Mental Illness Part 1 : The Genetic Factor

Looking back on my childhood memories (let's consider "childhood" in this instance to be birth to the onset of puberty), neither my parents or I knew or even considered that I may suffer from a mental illness. Born in 1972, mental illness in children rarely seemed to be a concern for parents or physicians in the upper-middle class community where I was raised.

Mental Illness, as a whole, was just coming to the forefront during this time period and after much research on my part, it is my opinion children definitely didn't seem to be the primary focus of the medical community's studies, research and development.

Needless to say, as a child, I never visited a psychologist or psychiatrist and I was never evaluated by any mental health professional. At most, I recall only one elementary counselor taking an interest in my behaviors. To the world, or the small world I knew as a child, I was just an "extremely shy", but very bright, little girl.

Looking back now, as I prepare to enter my forty-ninth year of life, the signs, some minor, some now blatantly obvious, were always there. I live as many individuals with mental illnesses live...in a constant battle to maintain my family relationships, my friendships, my employment and my sanity.

I have been aware of my family history with mental illness most of my life, but I never truly realized the true impact my genetics potentially played in my development until I entered adulthood. At times, the "defeatist" in me almost feels as though I was "set up" for a challenge given that mental illness runs on both my paternal and maternal side.

To my knowledge, looking back as far as my maternal great-grandmother, my family has endured a varied plethora of struggles and challenges that often accompany mental illness. Some of us have won the battle, some of us have trudged through day-by-day but ultimately survived, and unfortunately, some have clearly lost the fight.

Looking back on everything I know about my family history with mental "issues", I cannot help but wonder about the role genetics play in mental illness. This has led me to my own personal conclusion that mental illness has a strong correlation with genetics. While I cannot discount environmental factors such as abuse, tragedy, and trauma on mental development, today, I will focus on what I will refer to as "The Genetic Factor".

My knowledge begins with my maternal great-grandmother, yet my ancestors may likely have dealt with many of the same issues as far back as I can trace my family tree. I was told at an early age that my great-grandmother was involuntarily institutionalized when my grandmother was just a young girl. The details of my great-grandmother's illness are vague, as mental illness in the 1930's was not completely understood nor were the details freely shared by my grandmother or her siblings. I never thought twice about the implications this may have on the current generation of my family.

From my mother's recollections, passed on from stories from my grandmother, my great-grandmother suffered from what was termed "water on the brain" at the time of her involuntary commitment into a psychiatric hospital. However, to my knowledge, "insane asylum" would be a far more appropriate term for the psychiatric hospitals of the 1930's.

From everything I can glean, my great-grandmother was more than likely suffering from a mental illness we now simply (I say "simply" loosely) would treat with medication which, in most cases, enables individuals to live and function as productive members of society. My best guess is, by observing my grandmother, mother and aunt, my maternal great-grandmother most likely may now be diagnosed as severely obsessive-compulsive and suffering from extreme panic attacks and anxiety.

Whatever the case, as I will never claim to be an expert on the subject and will certainly never know the entire truth of my great-grandmother's life, I believe my great-grandmother was more than likely treated as a nuisance and lived the majority of her life in what, at the time, was disturbingly referred to as the "loony bin" receiving little to no medical or therapeutic treatment.

My great-grandmother, involuntarily, left behind eleven young children and a clueless and desperate husband. As a result, her absence forced my grandmother and her only sister to drop out of school and raise a large brood of brothers and a father that, out of necessity spent the majority of his time working himself "to the bone" to provide for his children.

It pains me to know the prevalence of drastic and inhumane treatment of patients with perceived mental "issues" during the 1930's through the 1950's and I quiver at the thought of what my great-grandmother experienced until her death.

Furthermore, I grieve for my great-grandmother, my grandmother and my mother. My great-grandmother was taken away from her children, husband and grandchildren for what today may be a condition treated out-patient with medication.

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I'd like to quickly share the story of Rosemary Kennedy, eldest daughter of the Kennedy clan and sister to President John F. Kennedy and Senators Robert F. and Ted Kennedy, for those of you who are not familiar with her tragic story, as an example of how even the most privileged looked upon and handled family members with similar behaviors to my great-grandmother.

