"A brain tumor appears as a malformed blob on a brain scan shining white among the surrounding gray tissuea certain and devastating diagnosis. Doctors can begin treatment immediately trying to save the most important organ in the body. The brain however is also vulnerable to many more much less visible ailments. Consider the case of Allie Orlando a yearold social service coordinator who has received a plethora of diagnoses since she first saw a psychologist at . First it was generalized anxiety disorder. Next she was told she had depression. Then when she was  it was settled She suffered from borderline personality disorder. But when Orlando traveled out of state for college she began seeing a new psychologist who strongly disagreed with her borderline diagnosis. Meanwhile she continued to struggle and entered the hospital for suicidal ideation her sophomore year. The doctors there agreed Borderline wasnt the right diagnosis and maybe she should stop taking the meds she had been prescribed.  I was just frustrated because the stigma attached to borderline is very strong Orlando says. She had been open about her diagnosis in high school but felt the borderline label may have scared some people off. She recalled her boyfriend at the time searching the web for her diagnosis and saying Oh God no. After that she kept quiet about her diagnosis worried it would drive friends away. Im sure it also affected what meds I was prescribed. It took a few years to find the right formula of meds. While the doctors recommended some medication that helped it was a matter of trial and error since Orlando still doesnt have a concrete diagnosis today. Research Into Biological Markers The problem is that mental health diagnosis has essentially remained unchanged for  years relying on symptoms and clinical interviews. Mental disorders lack what most other health diagnoses rely on biological markers. A tumor seen on a scan bacteria identified by a throat culture a fracture captured on an Xray Theyre all clear signs something is wrong. Mental health disorders are difficult to diagnose even by the most welltrained wellmeaning psychiatrists because all they have to go on are questions and sometimes answers. Diagnosis is really asking lots and lots of questions about their patients experience looking at patients answers both from what they say and how they say it says Dr. Michael Dulchin an assistant professor of psychiatry at the New York University Medical Center. The uncertainty can lead to dangerous misdiagnoses. Without such signs to confirm their diagnosis patients with mental illnesses are often burdened by the perception that they somehow have something less real than most other ailments. For years researchers searched in vain for concrete signs in the brain that could tell them the difference between for example bipolar and depression. Now some believe the key may be realizing that mental illnesses are not necessarily contained in the brain Biomarkers may be found throughout the entire body. Dr. Sabine Bahn a professor of neurotechnology at Cambridge University leads a team researching this premise. As a Ph.D. student she investigated the postmortem brains of psychiatric patients and was surprised to find differences in glucose regulation processes and certain parts of cell production in the brains of schizophrenia patients. Bahns team then looked at the cerebrospinal fluid of earlystage schizophrenia patients who had not yet taken any medication and again saw abnormalities in glucose handling. Bahn says it was a revelation that such changes could be spotted in the blood of patients in such early stages of the disease. What if her team began to think it could come up with a blood test for schizophrenia Having this kind of tool would be invaluablewith the current interviewbased methods of diagnosis subtle symptoms of schizophrenia are missed until too late delaying treatment by months or even years. Armed with her previous research Bahn and her team detailed a panel of blood biomarkers http in individuals who have an increased risk of schizophrenia but have no visible symptoms yet. The test says Bahn can accurately predict whether someone will develop schizophrenia over the next two years. Bahns finding is one of several recent advancements toward a comprehensive system of biological mental health diagnostic tools. One group of researchers for example recently worked backward to take on the problematic overlap between depression and bipolar disordermany bipolar patients are initially and incorrectly diagnosed with depression. The team took urine samples http from patients who had been diagnosed with one of the two disorders and looked for differences between the two groups. The results published in the Journal of Proteome Research showed that  different metabolites differentiated the two groups. Another team of scientists identified differences in the throat bacteria http of schizophrenic and healthy people. Previous research had suggested tentative links between immune disorders which are influenced in part by microbes in the body and schizophrenia the new study published in PeerJ furthered the possibility that differences in oral bacteria could be associated with the disorder. Challenging to Bring to Market Despite these exciting preliminary findings there arent yet any biological tests for mental illness widely used in medical practice. In some cases the reason is primarily financial. The problem with schizophrenia is that although about  percent of the population suffers from schizophrenia the number of new patients per year is quite low at . percent says Bahn. As the development costs of a test are very high there is a risk that the test will not be commercially viable. For severe mental illnesses like schizophrenia its also the case that even if a test made it through development and hit the market it may not be successfully integrated into psychiatric practice. Thats because Dulchin says if a patient comes in with schizophrenia symptoms that a doctor knows can be alleviated with drugs the doctor is not likely to deny that patient treatmentno matter what a biological test says. Those working on these sorts of tests see them being implemented in a different setting entirely when a patient comes into their internist seeking treatment for other conditions. Psychiatric disorders often present with other diseases such as diabetes and some immune disorders says Bahn. If there was a blood test for depression it could just become part of a standard paneland thus help achieve earlier diagnoses and in turn earlier treatment across the board. But if biological tests for mental illness do come to fruition even those already living with a condition could benefit. I think if this biological aspect was attached to it then people would see that stigmatizing someone for their depression is as ridiculous as stigmatizing someone for their diabetes Orlando says. People often need concrete tangible facts and thats what scares them about mental illness and what causes the stigmatizationthey just dont understand it."