From A LETHAL INHERITANCE…
Secrecy and denial in a family become habitual. If you and your relatives speak openly of mental illness, let alone a suicide in the family, yours is a rare and fortunate family. Most of us don’t know our real risks for mental illnesses because so many family members in past generations were not diagnosed or treated—and with treatments rates still only about 60 percent for serious mental disorders in the U.S., the same pattern unfortunately persists. Often, those who have been treated for a mental illness have kept it a secret from even close relatives. I argue in this book that this stance of silence and secrecy is no longer a viable option, least of all for parents of young children in a family with a pattern of mental illness and addiction. Secrets can cause harm and even kill.
You may be surprised to learn, for example, that if a prepubescent child’s family has a high aggregation of mood disorders, meaning a lot of depression or bipolar disorder along with alcoholism, that child is far more likely to develop a mood disorder before puberty, considerably earlier than the common age of onset for depression in mid-adolescence. Just knowing this information alerts parents to the need to monitor such a child’s moods closely—as well as their own.
Because so many of us don’t know our family mental health histories, we’re often thrust into the role of sleuths, connecting the dots between pieces of evidence drawn from at least three different realms—a child’s behaviors, family history, and the relevant new science—to identify a vulnerability that may be laying in wait. Researchers, too, particularly those doing multigenerational family studies, do a more technical version of this same sleuthing.
In one extraordinary 1990 family study in the U.K., researchers collected early home movies from families with a schizophrenic adult. As they suspected, early motor differences were vividly depicted in the home movies taken of these children (filmed with their siblings) decades before they went on to develop schizophrenia. Researchers watched the home movies blind to the identity of which children were which. They easily identified the pre-schizophrenic children from their siblings because of their flatter emotional states (they showed less joy or distress) and less coordinated movements.
So it seems we can add home movies to our checklist of potential sources of family history—and risk factors.
In the Foreword to A LETHAL INHERITANCE…Terrie Moffitt PhD, internationally recognized for her long term family studies of mental illness, describes why everyone should know their family mental health history.
“From Victoria Costello’s struggle to find and understand the possible links between the mental suffering she and her sons face in the present and a trail of secrets and tragedies going back three generations we can take away a vital message—the huge importance of knowing our family history.”
As Moffitt goes on to explain, this knowledge has immediate clinical applications.
“At the first signs of a child’s behavioral disturbance, parents and clinicians are faced with a difficult, sometimes terrible choice. Must we start treatment as soon as possible, and risk doing harm? Or is “wait and see” the wiser option? At the end of this book, Victoria writes compellingly about the “new, new parenting.” One of the most loving things parents can do is to find out about our children’s psychiatric family history. As Victoria found, the quest takes bravery. Research is proving that for most psychiatric conditions, having a family history makes all the difference between treat now and wait and see.”
A Sample Sequence of Questions from the Dunedin Family History Screening Tool,
The following questions, concerning symptoms of bipolar disorder, are asked of a study participant of himself and then about anyone he’s put on a list of biological family members, including: siblings, parents, and grandparents.
1. Has anyone on the list ever had a period of feeling extremely happy or high?
2. I mean ‘high as a kite’, so that other people worried about them, or so that it interfered with carrying out normal responsibilities. Has anyone been unusually happy or high, not because of drugs or alcohol, for two days or more?
3. Has anyone on the list ever had a period in which they were more active or talkative than normal?
4. I mean extremely overactive or talkative, so that people worried about them, or so that it interfered with carrying out their usual responsibilities. Has anyone been like that, without being under the influence of drugs or alcohol, for at least two days?
5. Has anyone on the list showed inappropriate behavior such as spending too much money, having more frequent sex than usual, talking too much or rarely sleeping?
6. Has anyone showed these inappropriate behaviors for two days or more and not because of alcohol or drugs?
Taken from the Dunedin Family Health Study “Parent Family Health Interview -Whole Questionnaire.” as presented in A LETHAL INHERITANCE.