When mental illness runs in the family

It isn’t that uncommon to have mental illness tied to your family history. With one in five Americans diagnosed with a mental illness of some kind, it makes sense that I have so many people close to me that are either learning to live with mental illness or loving someone who is mentally ill. Knowing how prevalent mental illness is should make it easier for me to voice my fears about my genetics, but that simply isn’t true. As a teenager, I quietly started the habit of watching for symptoms in myself that mimicked my dad’s. Now that I have children, I observe them closely as well. I am grateful to have healthy children; most of the time I avoid getting caught up in their quirks or difficult behaviors because I know they are behaving like typical toddlers. But after a hard week or when a new behavioral phase emerges, I find myself asking what is normal. Is extreme separation anxiety a sign of an underlying problem? Are the quirky habits my toddler has developed to manage anxiety over hard goodbyes part of being a typical toddler or is this something I need to address the next time we’re in the pediatrician’s office? I worry that something in my genetics is going to catch up to me, that my daughters’ childhoods, like mine, will be negatively impacted by mental illness. I talked to Dr. Laura Paret, Child and Adolescent psychologist at Union Square Practice in New York City, about fearing your genetic background, specifically related to mental illness. She says these fears are not uncommon in parents, pointing out that most people have been affected by mental illness in varying degrees. In fact, she said she often answers questions from young parents who feel anxious about their genetic background to some extent.

Paret says awareness is a key first step toward addressing concerns about the impact a family history of mental illness might have on a child. She suggests that parents channel their awareness of certain behaviors in their children and use it to watch for anxiety and hypervigilance in themselves that may contribute to a self-fulfilling prophecy in their child. “There is a difference between being careful and focused, and when it goes too far,” she explained. “Hypervigilant scanning of one’s child for potential issues could, in fact, be something that undermines their developmental course and puts them at higher risk for developing certain issues. In particular anxiety, we know there is a feedback loop for children who are a little more sensitive. They need a little more help and guidance handling novelty situations.” This feedback loop occurs when parents overprotect more sensitive children. This sends the message that the world isn’t safe or subtly implies that the child isn't capable of handling certain situations, and these children often internalize this message. Paret says this is why mothers and fathers who struggle to manage their own anxiety about their children’s mental health should begin by addressing their own fears. In general, therapy and regular mindfulness practice is a great place to start. Parents should also recognize that genetics play a varied role in mental health. “Things like schizophrenia, psychosis and bipolar [disorder] have a stronger heredity component,” Paret explained. “For those parents … it would be a good idea to get some counseling—even prenatally with one’s partner—to discuss options concerning risks, potential medication, and management.”

While anxiety-based disorders also have a hereditary component, they can be greatly influenced by the environment in which a child grows up. Overall, parents who find they are concerned about the mental health history in their family and how it will affect their children should take comfort in knowing that nothing about their young child is a foregone conclusion. How parents respond to stress in their own lives or how they interact with their sensitive child plays a role in teaching coping skills that will aid them in the future. “Children are unique and one day, one behavior, or one action hardly ever—if ever—means that they are going to be this type of person,” Paret says. “It’s amazing how, when you learn the skills to slow down your thoughts and notice them more objectively and non-judgmentally, you can understand where some of those fears might be coming from but distance yourself from them so they’re not coloring or filtering they way you’re interpreting a child’s behavior.” Learning to slow down and examine my own thoughts when I am getting caught up in fearfulness over the future of my child’s wellness isn’t easy. But, by taking the advice of Dr. Paret, seeking the support of a therapist, and practicing regular mindfulness, I am learning to see my children as their own people, with unique futures that aren’t constrained or predetermined by my fear of the past.