With 1 in every 5 Americans diagnosed with a mental illness in 2009 and no exact cause found, many doctors, researchers, and mental health professionals attempt to find effective treatments through genetic findings, according to the Substance Abuse and Mental Health Services Administration.
Almost everyone has experienced anxiety or some form of depression in his or her lifetime. After the death of my grandmother, I, too, went through a one month bout of depression. However, mood disorders involve longer periods of distressing and de-energizing symptoms.
In an attempt to find out the likelihood of developing depression, many people have turned to genetic testing; a type of medical testing of genes, chromosomes, and proteins.
Anyone-without a prescription or doctor’s advice-can submit samples of their saliva to testing companies to find out his or her chance of developing any illness. For years, people with diseases such as cancer have used genetic tests to help determine their susceptibility and to decide effective treatments.
Since research has shown that there is a strong link between depression and family history, the first step is to determine if your family history raises concerns about the possibility of developing depression.
In her book Touched with Fire: Manic-Depressive Illness and the Artist Temperament, Dr. Kay Redfield-Jamison examines the family histories of some famous people in order to develop a better understanding of this relationship.
Study #1: Virginia Woolf, known for works such as Mrs. Dalloway, is diagnosed as Bipolar by Dr. Redfield-Jamison.
Dr. Redfield-Jamison provides strong evidence that the Woolf family had a significant degree of mental illness; she found that Julia, Woolf’s mother, suffered from recurrent depression and that Leslie, Woolf’s father, suffered from the mild mood disorder known as Cyclothymia.
She additionally outlines the disorders of Woolf’s siblings: Adrian was Cyclothymic, and Thoby and Vanessa experienced recurrent depression.
This indicates that 25% of the children had bipolar, 50% developed depression, and 25% were Cyclothymic, meaning that depression of any kind can be indirectly passed on from previous generations. For example, if you have a close relative with bipolar, you have a 10 percent chance of getting any mood disorder, according to the National Institute of Mental Health.
Study#2: Vincent van Gogh, most famous for his painting Starry Night, is diagnosed as Bipolar by Dr. Redfield-Jamison as well.
Dr. Redfield-Jamison found that neither of the van Gogh parents, Anna or Theodorus, had a mental illness; however, van Gogh’s two uncles had shown symptoms of unspecified mental illnesses.
Of the six children, Vincent and Theo were the only ones with Bipolar; whereas, Anna and Elizabeth showed no signs of depression. It remains a mystery as to the diagnoses of Wilhelmina, who was committed to an insane asylum, and Cornelius, who committed suicide. The percentage of children in the van Gogh family with Bipolar, an unspecified illness, and no illness are the same.
These family histories show that there aren’t a specific and universal percentage of people with depression or bipolar, indicating that even family history does not provide the exact percentage of an individual’s likelihood of developing a mental illness. Family histories may also be limited to the information that can be obtained by only some and not all of an individual’s family. As shown in the van Gogh family history, mental illness can skip generations. Many people who are born with the bipolar gene, for example,-about 20-30%–will not develop the disorder, according to statistics by Dr. Redfield Jamison.
If someone does decide to undergo genetic testing, there is the question of accuracy. There isn’t a way to determine an exact percentage of accuracy. Advertisers of genetic testing usually do not state this fact nor do they mention the other limitations of genetic testing, providing only a partial picture of the individual’s risk of developing a certain disease. Genetic testing is also limited to providing the presence of a gene in an individual which may “influence” his or her risk, according to the National Human Genome Research Institute.
Those with a strong family history of illness and are concerned about the possibility of developing a disease as well as those with an unspecified illness who are attempting to find a fitting diagnosis are likely to choose genetic testing. Those who are planning on having children and have a strong family history of mental illness are also likely candidates for genetic testing. Other reasons why genetic testing maybe considered are to help a person with predisposed factors seek treatment before symptom onset, to determine life changes such as insurance coverage, and to help find the right medication or dose of medication.
