Some myths
• If a person has a mental illness that means his or her child will inherit it.
• Nursing mothers with mental disorders should not breastfeed.
• Don’t marry into a family with a history of mental illness.
• We don’t have mental illness in my family.
• Mental illness is caused by [intense stressful event].
Making a distinction
Most people seem to think of inheritance along the lines of what happens in a condition like sickle cell.
In sickle cell, transmission is relatively straightforward: if a parent has the sickle cell gene (S or C), he or she transfers it to the children.
If both parents have it, there’s a chance each of their children could have SS. (Of which it’s still a chance, but it’s a relatively high chance, at about 25 per cent for each child if both parents are AS).
In most mental disorders, it’s nothing like that. There is almost never a single gene that the disorder can be traced to.
Often it’s many genes, and it’s not even that the disorders can be traced to them, but more that they are known to be associated. And in many cases this association is still a subject of study.
Also, the chances of inheriting stuff based on available facts are often fractions of one, or single digits at best, and those chances are affected by lots of other stuff that are not genetic, like events surrounding birth and personal experiences.
So keeping that in mind, let’s get back to our traditional ideas…
1. If a person has a mental illness that means their child will inherit it
That someone has a mental disorder doesn’t mean his or her child will have it, any more than a parent having hypertension or breast cancer guarantees that the children will have it.
It does mean they are more likely, but this is relative.
That is, if there’s a 1 per cent chance of just anyone having that condition, and a parent having it raises that by fourfold, that’s still comes to a 4 per cent risk. Which is still pretty small.
And the risk of the more serious mental health problems is often smaller than 1 per cent.
You can’t make such predictions.
2. We don’t have mental illness in my family
Sorry to bust your bubble, but you don’t really know, do you? I mean, let’s face it, how well do most of us know our own families?
If you’re like most Nigerians, you’ve probably been introduced to some distant cousin or previously unknown uncle as recently as within the last couple years. (Especially when one takes considers the larger polygamous families we often hail from).
Of course, part of the issue is our belief that mental health disorders are obvious and we’d know if anyone had one. But that’s simply not the case.
Also keep in mind that mental health problems are not exactly a great topic for discussion over lunch.
As I often point out to people, if you had a mental disorder, how much of your family would you want it known to, if you could help it? What makes you think they’d tell you?
3. Don’t marry into a family with a history of mental illness
Although it’s true that mental illnesses can be inherited, our ideas of how are often very wrong.
In a sense, you could say people don’t mostly get mental illnesses from their parents: they get it from their families.
And they don’t mostly get it from one single gene, but from a complex interaction involving a little of everything from multiple genes to early childhood events and life stresses and even protective factors.
In other words, the heredity of mental illnesses is so complex, making predictions useless.
Which includes marriage-related predictions.
Don’t forget that (a) most of us don’t even know our families, and (b) you’d be amazed how many families have a history of one mental illness or another.
Making predictions based on something so complex really is just not very useful.
4. Nursing mothers with a history of mental disorder should not breastfeed
There’s no good reason for this. The traditional basis is that breastfeeding may transmit the illness to the child (unless there’s some other reason I’m missing?), but that’s just not real.
Genes are the transmitters of inheritable traits, and genes don’t exactly go through breast milk, sorry. It’s really that simple, though.
The truth is, given what we know about the benefits of breastfeeding, nursing mothers should breastfeed as soon as they possibly can. Those early days are key and breastfeeding is a key part of establishing the bond between mother and child.
We should be looking for more ways to make that possible, especially for those who find it difficult, not the other way around.
That’s why even in nursing mothers who have to be admitted for treatment of mental illness, you want to see them get well real quick so they can go back to their babies.
5. The mental illness is caused by intense stressful event
That word “cause” is a hard word for us doctors to use. And it’s even harder to use in mental health, where defining a cause is no small matter.
To say A caused B is to imply that B would not have happened if not for A. And that’s not something you can often prove in real life.
We also know that although mental disorders are largely genetic, a lot more things are involved: events surrounding labour, early childhood experiences, life challenges and adverse events, the nature of families and upbringing, individual personal
