Tag Archives: ‘better

‘Cannabis strengthened our bond’: can pot make you a better parent?

An Oregon mother posted a photo last year of herself breastfeeding her baby while she took a bong hit. Naturally, the image went viral.

Amid the expected backlash, some much milder criticism came from Jenn Lauder, an Oregon cannabis activist who co-founded Splimm, a newsletter on pot and parenting, with her husband. Lauder chided the breastfeeder for exposing the baby to smoke and for the “optics” of the image.

“That mom could have made better choices,” Lauder told me recently. The former teacher has said that while she did not use cannabis when pregnant with her daughter, she resumed shortly after giving birth, and while breastfeeding, to mitigate postpartum depression.

Lauder added: “I’ve yet to see compelling evidence that a lactating mother’s cannabis consumption produces any negative effects for a nursing child.”

Doctors would not agree. THC, the active ingredient in marijuana, is transmitted in breastmilk, according to a recent study. And while the effect on newborns hasn’t been intensely studied, the chemical is widely believed to impair brain development.

Yes, it’s jarring to see a woman in a quintessential act of motherhood, with her face in a bong. But the reality is some parents believe cannabis improves their child rearing. That number is bound to increase as cannabis use becomes more acceptable with legalization. And vape pens and edibles make it easy to do discreetly.

No cannabis brand I’m aware of directly markets to pregnant women, but scores promote themselves as health and “wellness” products, a message pregnant woman can absorb as easily as anyone else.

Aside from the more fraught area of breastfeeding, marijuana, as cannamoms and cannadads see it, relieves the tedium of parenting while helping them engage with their children. The phrase that keeps coming up is “being present”.

With marijuana, “I’m able to sit and play Legos for an extensive period of time or make dinner and make it more fun rather than something functional,” said April Pride, founder of Van der Pop, a line of stylish cannabis accessories for women.

She said it also helped break up the monotony of spending more time at home.

The drug’s complex legal status makes it difficult for researchers to study the phenomenon of parents who use cannabis or what it might mean for the children. As with so much else in the marijuana world, supporters see parenting and interactions with other parents as an opportunity to destigmatize weed and draw a favorable comparison with alcohol.

A New Jersey restaurant owner and dad, who asked that his name not be printed, said he had continued to use cannabis in moderation as a parent, but didn’t involve his “super well-adjusted” kids in it. “There’s too much taboo about it. It’s the equivalent of having a couple glasses of wine in my life.”

Pride said: “For me, alcohol feels more like an escape … And cannabis feels like something I participate in because I want to be more involved in what I’m doing.”

illustration of baby bag with bong


Marijuana, as cannamoms and cannadads see it, relieves the tedium of parenting. Illustration: George Wylesol

Living in Seattle, Washington, a liberal city in a legal state, Pride says it’s not especially awkward to discuss weed with the other parents. “People are more curious than judgmental,” she said. “I’ve found if people have opinions they keep it to themselves.”

As with many things marijuana related, one of the worst things that can happen when one combines responsible use while parenting is to get caught with it. Even in some legal states, evidence of pot smoking by parents is enough to call in child protective services. And when parents split, cannabis use can be used against them in custody hearings.

When a parent is an open cannabis user it can also change the tenor of conversations with kids about drug use. “Cannabis has strengthened the bond I have with my daughter because I’m honest about something that’s important to me,” Lauder said. “At age 10, she’s incredibly social justice minded.”

Lauder doesn’t give cannabis to her daughter because of the risks it poses to brain development, but she hopes when her daughter gets older she’ll consider marijuana as an alternative to alcohol. “For her, it’s just another kind of medicine.”

Garyn Angel, CEO of MagicalButter, a company which makes devices for infusing cannabis into cooking ingredients like butter and oil, said: “Parenting is about consciousness and cannabis makes you very conscious.” If nothing else, he said, it cut down on alcohol consumption, which he says improved his parenting.

As for what other parents think, he isn’t concerned. “If my kids were screw-ups that would be a different situation,” he said. “But my kids are amazing.”

For a different perspective, I reached out to an old friend whose father is a daily pot smoker. As a kid, he said, his father was unhappy with his work. He knew after dad came home and spent some time in the basement, he’d be in a better mood. “He was a lot chiller,” my friend said, and “more likely to give in to stuff.”

My friend saw other individuals use different drugs and suffer dire consequences but the only negative side-effect my friend noticed with his father was that he had a “memory like a Wiffle ball. I never knew if he was going to remember if we had a conversation or not.”

Why two brains are better than one

Last week, I was told my other brain is fully grown. It doesn’t look like much. A blob of pale flesh about the size of a small pea, it floats in a bath of blood-red nutrient. It would fit into the cranium of a foetus barely a month old.

Still, it’s a “brain” after a fashion and it’s made from me. From a piece of my arm, to be precise.

I’m not going to pretend this isn’t strange. But neither is it an exercise in gratuitously ghoulish biological engineering, a piece of Frankensteinian scientific hubris 200 years after Mary Shelley’s tale. The researchers who made my mini-brain are trying to understand how neurodegenerative diseases develop. With mini-brains grown from the tissues of people who have a genetic susceptibility to the early onset of conditions such as Alzheimer’s, they hope to unravel what goes awry in the mature adult brain.

It’s this link to studies of dementia that led me to the little room in the Dementia Research Centre of University College London last July, where neuroscientist Ross Paterson anaesthetised my upper arm and then sliced a small plug of flesh from it. This biopsy was going to be the seed for growing brain cells – neurons – that would organise themselves into mini-brains.

Fibroblasts grow from pieces of Philip Ball’s arm tissue.


Fibroblasts grow from pieces of Philip Ball’s arm tissue.

The Brains in a Dish project is one of many strands of Created Out of Mind, an initiative hosted at the Wellcome Collection in London and funded by the Wellcome Trust for two years to explore, challenge and shape perceptions and understanding of dementias through science and the creative arts. Neuroscientist Selina Wray at UCL is studying the genetics of Alzheimer’s and other neurodegenerative diseases and she and her PhD student Christopher Lovejoy gamely agreed to culture mini-brains from cells taken from four of the Created Out of Mind team: artist Charlie Murphy, who is leading Brains in a Dish, BBC journalist Fergus Walsh, neurologist Nick Fox and me.

It was a no-brainer… well, you know what I mean. Who could resist the narcissistic flattery of having another brain grown for them? I was curious how it would feel. Would I see this piece of disembodied tissue as truly mine? Would I feel protective of, even concerned for, a tiny “organoid” floating in a petri dish? Most of all, I was attracted by the extraordinary scientific feat of turning a lump of arm into something like a brain.

There’s a lot of baggage in that “something like”. Some researchers dislike the term “mini-brain” and with reason. This pea-size object is not a miniature version of the brain in my skull. It’s not even quite like the immature developing brain of an early-stage foetus. Without a body, neurons don’t quite know how to make a proper brain.

But neither are mini-brains blobs of identical neurons, like, say, a small chunk of my cortex. One can fairly say that the neurons “want” to make a brain but, lacking proper guidance, don’t quite know how to go about it. So they make a reasonable but imperfect approximation.

The mini-brain contains several types of brain cell, arranged somewhat as in a real brain – in layers such as those of the cortex, for example. The mini-brain even contains sketchy little versions of the folds and grooves on the surface of a true brain and appendages that, in a foetal brain, would become the brain stem and central nervous system, extending down the spine.

What’s most astonishing about this project is that these neurons started out as a piece of my arm. Those skin-forming cells, fibroblasts, were turned into brain cells using a technique discovered barely 10 years ago and that has revolutionised tissue engineering and embryo research and won its creator, Shinya Yamanaka, a Nobel prize. It also overturned decades of conventional wisdom in cell biology.

Induced stem cells labelled with fluorescent tags.


Induced stem cells labelled with fluorescent tags. Photograph: Chris Lovejoy and Selina Wray/UCL

Our bodies grow from a single cell – a fertilised egg – by cell division accompanied by increasing cell specialisation. In the very earliest days of an embryo’s development, all its cells are capable of growing into any kind of tissue in the body. These are called embryonic stem cells and their complete versatility is called “pluripotency”.

As the embryo grows, some cells become committed to particular fates – they become skin cells, liver, heart, brain or bone-forming cells and so on. This differentiation springs from a modification of the cells’ genetic programme: the switching on and off of genes. As they differentiate, cells may change their shapes as well as their functions. Neurons grow the long, thin appendages that wire them into networks, the ends equipped with synapses where one cell sends an electrical signal to others. That signalling is the stuff of thought.

It was believed cell differentiation was one way – that once a cell was committed to a fate, there was no going back and that the silenced genes were switched off for ever. So it came as a surprise to many researchers when, in 2007, Yamanaka, a biologist at Kyoto University, reported that he could convert differentiated human cells directly back to a stem-cell-like state by adding to them the genetic material for making certain types of protein.

Yamanaka and his colleagues used viruses to inject into the mature cells some of the genes that are highly active in embryonic stem cells and they found that just four of these were enough to switch the cells into a pluripotent state, becoming, to all intents and purposes, like stem cells. These became known as induced pluripotent stem cells (iPSCs).


I do think of these brain organoids as ‘mine’, although not with any sense of ownership or pastoral duty

In principle, iPSCs can be grown outside the body into any tissue type, perhaps even into entire organs such as a pancreas or kidney, to replace a malfunctioning one by transplantation. Organs could be grown from cells – taken, like mine, from an arm, say – of the recipient, thus avoiding problems of immune rejection.

Creating organs involves knowing how to guide iPSCs towards the appropriate fate. This might involve giving them an extra dose of the genes that are highly active in that particular tissue type. But Chris turned my own iPSCs into neurons simply by changing the nutrient medium; such stem cells seem to have a preference for becoming neurons, so they only need a nudge to get them going.

Organs aren’t just big masses of a single cell type, however. The heart, kidney, brain and so on all contain many types of cell, organised in particular ways and fed with a blood supply. Reproducing that complex architecture in organs grown outside the body remains a huge challenge.

