Expert: Libby Bonner - 12/19/2008

Question
QUESTION: For the past 6 months, I've been experiencing anxiety that has caused me to
worry about everything, including whether or not I'm mentally ill. The anxiety
has lessened quite a bit, and I'm getting back to normal, but the possibility of
mental illness still terrifies me. My dad was diagnosed bipolar, and my aunt
on my mother's side is schizophrenic. This makes me worry what my chances
of having either of these illnesses is. I've always been a tad on the anti-social
side, so that concerns me. Also, I'm only 18 and I know with schizophrenia, it
doesn't develop until young adulthood. My question is.. is it reasonable for
me to worry about becoming mentally ill? The thought never even occurred to
me 6 months ago, but now it constantly plagues me.

ANSWER: It's certainly reasonable to be concerned.  Mental illness in a parent or close family member would raise your chances slightly, but not hugely.

What's working FOR you, even if you should become ill:  the research on the brain has been very successful in the last 15 years or so.  There is a better understanding of how neurotransmitters work, better use of imaging, work w/ genes.  There are much better meds available than when your two relatives got sick, and a MUCH higher agreement among psychiatrists about approaches to treatment: which drugs are useful, which should be the initial drug used, when and why to add another med, or to changes doses.  

And so the results in patients are much better.  So much so that groups like NAMI, nami.org, now speak of recovery, a word not heard until 8 or ten years ago.  Don't confuse it w/ cure, but it does mean that the patient's life only changes some w/ diagnosis, and not that the patient's meaningful life is virtually over.

I'm glad that you have some of your anxiety under control.  If it interferes w/ your life regulary, though, I would try to see a therapist...OR you might find a psychiatrist, via nami.org or narsad.org, who is either looking for persons like you to 'study' OR who could give you more knowlegeable counseling.  Still, you will be left with questions, even if you should find someone doing imageing o genetic work who turns up some sort of 'marker' re future disease....since I know of no preventive action that can be taken.

You might also think about activities and practices aimed at keeping you "in the NOW," this actual moment that you are now living.  Learn to value that, if you can, rather than spending your 'now' tormented about something that may not happen, and that worry cannot prevent.

That is much easier said than done, but I hope you will look into it.  The odds really are in your favor, and I hope they will always be.



---------- FOLLOW-UP ----------

QUESTION: Thanks for your reply. I also wanted to ask if in every case of mental illness,
there is a genetic predisposition. With my father, he was abused as a child. Is
it possible that his childhood experiences alone resulted in his diagnosis, or
is there always a inherent vulnerability because of a genetic predisposition.

I will certainly try to remind myself to live in the "now." It seems like the best
option. Thank you again.

Answer
Sorry to be so late responding.

Though there are "spontaneous" cases of schizophrenia, where combing the family tree turns up not a single relative, I believe that schizophrenia is thought to be nearly always genetic.  But it would be familial, rather than heritable, the latter example being hemophilia.

Even w/ a familial relationsip, it could be not expressed in every generation, by any means.   I don't know if there are triggers, as you suggest your father's abuse might have been.  Google around, perhaps.  "childhood __________ " AND schizophrenia.  For the blank, you could use abuse, or triggers, or precursors.  Or you could just "causes of adult mental illness."

There is also the role of genetic mutation....which is what presumably occurs w/ spontaneous cases.

Google this AFTER you have had a good holiday and have started a Happy New Year.