Who suffers from mental illness?

[Storyteller.]

Who suffers from mental illness?
By Robin (PSY)

Many of you may be familiar with the nature vs. nurture debate in regards to mental illness. To briefly summarize, some people believe that genetics determine whether or not individuals will suffer from mental illness, while other people believe that the environment and life events are more responsible for this. In reality, nature AND nurture interact with each other. So what does this mean for those who worry that they or their loved ones may be at-risk for developing mental illnesses?

Genetics. We all know that genetics determine many things about a person – for example, their sex, height, or eye color. What you may not know, however, is that genetics can also play a role in determining our mental health. For example, major depressive disorder is more likely to be present in individuals with two short alleles of the 5-HTT gene. In layman's terms, the composition of specific genes may cause individuals to become more at-risk for developing mental illnesses. Since genetics are hereditary (passed down from parents to children), children whose parents suffer from mental illness may be more likely to develop a mental illness themselves. This conclusion has been supported by identical twin studies for numerous mental illnesses. Since identical twins share the same genetics, it can be assumed that if one twin suffers from a mental illness, the other twin should be more at-risk for developing a mental illness as well. In 1930, four identical sisters (named the “Genain quadruplets”) were observed by the United States National Institute of Mental Health. All four sisters were diagnosed with schizophrenia. It has been estimated that approximately 51 million people (or roughly 1.1% of the world population) over the age of 18 suffer from schizophrenia. Given how rare this mental illness is in the general population, the presence of this mental illness in all four sisters clearly demonstrates that there is a genetic basis for schizophrenia, as well as for many mental illnesses, including depression, anxiety, and substance abuse.

Environment. Wow, that was a lot of information about genetics! Does this mean that if our parents are alcoholics, and if our grandparents are alcoholics, and if our siblings are alcoholics, then we are doomed to become alcoholics as well? Not necessarily. Some genes become “activated” early on, such as the genes that determine what color our eyes will be. Other genes, however, may only become “activated” based on our environment. Again, this conclusion has been supported by identical twin studies. Researchers observed twins who had been separated at birth, and determined that the effects of genetics can either be enhanced or reduced by one's environment. For example, let's say an alcoholic mother gave birth to twins. If both children remained in the home and were exposed to physical/emotional abuse by their alcoholic mother for many years, then they may eventually turn to alcohol themselves in order to cope with the hostile home environment. Based on their genetic composition and the environment in which they were raised (learning that consuming large amounts of alcohol is acceptable, based on their mother's example), they may be more at-risk for becoming alcoholics than the average person. In studies where one twin was removed from their unhealthy environment, however, researchers found that the twin growing up in a loving, nurturing environment was much less at-risk for becoming alcoholic!

Life events. What about highly emotional or traumatic life events? Unfortunately, some people find it difficult to cope with one-time life events such as the loss of a loved one, a break-up or divorce, or being forced to drop out of high school/college. We see this fairly often with members of the military. Some soldiers can witness a comrade's death and eventually “move on” after a great deal of therapy. Other soldiers never quite get over the shock of the traumatic event. As a result, they may develop major depressive disorder or post-traumatic stress disorder. Even the healthiest person, who doesn't have a genetic/hereditary history of mental illness and grows up in a loving, nurturing home environment can develop a mental illness based on one or two highly emotional life events.

So what does all of this mean for you and your loved ones? Basically, no one is “doomed” to develop a mental illness. Genetics can make an individual more at-risk, but a loving, nurturing environment can also counter those effects. On the other hand, someone who is not genetically at-risk may become at-risk based on their hostile home environment and/or certain life events.

What can at-risk individuals do in order to prevent the development of a mental illness (or minimize the effects of a mental illness)? Those who know they have a family history of mental illness can take steps to protect themselves by seeking help from a psychological professional and ensuring that their environment does not enhance the effects of any genetic predispositions toward developing a mental illness. For example, teens who know their parents suffer from major depressive disorder can talk to a school counselor whenever they begin to feel depressed themselves. They can also surround themselves with friends who are upbeat and optimistic about life, rather than gravitating toward friends who also suffer from major depressive disorder. Changing the environment can help counter the effects of genetics. Those who are exposed to hostile home environments can also take steps to protect themselves by seeking help from a psychological professional and changing their environment. For example, teens who live with abusive parents can call Child Protective Services (or similar agencies who protect the welfare of minors) in order to be placed in the care of a more loving, nurturing legal guardian. Continuing to seek help can help counter the effects of environment, no matter how long those teens lived with abusive parents and no matter what they were exposed to while living with abusive parents.

In conclusion, while genetics, the environment, and life events can play a major role in determining whether or not someone develops a mental illness, people are rarely “lost causes”. There is ALWAYS hope for those who are at-risk, no matter how severe their situation may be!