Yet cells can do a lot of it themselves. The biologist Madeline Lancaster discovered this when she was studying the growth of neurons from stem cells as a doctoral student in Vienna with the neuroscientist Jürgen Knoblich in 2010. She found that the neurons, left to their own devices, would start to specialise and organise into mini-brains.

The author’s brain organoid.


The author’s brain organoid. Photograph: Chris Lovejoy and Selina Wray/UCL

The plan, Lancaster (who now runs her own lab at the University of Cambridge) told me, was that she would make flat neural structures called rosettes, which had been done before. But the mouse stem cells she worked with wouldn’t stick well to the surface of the dishes. Instead, says Lancaster, “they formed these really beautiful 3D structures. It was a complete accident.”

Once they realised what they had made, she and Knoblich started to grow the structures from human stem cells, too. “At first, it was totally surprising that these cells could make a structure rather like a brain all by themselves”, she says. But in retrospect, she says, it makes complete sense. That kind of self-organisation is “just what an embryo does.” And it’s what I can now see in my own mini-brain, the different cell types stained with fluorescent dye to become a beautiful, multicoloured constellation under the microscope.

Lancaster and others are now seeking to find ways to supply mini-brains with more of the environmental cues they would get in a developing foetus, so that they can become even more brain-like. “You don’t need a completely well-formed human brain in a dish to study biological questions,” she explains. But if you can improve the resemblance in the right respects, you’ll get a better picture of the process in real bodies.

Lancaster uses brain organoids to investigate how the size of the human brain gets fixed. She has studied microcephaly, a growth defect that results in abnormally small brain size, and is also interested in what can make brains grow too big, which, contrary to what you might expect, is not a good thing and is linked to neurological disorders such as autism.

Other researchers are using these mini-brains to study conditions such as schizophrenia and epilepsy. At UCL, Wray is making them to understand the neurodegenerative process in two types of dementia: Alzheimer’s and frontotemporal dementia. The atrophy of brain tissue may start when two proteins called tau and amyloid beta switch from normal to misshapen form. These forms stick together in clumps and tangles that accumulate in the brain and cause neurons to die.

The author’s brain organoid in cross-section, with the cells stained different colours by type.


The author’s brain organoid in cross-section, with the cells stained different colours by type. Photograph: Chris Lovejoy and Selina Wray/UCL

By culturing mini-brains from the cells of people with a genetic predisposition to these diseases (who account for about 1% to 5% of all cases), Wray hopes to find out what goes awry with the two proteins as neurons grow. “We are making mini-brains to try to follow the disease in real time,” she says. “We hope to see the very earliest disease-associated changes – that’s important when we think about developing treatment.” She has found that the tau proteins for the disease samples are different from those in healthy samples. My cultures may eventually be anonymised and used as one of those control samples.

How do I feel about these pieces of me growing in dishes in the centre of the city, six miles away from where I live? I was surprised to discover that they are no longer, officially, pieces of me at all. Cells that have divided outside the body are not classed as samples of tissue from an individual, but as “cell lines” – more nebulous entities that are distinct from their original donor.

Yet I do think of these brain organoids as “mine”, although not with any sense of ownership or pastoral duty. That’s probably a common response in people whose cells are cultured in the lab. The cancer cells taken in 1951 from the patient Henrietta Lacks at Johns Hopkins University hospital in Baltimore just before she died, and used for research (without her consent, which was not then required), are still regarded by Lacks’s surviving family as in some sense “her”, as Rebecca Skloot described in her bestselling 2011 book The Immortal Life of Henrietta Lacks. These “HeLa” cells are now the standard cell line for studying cancer and millions of tonnes of them have been grown worldwide: a piece of a person turned into a mass-produced commodity.

I’ll be very glad if my mini-brain can contribute in some small way to Wray’s research. I do not fear that it will have anything like anguished thoughts, any awareness at all, in its Matrix-like nutrient bath. But it does still seem like a piece of me, a wistful little attempt to remake the brain I take so much for granted. We have no frame of reference for thinking about such things. It is exciting and odd. But it’s also a glimpse of the future.

Why two brains are better than one

Last week, I was told my other brain is fully grown. It doesn’t look like much. A blob of pale flesh about the size of a small pea, it floats in a bath of blood-red nutrient. It would fit into the cranium of a foetus barely a month old.

Still, it’s a “brain” after a fashion and it’s made from me. From a piece of my arm, to be precise.

I’m not going to pretend this isn’t strange. But neither is it an exercise in gratuitously ghoulish biological engineering, a piece of Frankensteinian scientific hubris 200 years after Mary Shelley’s tale. The researchers who made my mini-brain are trying to understand how neurodegenerative diseases develop. With mini-brains grown from the tissues of people who have a genetic susceptibility to the early onset of conditions such as Alzheimer’s, they hope to unravel what goes awry in the mature adult brain.

It’s this link to studies of dementia that led me to the little room in the Dementia Research Centre of University College London last July, where neuroscientist Ross Paterson anaesthetised my upper arm and then sliced a small plug of flesh from it. This biopsy was going to be the seed for growing brain cells – neurons – that would organise themselves into mini-brains.

Fibroblasts grow from pieces of Philip Ball’s arm tissue.


Fibroblasts grow from pieces of Philip Ball’s arm tissue.

The Brains in a Dish project is one of many strands of Created Out of Mind, an initiative hosted at the Wellcome Collection in London and funded by the Wellcome Trust for two years to explore, challenge and shape perceptions and understanding of dementias through science and the creative arts. Neuroscientist Selina Wray at UCL is studying the genetics of Alzheimer’s and other neurodegenerative diseases and she and her PhD student Christopher Lovejoy gamely agreed to culture mini-brains from cells taken from four of the Created Out of Mind team: artist Charlie Murphy, who is leading Brains in a Dish, BBC journalist Fergus Walsh, neurologist Nick Fox and me.

It was a no-brainer… well, you know what I mean. Who could resist the narcissistic flattery of having another brain grown for them? I was curious how it would feel. Would I see this piece of disembodied tissue as truly mine? Would I feel protective of, even concerned for, a tiny “organoid” floating in a petri dish? Most of all, I was attracted by the extraordinary scientific feat of turning a lump of arm into something like a brain.

There’s a lot of baggage in that “something like”. Some researchers dislike the term “mini-brain” and with reason. This pea-size object is not a miniature version of the brain in my skull. It’s not even quite like the immature developing brain of an early-stage foetus. Without a body, neurons don’t quite know how to make a proper brain.

But neither are mini-brains blobs of identical neurons, like, say, a small chunk of my cortex. One can fairly say that the neurons “want” to make a brain but, lacking proper guidance, don’t quite know how to go about it. So they make a reasonable but imperfect approximation.

The mini-brain contains several types of brain cell, arranged somewhat as in a real brain – in layers such as those of the cortex, for example. The mini-brain even contains sketchy little versions of the folds and grooves on the surface of a true brain and appendages that, in a foetal brain, would become the brain stem and central nervous system, extending down the spine.

What’s most astonishing about this project is that these neurons started out as a piece of my arm. Those skin-forming cells, fibroblasts, were turned into brain cells using a technique discovered barely 10 years ago and that has revolutionised tissue engineering and embryo research and won its creator, Shinya Yamanaka, a Nobel prize. It also overturned decades of conventional wisdom in cell biology.

Induced stem cells labelled with fluorescent tags.


Induced stem cells labelled with fluorescent tags. Photograph: Chris Lovejoy and Selina Wray/UCL

Our bodies grow from a single cell – a fertilised egg – by cell division accompanied by increasing cell specialisation. In the very earliest days of an embryo’s development, all its cells are capable of growing into any kind of tissue in the body. These are called embryonic stem cells and their complete versatility is called “pluripotency”.

As the embryo grows, some cells become committed to particular fates – they become skin cells, liver, heart, brain or bone-forming cells and so on. This differentiation springs from a modification of the cells’ genetic programme: the switching on and off of genes. As they differentiate, cells may change their shapes as well as their functions. Neurons grow the long, thin appendages that wire them into networks, the ends equipped with synapses where one cell sends an electrical signal to others. That signalling is the stuff of thought.

It was believed cell differentiation was one way – that once a cell was committed to a fate, there was no going back and that the silenced genes were switched off for ever. So it came as a surprise to many researchers when, in 2007, Yamanaka, a biologist at Kyoto University, reported that he could convert differentiated human cells directly back to a stem-cell-like state by adding to them the genetic material for making certain types of protein.

Yamanaka and his colleagues used viruses to inject into the mature cells some of the genes that are highly active in embryonic stem cells and they found that just four of these were enough to switch the cells into a pluripotent state, becoming, to all intents and purposes, like stem cells. These became known as induced pluripotent stem cells (iPSCs).


I do think of these brain organoids as ‘mine’, although not with any sense of ownership or pastoral duty

In principle, iPSCs can be grown outside the body into any tissue type, perhaps even into entire organs such as a pancreas or kidney, to replace a malfunctioning one by transplantation. Organs could be grown from cells – taken, like mine, from an arm, say – of the recipient, thus avoiding problems of immune rejection.

Creating organs involves knowing how to guide iPSCs towards the appropriate fate. This might involve giving them an extra dose of the genes that are highly active in that particular tissue type. But Chris turned my own iPSCs into neurons simply by changing the nutrient medium; such stem cells seem to have a preference for becoming neurons, so they only need a nudge to get them going.

Organs aren’t just big masses of a single cell type, however. The heart, kidney, brain and so on all contain many types of cell, organised in particular ways and fed with a blood supply. Reproducing that complex architecture in organs grown outside the body remains a huge challenge.

Yet cells can do a lot of it themselves. The biologist Madeline Lancaster discovered this when she was studying the growth of neurons from stem cells as a doctoral student in Vienna with the neuroscientist Jürgen Knoblich in 2010. She found that the neurons, left to their own devices, would start to specialise and organise into mini-brains.

The author’s brain organoid.


The author’s brain organoid. Photograph: Chris Lovejoy and Selina Wray/UCL

The plan, Lancaster (who now runs her own lab at the University of Cambridge) told me, was that she would make flat neural structures called rosettes, which had been done before. But the mouse stem cells she worked with wouldn’t stick well to the surface of the dishes. Instead, says Lancaster, “they formed these really beautiful 3D structures. It was a complete accident.”

