Does mental illness run in families? In the past, people were prevented from marrying – and thus procreating – if they were considered to come from a ‘tainted’ line. In the 20^th century, theories of the heritability of mental illness fed the development of eugenics and the horrors of Nazi ‘experimentation’. Latterly, scientists have found that there is indeed a genetic element in the predisposition to certain mental illnesses, albeit influenced equally by the social and emotional conditions of a person’s life.

On my mother’s side several generations have suffered from psychiatric illnesses. My great-grandmother was diagnosed with ‘religious melancholia’ and was in and out of hospital, until ultimately dying in an asylum at the age of 61. She would prostrate herself in prayer for days at a time, refusing to eat until she began to hallucinate and hear voices. In past eras she might have been considered a visionary, or joined a strict religious order: think of the ‘anchorites’ of the Middle Ages, a majority of whom were women, who were literally walled up in small cells for a lifetime of prayer. But my great-grandmother had three children, a husband – she could only withdraw through madness.

Her condition might today be called ‘scrupulosity’, a form of obsessive compulsive disorder characterised by pathological guilt and the fear of divine judgement for perceived sins. But the word ‘melancholia’ also suggests depression and the hallucinations and voices something more. Recent research has found a significant genetic link between depression, bipolar disorder and schizophrenia*. My mother suffered from severe lifelong depression, and a young male cousin of hers hanged himself at sixteen in what was at the time passed off as an ‘accident’, suicide being illegal at the time, as well as a source of shame and opprobrium. Alzheimers disease, which also has strong links to depression, has affected three generations of my mother’s family, including her mother and her sister.

In my generation, one of my cousins has schizophrenia. She is the youngest daughter of the youngest daughter of the youngest daughter of my great-grandmother, who was herself a youngest daughter – it’s as though the illness has trickled down the female line to land in her lap, which sounds rather like a bad fairy-tale. Our understanding and labelling of mental illnesses keeps changing, as well as the degree of openness with which they are discussed, so I may well have other family members whose conditions remained secret or who I simply do not know about.

The recent science of epigenetics has begun exploring how what we experience can alter how our genes work, leading to changes in the brain and how we manage stress hormones. It’s not yet conclusive whether or how that alteration is actually passed on to future generations through the DNA. What seems certain, however, is that trauma can be and often is passed on through the generations by psychological means, especially trauma that is unresolved or unacknowledged. How a parent responds to their child, how they respond to events, how they teach their child to respond – either deliberately or by unconscious example – all shape that child’s psychological development and how, in turn, they will parent their own offspring. Even trying to parent differently, as most of us attempt in one way or another, does not always alter the underlying pattern – as a friend once commented: ‘180 degrees from wrong is not necessarily right.’

You could argue that there is barely a family without trauma in its background: poverty, displacement, early death, loss of children, sexual or physical abuse – these are the stuff of human history and you don’t have to look very far to find them. Above all, in the past century, there is war, on a scale and of a magnitude unprecedented in history, and wars encompass all of the other kinds of trauma imaginable, and add plenty of their own. We are all children of war, in one way or another, whether or not our families were directly involved, and it is the cumulative effects of this trauma in my family and society that is the main subject of my book.

 

*https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2962129-1/fulltext