Rosemary suffered from seizures or "convulsions" and violent mood swings or "rages" in her early 20's. Kennedy patriarch, Joseph P. Kennedy Sr., grew concerned (or as I see it..."perturbed") that Rosemary's occasional erratic behavior would embarrass and bring shame to the Kennedy name, to the family and potentially damage his and his other children's political careers. A compassionate father, in my opinion, Joseph F. Kennedy was not.

Unbeknownst to her mother, Rose, Joseph arranged for Rosemary to undergo a psychosurgery prefrontal lobotomy in 1941 when she was merely twenty-three years of age. Quickly after the surgery, it became blatantly obvious that the procedure was not successful. Rosemary was left with the mental capacity of a two year old child, losing the ability to walk, speak intelligibly and the ability to control her bodily functions. A twenty-three year old, at her father's request, now functioned at the level of an infant or toddler. I'd suggest her condition post-procedure, by most accounts, left Rosemary far inferior to a two year old toddler.

In my opinion, Joseph Kennedy's decision was more likely fueled by his arrogance and his ignorance, as well as his own embarrassment of the stigma that continues to surround mental illness to this day. I often compare Joseph Kennedy, all political beliefs aside, to the fictional Nurse Ratched from the critically-acclaimed movie "One Flew Over the Cuckoo's Nest". Both resorted to the psychosurgery to rid themselves of an individual that was a "nuisance", "hassle" or plain-ole "inconvenience" to their own personal agenda.

During John's senate reelection campaign, the family explained away Rosemary's absence by claiming she was a recluse. Some may call that lying, which seemed to be a on-going trend with Joseph. An outside party, privy to the Kennedy secrets and apparently "intimately" close to Joe, apparently stated that Rosemary's name "was never mentioned in the house" after the unsuccessful surgery.

Joseph kept the failed lobotomy a secret from the remaining Kennedy children until 1961. They only learned of her circumstances and whereabouts when Joseph suffered a stroke and was unable to speak (I assume Rose Kennedy shared the information with her children).

After John's reelection to the Presidency, the family did not disclose the failed lobotomy but claimed Rosemary was "mentally retarded" as opposed to mentally ill to protect John's reputation. Joseph did not visit his daughter at any time after the unsuccessful lobotomy. Rose Kennedy did not visit Rosemary for twenty-years. The tragic circumstances of Rosemary's failed surgery remained a secret from the public until 1987.

Given my family history, I am exceedingly pleased that the prefrontal lobotomy procedure has been banned in most countries. Unfortunately, the surgery continues to be performed, though only in extreme and rare circumstances, in the United States. Despite the advances in medicine, I will NEVER sign up for that particular procedure. At times, I find it unbelievable that my great-grandmother escaped what many call a "barbaric" option for treating mental illness.

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Fast forward one generation to my maternal grandmother, may she rest in peace. As a child, I fully believed I was blessed with a grandmother many others would envy. My grandmother continuously shared her warmth, love and her AMAZING culinary skills with her children, grand children and anyone she encountered...never asking for anything in return.

My grandmother, or "MawMaw", unselfishly opened her small, yet comfortable, home to her nieces and nephews when her own siblings were unfit or unable to care or provide for their own children. She not only provided shelter to my mother's cousins, but showered them with the love and structure that they so terribly needed or craved.

I can only surmise (once again, supporting the genetic factor) that my grandmother's siblings may have suffered from varying levels and forms of mental illness and felt their own children would have more opportunity to thrive living under my grandmother's roof. Parental abuse or neglect never appeared to be, even remotely, a factor in the decisions to pass their children's guardianship to my grandmother and grandfather.

As a young and beautiful, happily married, mother of four and guardian to more, my grandmother arose each morning at 4:30 am and began obsessively baking, cleaning and caring for her family in the stereotypical fashion of a housewife in the 1940s and 50s, never expressing any concerns or unhappiness.