Once they realised what they had made, she and Knoblich started to grow the structures from human stem cells, too. “At first, it was totally surprising that these cells could make a structure rather like a brain all by themselves”, she says. But in retrospect, she says, it makes complete sense. That kind of self-organisation is “just what an embryo does.” And it’s what I can now see in my own mini-brain, the different cell types stained with fluorescent dye to become a beautiful, multicoloured constellation under the microscope.

Lancaster and others are now seeking to find ways to supply mini-brains with more of the environmental cues they would get in a developing foetus, so that they can become even more brain-like. “You don’t need a completely well-formed human brain in a dish to study biological questions,” she explains. But if you can improve the resemblance in the right respects, you’ll get a better picture of the process in real bodies.

Lancaster uses brain organoids to investigate how the size of the human brain gets fixed. She has studied microcephaly, a growth defect that results in abnormally small brain size, and is also interested in what can make brains grow too big, which, contrary to what you might expect, is not a good thing and is linked to neurological disorders such as autism.

Other researchers are using these mini-brains to study conditions such as schizophrenia and epilepsy. At UCL, Wray is making them to understand the neurodegenerative process in two types of dementia: Alzheimer’s and frontotemporal dementia. The atrophy of brain tissue may start when two proteins called tau and amyloid beta switch from normal to misshapen form. These forms stick together in clumps and tangles that accumulate in the brain and cause neurons to die.

The author’s brain organoid in cross-section, with the cells stained different colours by type.


The author’s brain organoid in cross-section, with the cells stained different colours by type. Photograph: Chris Lovejoy and Selina Wray/UCL

By culturing mini-brains from the cells of people with a genetic predisposition to these diseases (who account for about 1% to 5% of all cases), Wray hopes to find out what goes awry with the two proteins as neurons grow. “We are making mini-brains to try to follow the disease in real time,” she says. “We hope to see the very earliest disease-associated changes – that’s important when we think about developing treatment.” She has found that the tau proteins for the disease samples are different from those in healthy samples. My cultures may eventually be anonymised and used as one of those control samples.

How do I feel about these pieces of me growing in dishes in the centre of the city, six miles away from where I live? I was surprised to discover that they are no longer, officially, pieces of me at all. Cells that have divided outside the body are not classed as samples of tissue from an individual, but as “cell lines” – more nebulous entities that are distinct from their original donor.

Yet I do think of these brain organoids as “mine”, although not with any sense of ownership or pastoral duty. That’s probably a common response in people whose cells are cultured in the lab. The cancer cells taken in 1951 from the patient Henrietta Lacks at Johns Hopkins University hospital in Baltimore just before she died, and used for research (without her consent, which was not then required), are still regarded by Lacks’s surviving family as in some sense “her”, as Rebecca Skloot described in her bestselling 2011 book The Immortal Life of Henrietta Lacks. These “HeLa” cells are now the standard cell line for studying cancer and millions of tonnes of them have been grown worldwide: a piece of a person turned into a mass-produced commodity.

I’ll be very glad if my mini-brain can contribute in some small way to Wray’s research. I do not fear that it will have anything like anguished thoughts, any awareness at all, in its Matrix-like nutrient bath. But it does still seem like a piece of me, a wistful little attempt to remake the brain I take so much for granted. We have no frame of reference for thinking about such things. It is exciting and odd. But it’s also a glimpse of the future.

Why two brains are better than one

Last week, I was told my other brain is fully grown. It doesn’t look like much. A blob of pale flesh about the size of a small pea, it floats in a bath of blood-red nutrient. It would fit into the cranium of a foetus barely a month old.

Still, it’s a “brain” after a fashion and it’s made from me. From a piece of my arm, to be precise.

I’m not going to pretend this isn’t strange. But neither is it an exercise in gratuitously ghoulish biological engineering, a piece of Frankensteinian scientific hubris 200 years after Mary Shelley’s tale. The researchers who made my mini-brain are trying to understand how neurodegenerative diseases develop. With mini-brains grown from the tissues of people who have a genetic susceptibility to the early onset of conditions such as Alzheimer’s, they hope to unravel what goes awry in the mature adult brain.

It’s this link to studies of dementia that led me to the little room in the Dementia Research Centre of University College London last July, where neuroscientist Ross Paterson anaesthetised my upper arm and then sliced a small plug of flesh from it. This biopsy was going to be the seed for growing brain cells – neurons – that would organise themselves into mini-brains.

Fibroblasts grow from pieces of Philip Ball’s arm tissue.


Fibroblasts grow from pieces of Philip Ball’s arm tissue.

The Brains in a Dish project is one of many strands of Created Out of Mind, an initiative hosted at the Wellcome Collection in London and funded by the Wellcome Trust for two years to explore, challenge and shape perceptions and understanding of dementias through science and the creative arts. Neuroscientist Selina Wray at UCL is studying the genetics of Alzheimer’s and other neurodegenerative diseases and she and her PhD student Christopher Lovejoy gamely agreed to culture mini-brains from cells taken from four of the Created Out of Mind team: artist Charlie Murphy, who is leading Brains in a Dish, BBC journalist Fergus Walsh, neurologist Nick Fox and me.

It was a no-brainer… well, you know what I mean. Who could resist the narcissistic flattery of having another brain grown for them? I was curious how it would feel. Would I see this piece of disembodied tissue as truly mine? Would I feel protective of, even concerned for, a tiny “organoid” floating in a petri dish? Most of all, I was attracted by the extraordinary scientific feat of turning a lump of arm into something like a brain.

There’s a lot of baggage in that “something like”. Some researchers dislike the term “mini-brain” and with reason. This pea-size object is not a miniature version of the brain in my skull. It’s not even quite like the immature developing brain of an early-stage foetus. Without a body, neurons don’t quite know how to make a proper brain.

But neither are mini-brains blobs of identical neurons, like, say, a small chunk of my cortex. One can fairly say that the neurons “want” to make a brain but, lacking proper guidance, don’t quite know how to go about it. So they make a reasonable but imperfect approximation.

The mini-brain contains several types of brain cell, arranged somewhat as in a real brain – in layers such as those of the cortex, for example. The mini-brain even contains sketchy little versions of the folds and grooves on the surface of a true brain and appendages that, in a foetal brain, would become the brain stem and central nervous system, extending down the spine.

What’s most astonishing about this project is that these neurons started out as a piece of my arm. Those skin-forming cells, fibroblasts, were turned into brain cells using a technique discovered barely 10 years ago and that has revolutionised tissue engineering and embryo research and won its creator, Shinya Yamanaka, a Nobel prize. It also overturned decades of conventional wisdom in cell biology.

Induced stem cells labelled with fluorescent tags.


Induced stem cells labelled with fluorescent tags. Photograph: Chris Lovejoy and Selina Wray/UCL

Our bodies grow from a single cell – a fertilised egg – by cell division accompanied by increasing cell specialisation. In the very earliest days of an embryo’s development, all its cells are capable of growing into any kind of tissue in the body. These are called embryonic stem cells and their complete versatility is called “pluripotency”.

As the embryo grows, some cells become committed to particular fates – they become skin cells, liver, heart, brain or bone-forming cells and so on. This differentiation springs from a modification of the cells’ genetic programme: the switching on and off of genes. As they differentiate, cells may change their shapes as well as their functions. Neurons grow the long, thin appendages that wire them into networks, the ends equipped with synapses where one cell sends an electrical signal to others. That signalling is the stuff of thought.

It was believed cell differentiation was one way – that once a cell was committed to a fate, there was no going back and that the silenced genes were switched off for ever. So it came as a surprise to many researchers when, in 2007, Yamanaka, a biologist at Kyoto University, reported that he could convert differentiated human cells directly back to a stem-cell-like state by adding to them the genetic material for making certain types of protein.

Yamanaka and his colleagues used viruses to inject into the mature cells some of the genes that are highly active in embryonic stem cells and they found that just four of these were enough to switch the cells into a pluripotent state, becoming, to all intents and purposes, like stem cells. These became known as induced pluripotent stem cells (iPSCs).


I do think of these brain organoids as ‘mine’, although not with any sense of ownership or pastoral duty

In principle, iPSCs can be grown outside the body into any tissue type, perhaps even into entire organs such as a pancreas or kidney, to replace a malfunctioning one by transplantation. Organs could be grown from cells – taken, like mine, from an arm, say – of the recipient, thus avoiding problems of immune rejection.

Creating organs involves knowing how to guide iPSCs towards the appropriate fate. This might involve giving them an extra dose of the genes that are highly active in that particular tissue type. But Chris turned my own iPSCs into neurons simply by changing the nutrient medium; such stem cells seem to have a preference for becoming neurons, so they only need a nudge to get them going.

Organs aren’t just big masses of a single cell type, however. The heart, kidney, brain and so on all contain many types of cell, organised in particular ways and fed with a blood supply. Reproducing that complex architecture in organs grown outside the body remains a huge challenge.

Yet cells can do a lot of it themselves. The biologist Madeline Lancaster discovered this when she was studying the growth of neurons from stem cells as a doctoral student in Vienna with the neuroscientist Jürgen Knoblich in 2010. She found that the neurons, left to their own devices, would start to specialise and organise into mini-brains.

The author’s brain organoid.


The author’s brain organoid. Photograph: Chris Lovejoy and Selina Wray/UCL

The plan, Lancaster (who now runs her own lab at the University of Cambridge) told me, was that she would make flat neural structures called rosettes, which had been done before. But the mouse stem cells she worked with wouldn’t stick well to the surface of the dishes. Instead, says Lancaster, “they formed these really beautiful 3D structures. It was a complete accident.”

Once they realised what they had made, she and Knoblich started to grow the structures from human stem cells, too. “At first, it was totally surprising that these cells could make a structure rather like a brain all by themselves”, she says. But in retrospect, she says, it makes complete sense. That kind of self-organisation is “just what an embryo does.” And it’s what I can now see in my own mini-brain, the different cell types stained with fluorescent dye to become a beautiful, multicoloured constellation under the microscope.

