence and dementias typically emerge later in life, preventive interventions appear increasingly feasible.

The interview highlights how technological advances, particularly in cellular reprogramming and genomic analysis, provide unprecedented opportunities for understanding inherent determinants of psychiatric disorders. These tools, increasingly accessible to researchers worldwide through initiatives prominently including those supported by Genomic Press, democratize scientific discovery while accelerating progress toward effective treatments.

Dr. Cohen emphasizes the importance of supporting unconventional ideas and new investigators, criticizing tendencies to restrict most funding to mainstream, next step research. His vision encompasses global scientific communities where innovation thrives regardless of geographic location or institutional prestige. This perspective aligns perfectly with open-access publishing models championed by Genomic Press, ensuring research reaches audiences worldwide without financial barriers.

Dr. Bruce M. Cohen’s Genomic Press interview is part of a larger series called Innovators & Ideas that highlights the people behind today’s most influential scientific breakthroughs. Each interview in the series offers a blend of cutting-edge research and personal reflections, providing readers with a comprehensive view of the scientists shaping the future. By combining a focus on professional achievements with personal insights, this interview style invites a richer narrative that both engages and educates readers. This format provides an ideal starting point for profiles that explore the scientist’s impact on the field, while also touching on broader human themes.

4155/v