Until the mid-80s, my grandmother was the model of what anyone could wish for in a family matriarch. I know, wholeheartedly, that her entire family adored, loved and modeled themselves after her. Needless to say, I feel blessed to have had a grandmother like mine.

However, when I was around eleven years old, my grandmother became an entirely different person. Post-menopausal, my grandmother's cheery disposition and loving personality faded at an unusually fast pace. She began to sleep more than she was awake, the sweet smiles on her cherubic Czech and German face were gone, and she lost the ability to function as she had up until that time.

My grandmother lost her "zest" for life and she was, to say it simply, extremely sad. Even then, I still failed to fully understand mental illness and in her case, severe depression. Unfortunately, I eventually learned everything about severe depression first hand and have lived and struggled to live with it every day since I hit puberty.

Many of those "outside" of the mental illness bubble often asked "What has happened to your grandmother? What is causing her to be so sad?" My response when I am asked the identical thing is "absolutely NOTHING". Compared to others, my grandparents enjoyed a pleasant and comfortable lifestyle. They were not rich, nor were they poor. However, my grandparents were always happy together and loved hosting our family gatherings.

My grandmother had not experienced any tragedies, trials or tribulations, thus far, during my lifetime. To those on the outside looking in, her life could be described as "ideal". She now had four grown children, all now blessed with health, intelligence and success, and nine blossoming grandchildren all living within fifteen miles from my grandparents' modest home...the home in which I spent every joyous holiday with my entire extended family.

But, when it became clear my grandmother's personality and mood had done a 180 degree flip, as the eldest child, my mother took action. Whatever the reason, I became the third-party that began taking my grandmother to the hospital for what I believe to be a regular visit to her physician. When I was old enough to understand, I learned my mother and I were taking my grandmother to the hospital for Electroshock Therapy, now known as Electroconvulsive Therapy or ECT.

As time has passed, I cannot recall how many times we made that trip, but I will NEVER forget the result. My grandmother, the grandmother I had known and worshiped since birth, had returned. After completing the prescribed round of treatments, we all had our "MawMaw" back until she passed away at eighty-five years old.

For any individuals that believe the controversy that surrounds the adverse effects, the efficacy, or ethics of ECT, I eloquently say "Suck it"! If a miracle cure existed for my grandmother, it was ECT or EST. Given I witnessed such amazing results with my grandmother's treatment, I have suggested to my psychiatrists that I am very open to this treatment. However, on a side note, I am loving the availability of the non-evasive Advanced Transcranial Magnetic Stimulation Therapy such as NeuroStar® approved by the FDA in 2008 and I am eager to begin my personal treatment.

The moral of my grandmother's story is not everyone who suffers from depression or other forms of mental illness responds to medication. I, like my grandmother, have been a guinea pig for psychiatrists for over twenty years. If I were to list the antidepressants, mood stabilizers, anti-anxiety medications and anti-psychotics, as well as combinations of two or more of the above, that I have been prescribed over the years, I'd be hard-pressed to fit them all onto one sheet of a legal-sized legal pad.

However, I digress. I will explore the agony of being over-medicated in a future chapter. Today, the factor genetics play in mental illness is my primary focus (don't get me started on ADD/focus as I could write a novel on the subject).

The moral to MY story, thus far, is some of my family members have had mental illness beat them and some have beat mental illness; some treatments have been successful, some moderately successful, and some have come with side effects that cause MORE depression and anxiety, such as drastic weight gain. And as I close in on forty-nine, I have yet to find "true" success through medicinal treatment.

However, my extremely stubborn nature, as well as my overwhelming love of my family, keeps me from completely failing, much like my grandmother before me. Yes, I have hit rock bottom, but I have powered through and have always found a way to crawl out from rock bottom, although temporary in most cases.

Unfortunately, my great-grandmother failed through no fault of her own. Thankfully, my grandmother succeeded and beat her mental illness with a treatment that worked for her with amazing results.