Lancaster and others are now seeking to find ways to supply mini-brains with more of the environmental cues they would get in a developing foetus, so that they can become even more brain-like. “You don’t need a completely well-formed human brain in a dish to study biological questions,” she explains. But if you can improve the resemblance in the right respects, you’ll get a better picture of the process in real bodies.

Lancaster uses brain organoids to investigate how the size of the human brain gets fixed. She has studied microcephaly, a growth defect that results in abnormally small brain size, and is also interested in what can make brains grow too big, which, contrary to what you might expect, is not a good thing and is linked to neurological disorders such as autism.

Other researchers are using these mini-brains to study conditions such as schizophrenia and epilepsy. At UCL, Wray is making them to understand the neurodegenerative process in two types of dementia: Alzheimer’s and frontotemporal dementia. The atrophy of brain tissue may start when two proteins called tau and amyloid beta switch from normal to misshapen form. These forms stick together in clumps and tangles that accumulate in the brain and cause neurons to die.

The author’s brain organoid in cross-section, with the cells stained different colours by type.


The author’s brain organoid in cross-section, with the cells stained different colours by type. Photograph: Chris Lovejoy and Selina Wray/UCL

By culturing mini-brains from the cells of people with a genetic predisposition to these diseases (who account for about 1% to 5% of all cases), Wray hopes to find out what goes awry with the two proteins as neurons grow. “We are making mini-brains to try to follow the disease in real time,” she says. “We hope to see the very earliest disease-associated changes – that’s important when we think about developing treatment.” She has found that the tau proteins for the disease samples are different from those in healthy samples. My cultures may eventually be anonymised and used as one of those control samples.

How do I feel about these pieces of me growing in dishes in the centre of the city, six miles away from where I live? I was surprised to discover that they are no longer, officially, pieces of me at all. Cells that have divided outside the body are not classed as samples of tissue from an individual, but as “cell lines” – more nebulous entities that are distinct from their original donor.

Yet I do think of these brain organoids as “mine”, although not with any sense of ownership or pastoral duty. That’s probably a common response in people whose cells are cultured in the lab. The cancer cells taken in 1951 from the patient Henrietta Lacks at Johns Hopkins University hospital in Baltimore just before she died, and used for research (without her consent, which was not then required), are still regarded by Lacks’s surviving family as in some sense “her”, as Rebecca Skloot described in her bestselling 2011 book The Immortal Life of Henrietta Lacks. These “HeLa” cells are now the standard cell line for studying cancer and millions of tonnes of them have been grown worldwide: a piece of a person turned into a mass-produced commodity.

I’ll be very glad if my mini-brain can contribute in some small way to Wray’s research. I do not fear that it will have anything like anguished thoughts, any awareness at all, in its Matrix-like nutrient bath. But it does still seem like a piece of me, a wistful little attempt to remake the brain I take so much for granted. We have no frame of reference for thinking about such things. It is exciting and odd. But it’s also a glimpse of the future.

Why two brains are better than one

Last week, I was told my other brain is fully grown. It doesn’t look like much. A blob of pale flesh about the size of a small pea, it floats in a bath of blood-red nutrient. It would fit into the cranium of a foetus barely a month old.

Still, it’s a “brain” after a fashion and it’s made from me. From a piece of my arm, to be precise.

I’m not going to pretend this isn’t strange. But neither is it an exercise in gratuitously ghoulish biological engineering, a piece of Frankensteinian scientific hubris 200 years after Mary Shelley’s tale. The researchers who made my mini-brain are trying to understand how neurodegenerative diseases develop. With mini-brains grown from the tissues of people who have a genetic susceptibility to the early onset of conditions such as Alzheimer’s, they hope to unravel what goes awry in the mature adult brain.

It’s this link to studies of dementia that led me to the little room in the Dementia Research Centre of University College London last July, where neuroscientist Ross Paterson anaesthetised my upper arm and then sliced a small plug of flesh from it. This biopsy was going to be the seed for growing brain cells – neurons – that would organise themselves into mini-brains.

Fibroblasts grow from pieces of Philip Ball’s arm tissue.


Fibroblasts grow from pieces of Philip Ball’s arm tissue.

The Brains in a Dish project is one of many strands of Created Out of Mind, an initiative hosted at the Wellcome Collection in London and funded by the Wellcome Trust for two years to explore, challenge and shape perceptions and understanding of dementias through science and the creative arts. Neuroscientist Selina Wray at UCL is studying the genetics of Alzheimer’s and other neurodegenerative diseases and she and her PhD student Christopher Lovejoy gamely agreed to culture mini-brains from cells taken from four of the Created Out of Mind team: artist Charlie Murphy, who is leading Brains in a Dish, BBC journalist Fergus Walsh, neurologist Nick Fox and me.

It was a no-brainer… well, you know what I mean. Who could resist the narcissistic flattery of having another brain grown for them? I was curious how it would feel. Would I see this piece of disembodied tissue as truly mine? Would I feel protective of, even concerned for, a tiny “organoid” floating in a petri dish? Most of all, I was attracted by the extraordinary scientific feat of turning a lump of arm into something like a brain.

There’s a lot of baggage in that “something like”. Some researchers dislike the term “mini-brain” and with reason. This pea-size object is not a miniature version of the brain in my skull. It’s not even quite like the immature developing brain of an early-stage foetus. Without a body, neurons don’t quite know how to make a proper brain.

But neither are mini-brains blobs of identical neurons, like, say, a small chunk of my cortex. One can fairly say that the neurons “want” to make a brain but, lacking proper guidance, don’t quite know how to go about it. So they make a reasonable but imperfect approximation.

The mini-brain contains several types of brain cell, arranged somewhat as in a real brain – in layers such as those of the cortex, for example. The mini-brain even contains sketchy little versions of the folds and grooves on the surface of a true brain and appendages that, in a foetal brain, would become the brain stem and central nervous system, extending down the spine.

What’s most astonishing about this project is that these neurons started out as a piece of my arm. Those skin-forming cells, fibroblasts, were turned into brain cells using a technique discovered barely 10 years ago and that has revolutionised tissue engineering and embryo research and won its creator, Shinya Yamanaka, a Nobel prize. It also overturned decades of conventional wisdom in cell biology.

Induced stem cells labelled with fluorescent tags.


Induced stem cells labelled with fluorescent tags. Photograph: Chris Lovejoy and Selina Wray/UCL

Our bodies grow from a single cell – a fertilised egg – by cell division accompanied by increasing cell specialisation. In the very earliest days of an embryo’s development, all its cells are capable of growing into any kind of tissue in the body. These are called embryonic stem cells and their complete versatility is called “pluripotency”.

As the embryo grows, some cells become committed to particular fates – they become skin cells, liver, heart, brain or bone-forming cells and so on. This differentiation springs from a modification of the cells’ genetic programme: the switching on and off of genes. As they differentiate, cells may change their shapes as well as their functions. Neurons grow the long, thin appendages that wire them into networks, the ends equipped with synapses where one cell sends an electrical signal to others. That signalling is the stuff of thought.

It was believed cell differentiation was one way – that once a cell was committed to a fate, there was no going back and that the silenced genes were switched off for ever. So it came as a surprise to many researchers when, in 2007, Yamanaka, a biologist at Kyoto University, reported that he could convert differentiated human cells directly back to a stem-cell-like state by adding to them the genetic material for making certain types of protein.

Yamanaka and his colleagues used viruses to inject into the mature cells some of the genes that are highly active in embryonic stem cells and they found that just four of these were enough to switch the cells into a pluripotent state, becoming, to all intents and purposes, like stem cells. These became known as induced pluripotent stem cells (iPSCs).


I do think of these brain organoids as ‘mine’, although not with any sense of ownership or pastoral duty

In principle, iPSCs can be grown outside the body into any tissue type, perhaps even into entire organs such as a pancreas or kidney, to replace a malfunctioning one by transplantation. Organs could be grown from cells – taken, like mine, from an arm, say – of the recipient, thus avoiding problems of immune rejection.

Creating organs involves knowing how to guide iPSCs towards the appropriate fate. This might involve giving them an extra dose of the genes that are highly active in that particular tissue type. But Chris turned my own iPSCs into neurons simply by changing the nutrient medium; such stem cells seem to have a preference for becoming neurons, so they only need a nudge to get them going.

Organs aren’t just big masses of a single cell type, however. The heart, kidney, brain and so on all contain many types of cell, organised in particular ways and fed with a blood supply. Reproducing that complex architecture in organs grown outside the body remains a huge challenge.

Yet cells can do a lot of it themselves. The biologist Madeline Lancaster discovered this when she was studying the growth of neurons from stem cells as a doctoral student in Vienna with the neuroscientist Jürgen Knoblich in 2010. She found that the neurons, left to their own devices, would start to specialise and organise into mini-brains.

The author’s brain organoid.


The author’s brain organoid. Photograph: Chris Lovejoy and Selina Wray/UCL

The plan, Lancaster (who now runs her own lab at the University of Cambridge) told me, was that she would make flat neural structures called rosettes, which had been done before. But the mouse stem cells she worked with wouldn’t stick well to the surface of the dishes. Instead, says Lancaster, “they formed these really beautiful 3D structures. It was a complete accident.”

Once they realised what they had made, she and Knoblich started to grow the structures from human stem cells, too. “At first, it was totally surprising that these cells could make a structure rather like a brain all by themselves”, she says. But in retrospect, she says, it makes complete sense. That kind of self-organisation is “just what an embryo does.” And it’s what I can now see in my own mini-brain, the different cell types stained with fluorescent dye to become a beautiful, multicoloured constellation under the microscope.

Lancaster and others are now seeking to find ways to supply mini-brains with more of the environmental cues they would get in a developing foetus, so that they can become even more brain-like. “You don’t need a completely well-formed human brain in a dish to study biological questions,” she explains. But if you can improve the resemblance in the right respects, you’ll get a better picture of the process in real bodies.

Lancaster uses brain organoids to investigate how the size of the human brain gets fixed. She has studied microcephaly, a growth defect that results in abnormally small brain size, and is also interested in what can make brains grow too big, which, contrary to what you might expect, is not a good thing and is linked to neurological disorders such as autism.

