The Science of Risk and Recovery

In A LETHAL INHERITANCE Victoria Costello shares accessible dispatches from the frontiers of neuroscience, which, the author demonstrates, is increasingly offering those with a genetic predisposition to mental illness an understanding of how they can limit their risk of ultimately developing conditions like schizophrenia, depression, and bipolar disorder. She interviews top researchers and digests hundreds of studies that demonstrate the interplay of genetics and environment now believed to be at the heart of many psychiatric disorders. She visits Harvard’s McLean Hospital where researchers are discovering links between certain speech disorders and schizophrenia. She travels to London to meet with eminent brain scientist (and foreword writer) Terrie Moffitt, who explains how certain genetic variants, known as “alleles” may predispose some trauma sufferers to long-term depression. She tracks the successes and failures of pioneers who are leading clinical trials in early intervention for schizophrenia and bipolar disorder in attempts to halt these often debilitating conditions. She plumbs the relationship between creativity and mental illness and wades into the heated debate about if and when to medicate children.

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Here’s a sample of what she found.

From A LETHAL INHERITANCE

Scientific research—including family mental health studies, genetics, neuroimaging, and clinical trials using early interventions for serious mental disorders—determines if, when and how an adult or child with symptoms of mental illness will be diagnosed and treated.

An inkblot from the Rorschach Test created by Herman Rorschach in 1921 and still used diagnostically at such leading research centers as Harvard McLean Hospital’s Psychology Lab.

Because of this, I encourage everyone, especially parents, to dive into the science of mental illness and make it serve you and your family.

This science can seem daunting at first, as it was for me when my son Alex was first diagnosed with schizophrenia. But as I soon discovered, it’s no more confusing that doing your income taxes or following the instructions that come with the average piece of “assembly not included” furniture—with a lot bigger payoff. As parents of autistic children have already discovered, parents who can speak knowledgeably about the neurobiology of a child’s mental disorder are better advocates for their children. As a result these kids receive better care and appropriate schooling.

I refer to this emerging area of research as the science of “risk and recovery.” But it has as just much to do with the prevention of mental illness—which is the next and most important frontier we must cross to achieve family mental wellness.

Pulses of blue and yellow light precisely turn neurons on-and-off using genetically-targeted probes that take advantage of light-sensitive genes borrowed from primitive life-forms. Artist’s rendering. Source: Karl Deisseroth, M.D., Ph.D., Stanford University

Within the scientific establishment, there are continuing fierce debates about whether it “pays” to invest the necessary research dollars and raise public hopes about preventing schizophrenia and other serious mental disorders—when the interventions being tried may not pan out. In response, I like this measured view from one scientist writing in Schizophrenia Bulletin. Answering the “don’t get their hopes up” argument, he said,

“The history of medicine shows that there have been some spectacular applications of primary prevention based on incomplete knowledge… The consumption of limes on long sea voyages was found to prevent scurvy without the benefit of an understanding of vitamin C. Conceivably, public health approaches that have already been implemented in the developed and increasingly in the developing world, including control of infectious diseases, improvements in obstetric and neonatal care, and nutritional supplementation, may already be reaping benefits with regard to the prevention of psychiatric disorders of neurodevelopmental origin, including schizophrenia.” 

By referencing obstetrical complications and nutritional deficits, this scientist raises risk factors that we as parents have some control over. Perhaps we resist the idea of prevention because we’re uncomfortable dwelling in the grey areas where genes meet environment, or as we’ve always thought of it, where nature meets nurture. But that is where the prevention of mental illness puts us. I call this place the “new, new parenting,” a subject I cover at length in my book.

Knowing your family history is now and will remain absolutely critical to ascertaining your risk for mental illness and getting proper mental health treatment. In science speak they say it’s the “best predictor” of risk. Even then, don’t labor under the mistaken impression that your family history puts everything you need to know in a neat black and white profile of measured vulnerability. Risk is best seen as a moving picture, not a snapshot. Even after you’ve filled in all the blanks about relatives long gone, your risk profile will remain filled with grays, or I should say “factors,” since we are now talking about a “multifactorial disease model” for most mental (and physical) disorders.

This is not necessarily bad news. Put simply, it means you have the opportunity to make up for anything “lethal” that nature heaped on you with some conscious self and child-directed nurture to counteract its effects. Instead of viewing DNA as a fixed and passively inherited legacy, I now see risk and responsibility for the health of one’s brain health as a larger, shared undertaking. It begins with the individual and then moves outward to include anything and anyone with whom we come into significant contact—extended family, school, community, the physical environment and our culture.

Click here for a timeline of important discoveries in the Science of Mental Illness, part of the Reader/Teacher Guides for A LETHAL INHERITANCE.

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