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However, the next story I'd like to share can clearly be described as a "fail". Yet, sadly, I also view it as the most clear example of mental illness being impacted by genetics and passed from generation to generation, as both my father and I wrestle with the same tendencies daily. However, I consider this case to be a a failure exacerbated by the individual's lack of acknowledgment and acceptance of mental illness.

As I mentioned at the beginning of my story, mental illness runs not only on my maternal side of the family, but unequivocally runs deep on my paternal side. In my opinion, the greatest and most obvious difference between the two sides of my family lies within an acceptance of "mental illness" versus an acceptance of a "stigma" and an underlying "fear of embarrassment".

The individuals on my paternal side have time-after-time, aside from me, failed to seek ANY treatment and regarded mental ailments as nothing more than excuses or weaknesses. Much like the Kennedy family, my father's family, as well as their small community, failed to understand the gravity or even denied the existence of mental illness or mental illness treatment.

Therefore, this side of my family ignored, hid or failed to acknowledge any problem in the ranks. They fell victim to the "stigma" that surrounds mental illness and viewed all signs and symptoms of mental illness, whether minor or severe, as a fiction and fallacy. I'd compare my paternal family's view on mental illness to Joseph Kennedy's logic...just ignore it, or hide it, or suck it up! I'd say the phrases "be a man" and "don't be a pussy" were commonplace in my father's small, rural community.

As you probably can surmise from my last statement, the mental illness on my father's side, aside from me, primarily impacted the men in the family. I am only able to trace this back to my paternal grandfather, yet his story most definitely resulted in the most severe, as well as the most tragic, ending.

As his granddaughter, you may believe his story would sadden me; however, after I share this part of my family's history, I will explain how I truly feel given my personal experiences with the same affliction.

My father speaks very little about THIS side of my grandfather, yet I have learned a great deal more about the man over the years from other family members. From all accounts, my grandfather lived a life of unhappiness, never displaying love, compassion or even an iota of pleasantry to his family.

As a very wealthy and successful owner of one of the largest, if not the largest, farm in my father's hometown, I find difficulty in finding any environmental reasons behind my grandfather's personality flaws. He led a rather enviable life with a stunning and loving wife, three beautiful and highly intelligent and talented children, and prosperity others desired. Yet, apparently nothing ever lived up to his expectations and nothing, by all accounts, made him happy.

My father, in most families, would have been the pride and joy of any father. A handsome young man, brilliant student, gifted athlete, and popular among his peers, my father excelled at anything he attempted. However, despite the fact that my father achieved just about everything that he could have achieved in a small town from childhood through his teens, his father criticized and belittled him incessantly. Apparently, nothing pleased the man, and my father and grandmother took the brunt of the criticism.

I know now in my adulthood that my grandfather's anger, resentment and overall unpleasant disposition likely grew out of his own insecurities and self-loathing. I'd venture to say he was treated poorly by one of his parents, but as my father rarely opens up about him, I will never truly know what my grandfather experienced as a child and young adult.

I find it very challenging to delve into this topic, not out of sadness or sympathy for the man I cannot and will not call "PaPa", but because I feel robbed of the opportunity to ever even know my grandfather.

Knowing what I know about mental illness, and as an individual with a B.A. in Psychology that I have previously failed to mention, all signs point to a man who suffered from severe depression or manic depression/bipolar disorder. And given my maternal side leans more towards obsessive-compulsive behavior and high levels of anxiety, my educated guess is that if mental illness is in fact genetic, I definitely inherited my depression and/or bipolar disorder from my grandfather.

Yet, as I mention previously, I would "bet the house" on his denial and failure to acknowledge the illness he perceived as an unmanly weakness. "Stop your whining and get to work" and "Don't be a little girl, pussy" is what I envision when I think of my grandfather talking to my father.

And honestly, I doubt my father's hometown, population 750+/-, had anything resembling a qualified mental health provider. I'm guessing they had a "catch-all" vet/lawyer/doctor figure (imagine the doctor in the movie "Doc Hollywood" if you are old enough to remember the Michael J. Fox classic).