Other researchers are using these mini-brains to study conditions such as schizophrenia and epilepsy. At UCL, Wray is making them to understand the neurodegenerative process in two types of dementia: Alzheimer’s and frontotemporal dementia. The atrophy of brain tissue may start when two proteins called tau and amyloid beta switch from normal to misshapen form. These forms stick together in clumps and tangles that accumulate in the brain and cause neurons to die.

The author’s brain organoid in cross-section, with the cells stained different colours by type.


The author’s brain organoid in cross-section, with the cells stained different colours by type. Photograph: Chris Lovejoy and Selina Wray/UCL

By culturing mini-brains from the cells of people with a genetic predisposition to these diseases (who account for about 1% to 5% of all cases), Wray hopes to find out what goes awry with the two proteins as neurons grow. “We are making mini-brains to try to follow the disease in real time,” she says. “We hope to see the very earliest disease-associated changes – that’s important when we think about developing treatment.” She has found that the tau proteins for the disease samples are different from those in healthy samples. My cultures may eventually be anonymised and used as one of those control samples.

How do I feel about these pieces of me growing in dishes in the centre of the city, six miles away from where I live? I was surprised to discover that they are no longer, officially, pieces of me at all. Cells that have divided outside the body are not classed as samples of tissue from an individual, but as “cell lines” – more nebulous entities that are distinct from their original donor.

Yet I do think of these brain organoids as “mine”, although not with any sense of ownership or pastoral duty. That’s probably a common response in people whose cells are cultured in the lab. The cancer cells taken in 1951 from the patient Henrietta Lacks at Johns Hopkins University hospital in Baltimore just before she died, and used for research (without her consent, which was not then required), are still regarded by Lacks’s surviving family as in some sense “her”, as Rebecca Skloot described in her bestselling 2011 book The Immortal Life of Henrietta Lacks. These “HeLa” cells are now the standard cell line for studying cancer and millions of tonnes of them have been grown worldwide: a piece of a person turned into a mass-produced commodity.

I’ll be very glad if my mini-brain can contribute in some small way to Wray’s research. I do not fear that it will have anything like anguished thoughts, any awareness at all, in its Matrix-like nutrient bath. But it does still seem like a piece of me, a wistful little attempt to remake the brain I take so much for granted. We have no frame of reference for thinking about such things. It is exciting and odd. But it’s also a glimpse of the future.

Why two brains are better than one

Last week, I was told my other brain is fully grown. It doesn’t look like much. A blob of pale flesh about the size of a small pea, it floats in a bath of blood-red nutrient. It would fit into the cranium of a foetus barely a month old.

Still, it’s a “brain” after a fashion and it’s made from me. From a piece of my arm, to be precise.

I’m not going to pretend this isn’t strange. But neither is it an exercise in gratuitously ghoulish biological engineering, a piece of Frankensteinian scientific hubris 200 years after Mary Shelley’s tale. The researchers who made my mini-brain are trying to understand how neurodegenerative diseases develop. With mini-brains grown from the tissues of people who have a genetic susceptibility to the early onset of conditions such as Alzheimer’s, they hope to unravel what goes awry in the mature adult brain.

It’s this link to studies of dementia that led me to the little room in the Dementia Research Centre of University College London last July, where neuroscientist Ross Paterson anaesthetised my upper arm and then sliced a small plug of flesh from it. This biopsy was going to be the seed for growing brain cells – neurons – that would organise themselves into mini-brains.

Fibroblasts grow from pieces of Philip Ball’s arm tissue.


Fibroblasts grow from pieces of Philip Ball’s arm tissue.

The Brains in a Dish project is one of many strands of Created Out of Mind, an initiative hosted at the Wellcome Collection in London and funded by the Wellcome Trust for two years to explore, challenge and shape perceptions and understanding of dementias through science and the creative arts. Neuroscientist Selina Wray at UCL is studying the genetics of Alzheimer’s and other neurodegenerative diseases and she and her PhD student Christopher Lovejoy gamely agreed to culture mini-brains from cells taken from four of the Created Out of Mind team: artist Charlie Murphy, who is leading Brains in a Dish, BBC journalist Fergus Walsh, neurologist Nick Fox and me.

It was a no-brainer… well, you know what I mean. Who could resist the narcissistic flattery of having another brain grown for them? I was curious how it would feel. Would I see this piece of disembodied tissue as truly mine? Would I feel protective of, even concerned for, a tiny “organoid” floating in a petri dish? Most of all, I was attracted by the extraordinary scientific feat of turning a lump of arm into something like a brain.

There’s a lot of baggage in that “something like”. Some researchers dislike the term “mini-brain” and with reason. This pea-size object is not a miniature version of the brain in my skull. It’s not even quite like the immature developing brain of an early-stage foetus. Without a body, neurons don’t quite know how to make a proper brain.

But neither are mini-brains blobs of identical neurons, like, say, a small chunk of my cortex. One can fairly say that the neurons “want” to make a brain but, lacking proper guidance, don’t quite know how to go about it. So they make a reasonable but imperfect approximation.

The mini-brain contains several types of brain cell, arranged somewhat as in a real brain – in layers such as those of the cortex, for example. The mini-brain even contains sketchy little versions of the folds and grooves on the surface of a true brain and appendages that, in a foetal brain, would become the brain stem and central nervous system, extending down the spine.

What’s most astonishing about this project is that these neurons started out as a piece of my arm. Those skin-forming cells, fibroblasts, were turned into brain cells using a technique discovered barely 10 years ago and that has revolutionised tissue engineering and embryo research and won its creator, Shinya Yamanaka, a Nobel prize. It also overturned decades of conventional wisdom in cell biology.

Induced stem cells labelled with fluorescent tags.


Induced stem cells labelled with fluorescent tags. Photograph: Chris Lovejoy and Selina Wray/UCL

Our bodies grow from a single cell – a fertilised egg – by cell division accompanied by increasing cell specialisation. In the very earliest days of an embryo’s development, all its cells are capable of growing into any kind of tissue in the body. These are called embryonic stem cells and their complete versatility is called “pluripotency”.

As the embryo grows, some cells become committed to particular fates – they become skin cells, liver, heart, brain or bone-forming cells and so on. This differentiation springs from a modification of the cells’ genetic programme: the switching on and off of genes. As they differentiate, cells may change their shapes as well as their functions. Neurons grow the long, thin appendages that wire them into networks, the ends equipped with synapses where one cell sends an electrical signal to others. That signalling is the stuff of thought.

It was believed cell differentiation was one way – that once a cell was committed to a fate, there was no going back and that the silenced genes were switched off for ever. So it came as a surprise to many researchers when, in 2007, Yamanaka, a biologist at Kyoto University, reported that he could convert differentiated human cells directly back to a stem-cell-like state by adding to them the genetic material for making certain types of protein.

Yamanaka and his colleagues used viruses to inject into the mature cells some of the genes that are highly active in embryonic stem cells and they found that just four of these were enough to switch the cells into a pluripotent state, becoming, to all intents and purposes, like stem cells. These became known as induced pluripotent stem cells (iPSCs).


I do think of these brain organoids as ‘mine’, although not with any sense of ownership or pastoral duty

In principle, iPSCs can be grown outside the body into any tissue type, perhaps even into entire organs such as a pancreas or kidney, to replace a malfunctioning one by transplantation. Organs could be grown from cells – taken, like mine, from an arm, say – of the recipient, thus avoiding problems of immune rejection.

Creating organs involves knowing how to guide iPSCs towards the appropriate fate. This might involve giving them an extra dose of the genes that are highly active in that particular tissue type. But Chris turned my own iPSCs into neurons simply by changing the nutrient medium; such stem cells seem to have a preference for becoming neurons, so they only need a nudge to get them going.

Organs aren’t just big masses of a single cell type, however. The heart, kidney, brain and so on all contain many types of cell, organised in particular ways and fed with a blood supply. Reproducing that complex architecture in organs grown outside the body remains a huge challenge.

Yet cells can do a lot of it themselves. The biologist Madeline Lancaster discovered this when she was studying the growth of neurons from stem cells as a doctoral student in Vienna with the neuroscientist Jürgen Knoblich in 2010. She found that the neurons, left to their own devices, would start to specialise and organise into mini-brains.

The author’s brain organoid.


The author’s brain organoid. Photograph: Chris Lovejoy and Selina Wray/UCL

The plan, Lancaster (who now runs her own lab at the University of Cambridge) told me, was that she would make flat neural structures called rosettes, which had been done before. But the mouse stem cells she worked with wouldn’t stick well to the surface of the dishes. Instead, says Lancaster, “they formed these really beautiful 3D structures. It was a complete accident.”

Once they realised what they had made, she and Knoblich started to grow the structures from human stem cells, too. “At first, it was totally surprising that these cells could make a structure rather like a brain all by themselves”, she says. But in retrospect, she says, it makes complete sense. That kind of self-organisation is “just what an embryo does.” And it’s what I can now see in my own mini-brain, the different cell types stained with fluorescent dye to become a beautiful, multicoloured constellation under the microscope.

Lancaster and others are now seeking to find ways to supply mini-brains with more of the environmental cues they would get in a developing foetus, so that they can become even more brain-like. “You don’t need a completely well-formed human brain in a dish to study biological questions,” she explains. But if you can improve the resemblance in the right respects, you’ll get a better picture of the process in real bodies.

Lancaster uses brain organoids to investigate how the size of the human brain gets fixed. She has studied microcephaly, a growth defect that results in abnormally small brain size, and is also interested in what can make brains grow too big, which, contrary to what you might expect, is not a good thing and is linked to neurological disorders such as autism.

Other researchers are using these mini-brains to study conditions such as schizophrenia and epilepsy. At UCL, Wray is making them to understand the neurodegenerative process in two types of dementia: Alzheimer’s and frontotemporal dementia. The atrophy of brain tissue may start when two proteins called tau and amyloid beta switch from normal to misshapen form. These forms stick together in clumps and tangles that accumulate in the brain and cause neurons to die.

The author’s brain organoid in cross-section, with the cells stained different colours by type.