While the procedure is overall not physically harmful, there are some possible repercussions: There is a small risk associated with prenatal testing, in which the pregnant woman may miscarry, according to the National Institutes of Health. Additionally, the Genetics Home Reference has listed many disclaimers regarding the possibility of misleading a person into thinking that they have an illness when they may just be a carrier of a specific gene.
Many people who receive genetic tests also seek understanding from Genetic Counselors who assess the risks of developing a disease by looking at family history and medical records, explain the results of genetic testing, and provide supportive counseling. They also help to decide if genetic testing can be beneficial.
Even though there are federal laws such as The Genetic Information Nondiscrimination Act that prohibit discrimination towards an individual’s health coverage and employment, based on his or her genetic information, insurance companies or employers may have a right to view an individual’s medical records, which could possibly affect a person’s insurance and/or employment. Since the tests are kept in their medical records, the National Institutes of Health advises people to examine other federal and state laws regarding their privacy and rights. They also state that these laws do not account for all situations, and that it may be difficult to completely protect the results.
There is also the issue of stigma that continues to haunt many people with mental illness. Stigma is “a negative judgment based on a personal trait,” as defined by the Mayo Clinic, and people with mental illness are still viewed as dangerous by some, according to the American Journal of Psychiatry.
Even though modern research has identified possible places in the genetic makeup that maybe partially responsible for developing certain mental illnesses, such as bipolar and schizophrenia, ” knowing that you have one of these [genetic] variations won’t tell you nearly as much about your risk as your family history can,” as pointed out by the National Institute of Mental Health. They also note that t here are not any specific places in the genetic makeup that scientists have found to be completely responsible for the development of depression, indicating that genetic testing is not an exact science. Furthermore, genetic testing also does not include environmental or lifestyle factors that may influence the development of any disease. Disorders like depression that do not have cures or any significant ways of preventing them, are already worrisome to individuals and their families, and genetic testing may cause additional grief and depression because it implies that having a gene will ultimately determine that disease will occur, according to the Genetics Home Reference.
“Mental illnesses are medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning,” as defined by the National Alliance on Mental Illness. The ability to relate to others is, however, rather subjective to societal standards. What is considered as “abnormal” behavior that may require genetic testing may also promote stigma because of a belief in sustaining the “normal” standard of behavior.
In the event that genetic test results are forcibly shared with insurance companies and/or employers, a lot of people may lose their insurance, job, or both as a result, encouraging further stigmatization of people with mental illness. Considering all laws and rights pertaining to genetic testing may help prevent such an occurrence, but becoming both knowledgeable and aware of mental illness in your family and the world would be the best way to discourage the spreading of stigma.
In words of Abraham Lincoln, ” A tendency to melancholy…is a misfortune, not a fault.”
Jamison, Kay Redfield. Touched with Fire: Manic-Depressive Illness and the Artistic Temperament. Simon & Schuster Inc. 1993.
National Institute of Mental Illness, “Look at my Genes: What can they Tell me?” National Institute of Mental IllnessNational Institutes of Health, “Talking Glossary of Genetic Terms: Genetic Counseling,” National Human Genome Research Institute
National Institutes of Health, “Frequently Asked Questions about Genetic Testing,” National Human Genome Research Institute
Genetic Alliance, “Genetic Discrimination,” Genetic Alliance
National Institutes of Health, “What are the Risks and Limitations of Genetic Testing?” Genetic Home Reference
National Institutes of Health, “Direct to Consumer Marketing Genetics,” National Human Genome Research Institute
The Associated Press, “Survey: 1 in 5 U.S. Adult Face Mental Illness: Government Research Finds 45M Americans Experienced Some Form of Mental Illness in 2009; Most Didn’t Get Treatment,” CBS News
Roger J. Norton, “Depressed? Read Abraham Lincoln’s Words,” Abraham Lincoln Research Site
The Mayo Clinic Staff,” Mental Health: Overcoming the Stigma of Mental Illness,” The Mayo Clinic
National Alliance on Mental Illness, “Mental Illnesses,” National Alliance on Mental Illness
HealthDay, “For Many, Stigma of Mental Illness Lingers,” MedlinePlus