Many small towns, from my understanding, function like a soap opera or a "Desperate Housewives" type community (yes, I am aging myself). But try to imagine a Southern Baptist community with no alcohol, no dancing, a lot of infidelity, back stabbing and hypocrisy...and, unfortunately, I am referring to the adults. Needless to say, despite all of his successes and the successes of his kids, my grandfather was a miserable man.

Cut to 1974 - my father, mother and a two year old, squishy, adorable me (I have never claimed to be modest) boarded a plane concluding a much anticipated visit with my grandmother and grandfather...the first official introduction of my grandparent's first born's first born to my extended family in rural America.

As my mother and father flew back to the big city, along with their toddler, my grandfather proceeded to return home, shoot and kill himself. My father kept the truth from me until I was forty years old. However, unbeknownst to my father, I had known since my preteen years that my grandfather committed suicide.

I will admit, I suffer from suicidal ideations on a daily basis. However, I know these thoughts that race through my head are compulsions and ONLY compulsions. I consider myself, even when I am at rock bottom, to be stronger than my grandfather and more importantly, I do not consider myself to be a self-absorbed bastard who has no regard for the impact my actions will have on my entire family.

There it is. My true and unfiltered feelings towards my grandfather and his decision to take his own life. Given I was only two years old, I never knew the man. But, watching your only son (who by the way was now a very successful businessman in one of America's largest cities, with a beautiful wife and two beautiful step-daughters) and watching your baby granddaughter that you just met for the first time, the granddaughter that is and was his mirror image, board a plane to the city and then returning home and killing yourself, in my opinion, gave him no pause. I have two words to describe him "Selfish Coward".

Despite my resentment and anger towards the man that ensured I would have no memory of him, I know he was also a victim. But I pose the question, was he a victim only of his severe depression or a victim of his own selfishness? I will never know. I will never know if ANY doctor, even a small town general practitioner, could have altered the outcome or if it was destined to happen no matter if he admitted he had a problem and sought treatment.

Ultimately, my grandfather never gave us the chance to know if anything could or would have changed the outcome because he fell into the worst trap that exists with mental illness...worrying about the "stigma" or the embarrassment to the family name that he prioritized over admitting he suffered from a mental illness.

The only sliver of a silver-lining that exists with my grandfather's story is his failure to crawl out of the depths of rock bottom and the failure of putting his pride before his family keep me from acting on my ideations. So, I thank my grandfather for keeping me alive and giving me the compassion he did not have to realize that although my suffering may end, my action would kill my parents and cause never ending suffering to my loved ones.

I am proud to say I did NOT inherit the "selfish coward" trait from my grandfather, despite my daily struggle with mental illness and my tendencies to think "I want to end it all". I choose to think twice and move forward with living my life.

No one wants to end on a bad note; however, I believe my last story is the one that has impacted me, and more importantly my father, more than any of the other stories I have shared with you.

If you knew me, you would know my simple rules...#1 Don't Mess with Texas and, more importantly, #2 Do NOT MESS WITH MY FATHER! My grandfather failed to acknowledge the existence of mental illness and failed to acknowledge my rules; therefore, I fail to have any sympathy for him.

I will discuss my parents in my next chapter, as they both live with what I believe to be various forms of untreated mental illness. I thank the Lord that my parents and I are stronger individuals than my grandfather.

My final words:

Seek treatment immediately if you believe you or a family member may suffer from a mental illness and finally, if you or anyone you know is suicidal, keep this number programmed into your phone:

1-800-273-8255 - Suicide Prevention Hotline

*My future chapters will discuss:

The effect of environmental factors on mental illness - Nature vs. Nurture

The impact childhood trauma plays in mental illness

Early and subtle signs of mental illness

Finding the right medical practitioner for diagnosis and treatment

A summary of the most common mental illnesses and my own experiences

An honest, personal review of the most popular medications prescribed to treat mental illness

How to handle misdiagnosis and over-medication

How to help your loved ones understand your struggle

How to help other who struggle with mental illness

The positive and negative impact on relationships, family, partners and friends

The positive and negative impact on employment, financial well-being and responsibilities

The impact of hormonal changes on mental illness

And...Tips on how to make it through...one day at a time