The author’s brain organoid in cross-section, with the cells stained different colours by type. Photograph: Chris Lovejoy and Selina Wray/UCL

By culturing mini-brains from the cells of people with a genetic predisposition to these diseases (who account for about 1% to 5% of all cases), Wray hopes to find out what goes awry with the two proteins as neurons grow. “We are making mini-brains to try to follow the disease in real time,” she says. “We hope to see the very earliest disease-associated changes – that’s important when we think about developing treatment.” She has found that the tau proteins for the disease samples are different from those in healthy samples. My cultures may eventually be anonymised and used as one of those control samples.

How do I feel about these pieces of me growing in dishes in the centre of the city, six miles away from where I live? I was surprised to discover that they are no longer, officially, pieces of me at all. Cells that have divided outside the body are not classed as samples of tissue from an individual, but as “cell lines” – more nebulous entities that are distinct from their original donor.

Yet I do think of these brain organoids as “mine”, although not with any sense of ownership or pastoral duty. That’s probably a common response in people whose cells are cultured in the lab. The cancer cells taken in 1951 from the patient Henrietta Lacks at Johns Hopkins University hospital in Baltimore just before she died, and used for research (without her consent, which was not then required), are still regarded by Lacks’s surviving family as in some sense “her”, as Rebecca Skloot described in her bestselling 2011 book The Immortal Life of Henrietta Lacks. These “HeLa” cells are now the standard cell line for studying cancer and millions of tonnes of them have been grown worldwide: a piece of a person turned into a mass-produced commodity.

I’ll be very glad if my mini-brain can contribute in some small way to Wray’s research. I do not fear that it will have anything like anguished thoughts, any awareness at all, in its Matrix-like nutrient bath. But it does still seem like a piece of me, a wistful little attempt to remake the brain I take so much for granted. We have no frame of reference for thinking about such things. It is exciting and odd. But it’s also a glimpse of the future.

Why two brains are better than one

Last week, I was told my other brain is fully grown. It doesn’t look like much. A blob of pale flesh about the size of a small pea, it floats in a bath of blood-red nutrient. It would fit into the cranium of a foetus barely a month old.

Still, it’s a “brain” after a fashion and it’s made from me. From a piece of my arm, to be precise.

I’m not going to pretend this isn’t strange. But neither is it an exercise in gratuitously ghoulish biological engineering, a piece of Frankensteinian scientific hubris 200 years after Mary Shelley’s tale. The researchers who made my mini-brain are trying to understand how neurodegenerative diseases develop. With mini-brains grown from the tissues of people who have a genetic susceptibility to the early onset of conditions such as Alzheimer’s, they hope to unravel what goes awry in the mature adult brain.

It’s this link to studies of dementia that led me to the little room in the Dementia Research Centre of University College London last July, where neuroscientist Ross Paterson anaesthetised my upper arm and then sliced a small plug of flesh from it. This biopsy was going to be the seed for growing brain cells – neurons – that would organise themselves into mini-brains.

Fibroblasts grow from pieces of Philip Ball’s arm tissue.


Fibroblasts grow from pieces of Philip Ball’s arm tissue.

The Brains in a Dish project is one of many strands of Created Out of Mind, an initiative hosted at the Wellcome Collection in London and funded by the Wellcome Trust for two years to explore, challenge and shape perceptions and understanding of dementias through science and the creative arts. Neuroscientist Selina Wray at UCL is studying the genetics of Alzheimer’s and other neurodegenerative diseases and she and her PhD student Christopher Lovejoy gamely agreed to culture mini-brains from cells taken from four of the Created Out of Mind team: artist Charlie Murphy, who is leading Brains in a Dish, BBC journalist Fergus Walsh, neurologist Nick Fox and me.

It was a no-brainer… well, you know what I mean. Who could resist the narcissistic flattery of having another brain grown for them? I was curious how it would feel. Would I see this piece of disembodied tissue as truly mine? Would I feel protective of, even concerned for, a tiny “organoid” floating in a petri dish? Most of all, I was attracted by the extraordinary scientific feat of turning a lump of arm into something like a brain.

There’s a lot of baggage in that “something like”. Some researchers dislike the term “mini-brain” and with reason. This pea-size object is not a miniature version of the brain in my skull. It’s not even quite like the immature developing brain of an early-stage foetus. Without a body, neurons don’t quite know how to make a proper brain.

But neither are mini-brains blobs of identical neurons, like, say, a small chunk of my cortex. One can fairly say that the neurons “want” to make a brain but, lacking proper guidance, don’t quite know how to go about it. So they make a reasonable but imperfect approximation.

The mini-brain contains several types of brain cell, arranged somewhat as in a real brain – in layers such as those of the cortex, for example. The mini-brain even contains sketchy little versions of the folds and grooves on the surface of a true brain and appendages that, in a foetal brain, would become the brain stem and central nervous system, extending down the spine.

What’s most astonishing about this project is that these neurons started out as a piece of my arm. Those skin-forming cells, fibroblasts, were turned into brain cells using a technique discovered barely 10 years ago and that has revolutionised tissue engineering and embryo research and won its creator, Shinya Yamanaka, a Nobel prize. It also overturned decades of conventional wisdom in cell biology.

Induced stem cells labelled with fluorescent tags.


Induced stem cells labelled with fluorescent tags. Photograph: Chris Lovejoy and Selina Wray/UCL

Our bodies grow from a single cell – a fertilised egg – by cell division accompanied by increasing cell specialisation. In the very earliest days of an embryo’s development, all its cells are capable of growing into any kind of tissue in the body. These are called embryonic stem cells and their complete versatility is called “pluripotency”.

As the embryo grows, some cells become committed to particular fates – they become skin cells, liver, heart, brain or bone-forming cells and so on. This differentiation springs from a modification of the cells’ genetic programme: the switching on and off of genes. As they differentiate, cells may change their shapes as well as their functions. Neurons grow the long, thin appendages that wire them into networks, the ends equipped with synapses where one cell sends an electrical signal to others. That signalling is the stuff of thought.

It was believed cell differentiation was one way – that once a cell was committed to a fate, there was no going back and that the silenced genes were switched off for ever. So it came as a surprise to many researchers when, in 2007, Yamanaka, a biologist at Kyoto University, reported that he could convert differentiated human cells directly back to a stem-cell-like state by adding to them the genetic material for making certain types of protein.

Yamanaka and his colleagues used viruses to inject into the mature cells some of the genes that are highly active in embryonic stem cells and they found that just four of these were enough to switch the cells into a pluripotent state, becoming, to all intents and purposes, like stem cells. These became known as induced pluripotent stem cells (iPSCs).


I do think of these brain organoids as ‘mine’, although not with any sense of ownership or pastoral duty

In principle, iPSCs can be grown outside the body into any tissue type, perhaps even into entire organs such as a pancreas or kidney, to replace a malfunctioning one by transplantation. Organs could be grown from cells – taken, like mine, from an arm, say – of the recipient, thus avoiding problems of immune rejection.

Creating organs involves knowing how to guide iPSCs towards the appropriate fate. This might involve giving them an extra dose of the genes that are highly active in that particular tissue type. But Chris turned my own iPSCs into neurons simply by changing the nutrient medium; such stem cells seem to have a preference for becoming neurons, so they only need a nudge to get them going.

Organs aren’t just big masses of a single cell type, however. The heart, kidney, brain and so on all contain many types of cell, organised in particular ways and fed with a blood supply. Reproducing that complex architecture in organs grown outside the body remains a huge challenge.

Yet cells can do a lot of it themselves. The biologist Madeline Lancaster discovered this when she was studying the growth of neurons from stem cells as a doctoral student in Vienna with the neuroscientist Jürgen Knoblich in 2010. She found that the neurons, left to their own devices, would start to specialise and organise into mini-brains.

The author’s brain organoid.


The author’s brain organoid. Photograph: Chris Lovejoy and Selina Wray/UCL

The plan, Lancaster (who now runs her own lab at the University of Cambridge) told me, was that she would make flat neural structures called rosettes, which had been done before. But the mouse stem cells she worked with wouldn’t stick well to the surface of the dishes. Instead, says Lancaster, “they formed these really beautiful 3D structures. It was a complete accident.”

Once they realised what they had made, she and Knoblich started to grow the structures from human stem cells, too. “At first, it was totally surprising that these cells could make a structure rather like a brain all by themselves”, she says. But in retrospect, she says, it makes complete sense. That kind of self-organisation is “just what an embryo does.” And it’s what I can now see in my own mini-brain, the different cell types stained with fluorescent dye to become a beautiful, multicoloured constellation under the microscope.

Lancaster and others are now seeking to find ways to supply mini-brains with more of the environmental cues they would get in a developing foetus, so that they can become even more brain-like. “You don’t need a completely well-formed human brain in a dish to study biological questions,” she explains. But if you can improve the resemblance in the right respects, you’ll get a better picture of the process in real bodies.

Lancaster uses brain organoids to investigate how the size of the human brain gets fixed. She has studied microcephaly, a growth defect that results in abnormally small brain size, and is also interested in what can make brains grow too big, which, contrary to what you might expect, is not a good thing and is linked to neurological disorders such as autism.

Other researchers are using these mini-brains to study conditions such as schizophrenia and epilepsy. At UCL, Wray is making them to understand the neurodegenerative process in two types of dementia: Alzheimer’s and frontotemporal dementia. The atrophy of brain tissue may start when two proteins called tau and amyloid beta switch from normal to misshapen form. These forms stick together in clumps and tangles that accumulate in the brain and cause neurons to die.

The author’s brain organoid in cross-section, with the cells stained different colours by type.


The author’s brain organoid in cross-section, with the cells stained different colours by type. Photograph: Chris Lovejoy and Selina Wray/UCL

By culturing mini-brains from the cells of people with a genetic predisposition to these diseases (who account for about 1% to 5% of all cases), Wray hopes to find out what goes awry with the two proteins as neurons grow. “We are making mini-brains to try to follow the disease in real time,” she says. “We hope to see the very earliest disease-associated changes – that’s important when we think about developing treatment.” She has found that the tau proteins for the disease samples are different from those in healthy samples. My cultures may eventually be anonymised and used as one of those control samples.

How do I feel about these pieces of me growing in dishes in the centre of the city, six miles away from where I live? I was surprised to discover that they are no longer, officially, pieces of me at all. Cells that have divided outside the body are not classed as samples of tissue from an individual, but as “cell lines” – more nebulous entities that are distinct from their original donor.

Yet I do think of these brain organoids as “mine”, although not with any sense of ownership or pastoral duty. That’s probably a common response in people whose cells are cultured in the lab. The cancer cells taken in 1951 from the patient Henrietta Lacks at Johns Hopkins University hospital in Baltimore just before she died, and used for research (without her consent, which was not then required), are still regarded by Lacks’s surviving family as in some sense “her”, as Rebecca Skloot described in her bestselling 2011 book The Immortal Life of Henrietta Lacks. These “HeLa” cells are now the standard cell line for studying cancer and millions of tonnes of them have been grown worldwide: a piece of a person turned into a mass-produced commodity.

I’ll be very glad if my mini-brain can contribute in some small way to Wray’s research. I do not fear that it will have anything like anguished thoughts, any awareness at all, in its Matrix-like nutrient bath. But it does still seem like a piece of me, a wistful little attempt to remake the brain I take so much for granted. We have no frame of reference for thinking about such things. It is exciting and odd. But it’s also a glimpse of the future.

Why two brains are better than one

Last week, I was told my other brain is fully grown. It doesn’t look like much. A blob of pale flesh about the size of a small pea, it floats in a bath of blood-red nutrient. It would fit into the cranium of a foetus barely a month old.

Still, it’s a “brain” after a fashion and it’s made from me. From a piece of my arm, to be precise.

I’m not going to pretend this isn’t strange. But neither is it an exercise in gratuitously ghoulish biological engineering, a piece of Frankensteinian scientific hubris 200 years after Mary Shelley’s tale. The researchers who made my mini-brain are trying to understand how neurodegenerative diseases develop. With mini-brains grown from the tissues of people who have a genetic susceptibility to the early onset of conditions such as Alzheimer’s, they hope to unravel what goes awry in the mature adult brain.

It’s this link to studies of dementia that led me to the little room in the Dementia Research Centre of University College London last July, where neuroscientist Ross Paterson anaesthetised my upper arm and then sliced a small plug of flesh from it. This biopsy was going to be the seed for growing brain cells – neurons – that would organise themselves into mini-brains.

Fibroblasts grow from pieces of Philip Ball’s arm tissue.


Fibroblasts grow from pieces of Philip Ball’s arm tissue.

The Brains in a Dish project is one of many strands of Created Out of Mind, an initiative hosted at the Wellcome Collection in London and funded by the Wellcome Trust for two years to explore, challenge and shape perceptions and understanding of dementias through science and the creative arts. Neuroscientist Selina Wray at UCL is studying the genetics of Alzheimer’s and other neurodegenerative diseases and she and her PhD student Christopher Lovejoy gamely agreed to culture mini-brains from cells taken from four of the Created Out of Mind team: artist Charlie Murphy, who is leading Brains in a Dish, BBC journalist Fergus Walsh, neurologist Nick Fox and me.

It was a no-brainer… well, you know what I mean. Who could resist the narcissistic flattery of having another brain grown for them? I was curious how it would feel. Would I see this piece of disembodied tissue as truly mine? Would I feel protective of, even concerned for, a tiny “organoid” floating in a petri dish? Most of all, I was attracted by the extraordinary scientific feat of turning a lump of arm into something like a brain.

There’s a lot of baggage in that “something like”. Some researchers dislike the term “mini-brain” and with reason. This pea-size object is not a miniature version of the brain in my skull. It’s not even quite like the immature developing brain of an early-stage foetus. Without a body, neurons don’t quite know how to make a proper brain.

But neither are mini-brains blobs of identical neurons, like, say, a small chunk of my cortex. One can fairly say that the neurons “want” to make a brain but, lacking proper guidance, don’t quite know how to go about it. So they make a reasonable but imperfect approximation.

The mini-brain contains several types of brain cell, arranged somewhat as in a real brain – in layers such as those of the cortex, for example. The mini-brain even contains sketchy little versions of the folds and grooves on the surface of a true brain and appendages that, in a foetal brain, would become the brain stem and central nervous system, extending down the spine.

What’s most astonishing about this project is that these neurons started out as a piece of my arm. Those skin-forming cells, fibroblasts, were turned into brain cells using a technique discovered barely 10 years ago and that has revolutionised tissue engineering and embryo research and won its creator, Shinya Yamanaka, a Nobel prize. It also overturned decades of conventional wisdom in cell biology.

Induced stem cells labelled with fluorescent tags.


Induced stem cells labelled with fluorescent tags. Photograph: Chris Lovejoy and Selina Wray/UCL

Our bodies grow from a single cell – a fertilised egg – by cell division accompanied by increasing cell specialisation. In the very earliest days of an embryo’s development, all its cells are capable of growing into any kind of tissue in the body. These are called embryonic stem cells and their complete versatility is called “pluripotency”.

As the embryo grows, some cells become committed to particular fates – they become skin cells, liver, heart, brain or bone-forming cells and so on. This differentiation springs from a modification of the cells’ genetic programme: the switching on and off of genes. As they differentiate, cells may change their shapes as well as their functions. Neurons grow the long, thin appendages that wire them into networks, the ends equipped with synapses where one cell sends an electrical signal to others. That signalling is the stuff of thought.

It was believed cell differentiation was one way – that once a cell was committed to a fate, there was no going back and that the silenced genes were switched off for ever. So it came as a surprise to many researchers when, in 2007, Yamanaka, a biologist at Kyoto University, reported that he could convert differentiated human cells directly back to a stem-cell-like state by adding to them the genetic material for making certain types of protein.

Yamanaka and his colleagues used viruses to inject into the mature cells some of the genes that are highly active in embryonic stem cells and they found that just four of these were enough to switch the cells into a pluripotent state, becoming, to all intents and purposes, like stem cells. These became known as induced pluripotent stem cells (iPSCs).


I do think of these brain organoids as ‘mine’, although not with any sense of ownership or pastoral duty

In principle, iPSCs can be grown outside the body into any tissue type, perhaps even into entire organs such as a pancreas or kidney, to replace a malfunctioning one by transplantation. Organs could be grown from cells – taken, like mine, from an arm, say – of the recipient, thus avoiding problems of immune rejection.

Creating organs involves knowing how to guide iPSCs towards the appropriate fate. This might involve giving them an extra dose of the genes that are highly active in that particular tissue type. But Chris turned my own iPSCs into neurons simply by changing the nutrient medium; such stem cells seem to have a preference for becoming neurons, so they only need a nudge to get them going.

Organs aren’t just big masses of a single cell type, however. The heart, kidney, brain and so on all contain many types of cell, organised in particular ways and fed with a blood supply. Reproducing that complex architecture in organs grown outside the body remains a huge challenge.

Yet cells can do a lot of it themselves. The biologist Madeline Lancaster discovered this when she was studying the growth of neurons from stem cells as a doctoral student in Vienna with the neuroscientist Jürgen Knoblich in 2010. She found that the neurons, left to their own devices, would start to specialise and organise into mini-brains.

The author’s brain organoid.


The author’s brain organoid. Photograph: Chris Lovejoy and Selina Wray/UCL

The plan, Lancaster (who now runs her own lab at the University of Cambridge) told me, was that she would make flat neural structures called rosettes, which had been done before. But the mouse stem cells she worked with wouldn’t stick well to the surface of the dishes. Instead, says Lancaster, “they formed these really beautiful 3D structures. It was a complete accident.”

Once they realised what they had made, she and Knoblich started to grow the structures from human stem cells, too. “At first, it was totally surprising that these cells could make a structure rather like a brain all by themselves”, she says. But in retrospect, she says, it makes complete sense. That kind of self-organisation is “just what an embryo does.” And it’s what I can now see in my own mini-brain, the different cell types stained with fluorescent dye to become a beautiful, multicoloured constellation under the microscope.

Lancaster and others are now seeking to find ways to supply mini-brains with more of the environmental cues they would get in a developing foetus, so that they can become even more brain-like. “You don’t need a completely well-formed human brain in a dish to study biological questions,” she explains. But if you can improve the resemblance in the right respects, you’ll get a better picture of the process in real bodies.

Lancaster uses brain organoids to investigate how the size of the human brain gets fixed. She has studied microcephaly, a growth defect that results in abnormally small brain size, and is also interested in what can make brains grow too big, which, contrary to what you might expect, is not a good thing and is linked to neurological disorders such as autism.

Other researchers are using these mini-brains to study conditions such as schizophrenia and epilepsy. At UCL, Wray is making them to understand the neurodegenerative process in two types of dementia: Alzheimer’s and frontotemporal dementia. The atrophy of brain tissue may start when two proteins called tau and amyloid beta switch from normal to misshapen form. These forms stick together in clumps and tangles that accumulate in the brain and cause neurons to die.

The author’s brain organoid in cross-section, with the cells stained different colours by type.


The author’s brain organoid in cross-section, with the cells stained different colours by type. Photograph: Chris Lovejoy and Selina Wray/UCL

By culturing mini-brains from the cells of people with a genetic predisposition to these diseases (who account for about 1% to 5% of all cases), Wray hopes to find out what goes awry with the two proteins as neurons grow. “We are making mini-brains to try to follow the disease in real time,” she says. “We hope to see the very earliest disease-associated changes – that’s important when we think about developing treatment.” She has found that the tau proteins for the disease samples are different from those in healthy samples. My cultures may eventually be anonymised and used as one of those control samples.

How do I feel about these pieces of me growing in dishes in the centre of the city, six miles away from where I live? I was surprised to discover that they are no longer, officially, pieces of me at all. Cells that have divided outside the body are not classed as samples of tissue from an individual, but as “cell lines” – more nebulous entities that are distinct from their original donor.

Yet I do think of these brain organoids as “mine”, although not with any sense of ownership or pastoral duty. That’s probably a common response in people whose cells are cultured in the lab. The cancer cells taken in 1951 from the patient Henrietta Lacks at Johns Hopkins University hospital in Baltimore just before she died, and used for research (without her consent, which was not then required), are still regarded by Lacks’s surviving family as in some sense “her”, as Rebecca Skloot described in her bestselling 2011 book The Immortal Life of Henrietta Lacks. These “HeLa” cells are now the standard cell line for studying cancer and millions of tonnes of them have been grown worldwide: a piece of a person turned into a mass-produced commodity.

I’ll be very glad if my mini-brain can contribute in some small way to Wray’s research. I do not fear that it will have anything like anguished thoughts, any awareness at all, in its Matrix-like nutrient bath. But it does still seem like a piece of me, a wistful little attempt to remake the brain I take so much for granted. We have no frame of reference for thinking about such things. It is exciting and odd. But it’s also a glimpse of the future.

Antidepressants work, but there is a better way to break the cycle of harm | Mike Shooter

Sian was just 14, brought by her misery to the edge of self-harm, when I met her in a cafe at the top end of one of the old mining valleys. Neutral ground. She told me about her rugby-playing older brother and her bright little sister who had lots of pets and wanted to be a vet. She felt that her parents doted on them and that there could be no room in anyone’s heart for her. She told me about her only friend, who had been killed in a road accident just as they went up to big school. About the recent death of her grandmother, who had been the only person she could confide in. And about the GP who had said she was depressed and given her a course of pills.

I thought about Sian again this week. The newspaper headlines across the world were welcoming a major study that confirmed the value of antidepressant medication in the treatment of depression in adults. And so did I. Depression was validated at long last as an illness every bit as serious as physical conditions, that could cause untold human suffering and economic devastation, but could be helped with a course of antidepressant pills.

First things first, I heartily agree with what that survey was saying about adult treatment. After all, I have a recurrent depression myself that has needed frequent treatment over the years. I talked about it openly when I was president of the Royal College of Psychiatrists and have continued to do so from the public platform, in the media, and to anyone who will listen. I do this in the hope that it will help to dispel the stigma that surrounds mental illness and prevents people from seeking therapy until it is too late. The diagnosis made sense of what I was going through. It wasn’t my fault. And I was grateful for the medication.


Adult mental illnesses such as depression can be treated when they occur, but most of them have their roots in childhood

Pills do help adults and we shouldn’t be afraid of saying so. And hidden below all the headlines about antidepressant medication was the finding that talking therapies such as cognitive behavioural therapy (CBT) may be just as effective on their own for a lot of people and a vital help in combination with pills for many others – including me. But a warning bell. The situation often requires more than a course of pills and CBT. What helped me, in addition, was the trusting relationship that I found with a psychiatrist who gave me the time, the continuity and the space to explore my feelings about the illness and its origins in the relationships buried deep in my childhood.

And thereby lies my worry as a child psychiatrist, about how the public and professionals might sell this survey short. Adult mental illnesses such as depression can be treated when they occur, but most of them have their roots in childhood and there will be many opportunities to intervene in children’s lives to stop it happening – if only we care to look. The vast majority of young people that I saw had not yet fulfilled a formal diagnosis, did not need a pill for their unhappiness, but their lives were in a mess. Their development had been disrupted by physical illnesses, their trust destroyed by abuse, their faith in the world undermined by death, divorce and natural calamities, and their self-confidence stressed to breaking point by social and academic pressures. Their parents were desperate to help, had been rebuffed or didn’t know what to do.

My book, Growing Pains, is a collection of their stories, just like that of Sian. It is an account of the ways in which I gave them the space to confide in me, perhaps for the very first time, the feelings they had tried so hard to conceal. Feelings that they had taken out on themselves or on those around them. And my work with them, individually and with their parents and carers, helped them to re-tell their story towards a happier ending. Work to prevent the old story from pervading their lives and being passed on to their own children in turn, in a never-ending cycle of harm. It is an affirmation of the healing power of stories and how unhappiness can be helped before it develops into something worse.

Yes, of course, I welcome the messages that adults should take from this survey. But as a child psychiatrist I hope that the pressures on managers, doctors and parents to seek concrete results that can easily be measured will not result in children being burdened with diagnostic formulations and medical treatment before their time, or being diverted into social care because they don’t fit psychiatric categories. Understandable perhaps, but it would miss the chance.

By not offering help in their early years, we run the risk that young people’s unhappiness may crystallise into an adult disorder for which pills may be part of the answer; but we can head most of it off at the pass. We need to get out from the clinic desk and into the community to see children and young people wherever they are, whatever distress they are struggling with, and for as long as it takes to help. We must hold their pain in the intimacy of the relationship that they have with us, no matter how difficult that may be for us on the end of it.

I saw Sian in that cafe every few days for a while. We talked about how she felt about life and how she might begin to love herself as much as she wanted others to love her too. As her self-confidence grew, we agreed to talk with her parents and siblings at home and discovered, to her surprise, that they were just as worried about how she might feel about them. They grieved together about the death of her grandmother, sharing the feelings that had been locked away in Sian. And they were brought closer in their loss.

I sympathise with managers who have to record such help in figures. What I did with Sian and other children in my book would not have sat easily in the figures for through-put of patients, formal diagnoses, treatment and outcome measures. But I do know that Sian had begun to find her true identity, and that her relationships were changed forever. Antidepressants are a vital help for adults who have sunk into a depressive illness, just as I did. Sian was thoroughly miserable but she was not yet formally depressed. What she needed was space to tell her story and someone she could trust to share it with.

Dr Mike Shooter is former president of the Royal College of Psychiatrists and author of Growing Pains: Making Sense of Childhood, A Psychiatrist’s Story

Antidepressants work, but there is a better way to break the cycle of harm | Mike Shooter

Sian was just 14, brought by her misery to the edge of self-harm, when I met her in a cafe at the top end of one of the old mining valleys. Neutral ground. She told me about her rugby-playing older brother and her bright little sister who had lots of pets and wanted to be a vet. She felt that her parents doted on them and that there could be no room in anyone’s heart for her. She told me about her only friend, who had been killed in a road accident just as they went up to big school. About the recent death of her grandmother, who had been the only person she could confide in. And about the GP who had said she was depressed and given her a course of pills.

I thought about Sian again this week. The newspaper headlines across the world were welcoming a major study that confirmed the value of antidepressant medication in the treatment of depression in adults. And so did I. Depression was validated at long last as an illness every bit as serious as physical conditions, that could cause untold human suffering and economic devastation, but could be helped with a course of antidepressant pills.

First things first, I heartily agree with what that survey was saying about adult treatment. After all, I have a recurrent depression myself that has needed frequent treatment over the years. I talked about it openly when I was president of the Royal College of Psychiatrists and have continued to do so from the public platform, in the media, and to anyone who will listen. I do this in the hope that it will help to dispel the stigma that surrounds mental illness and prevents people from seeking therapy until it is too late. The diagnosis made sense of what I was going through. It wasn’t my fault. And I was grateful for the medication.


Adult mental illnesses such as depression can be treated when they occur, but most of them have their roots in childhood

Pills do help adults and we shouldn’t be afraid of saying so. And hidden below all the headlines about antidepressant medication was the finding that talking therapies such as cognitive behavioural therapy (CBT) may be just as effective on their own for a lot of people and a vital help in combination with pills for many others – including me. But a warning bell. The situation often requires more than a course of pills and CBT. What helped me, in addition, was the trusting relationship that I found with a psychiatrist who gave me the time, the continuity and the space to explore my feelings about the illness and its origins in the relationships buried deep in my childhood.

And thereby lies my worry as a child psychiatrist, about how the public and professionals might sell this survey short. Adult mental illnesses such as depression can be treated when they occur, but most of them have their roots in childhood and there will be many opportunities to intervene in children’s lives to stop it happening – if only we care to look. The vast majority of young people that I saw had not yet fulfilled a formal diagnosis, did not need a pill for their unhappiness, but their lives were in a mess. Their development had been disrupted by physical illnesses, their trust destroyed by abuse, their faith in the world undermined by death, divorce and natural calamities, and their self-confidence stressed to breaking point by social and academic pressures. Their parents were desperate to help, had been rebuffed or didn’t know what to do.

My book, Growing Pains, is a collection of their stories, just like that of Sian. It is an account of the ways in which I gave them the space to confide in me, perhaps for the very first time, the feelings they had tried so hard to conceal. Feelings that they had taken out on themselves or on those around them. And my work with them, individually and with their parents and carers, helped them to re-tell their story towards a happier ending. Work to prevent the old story from pervading their lives and being passed on to their own children in turn, in a never-ending cycle of harm. It is an affirmation of the healing power of stories and how unhappiness can be helped before it develops into something worse.

Yes, of course, I welcome the messages that adults should take from this survey. But as a child psychiatrist I hope that the pressures on managers, doctors and parents to seek concrete results that can easily be measured will not result in children being burdened with diagnostic formulations and medical treatment before their time, or being diverted into social care because they don’t fit psychiatric categories. Understandable perhaps, but it would miss the chance.

By not offering help in their early years, we run the risk that young people’s unhappiness may crystallise into an adult disorder for which pills may be part of the answer; but we can head most of it off at the pass. We need to get out from the clinic desk and into the community to see children and young people wherever they are, whatever distress they are struggling with, and for as long as it takes to help. We must hold their pain in the intimacy of the relationship that they have with us, no matter how difficult that may be for us on the end of it.

I saw Sian in that cafe every few days for a while. We talked about how she felt about life and how she might begin to love herself as much as she wanted others to love her too. As her self-confidence grew, we agreed to talk with her parents and siblings at home and discovered, to her surprise, that they were just as worried about how she might feel about them. They grieved together about the death of her grandmother, sharing the feelings that had been locked away in Sian. And they were brought closer in their loss.

I sympathise with managers who have to record such help in figures. What I did with Sian and other children in my book would not have sat easily in the figures for through-put of patients, formal diagnoses, treatment and outcome measures. But I do know that Sian had begun to find her true identity, and that her relationships were changed forever. Antidepressants are a vital help for adults who have sunk into a depressive illness, just as I did. Sian was thoroughly miserable but she was not yet formally depressed. What she needed was space to tell her story and someone she could trust to share it with.

Dr Mike Shooter is former president of the Royal College of Psychiatrists and author of Growing Pains: Making Sense of Childhood, A Psychiatrist’s Story