To Americans, genetics means little when evaluating mental illness

On one side of my family, mental illness is essentially the norm. We all have it- typically anxiety disorders, mood disorders, and eating/addiction disorders. That there is some genetic link to all of this brain disease and mental hijinks seems pretty obvious. Come to any of my family gatherings and let the weirdness begin!

But while many Americans are aware of the genetic links and origins of mental illness, it has yet to seep beneath that cursory "Yep, depression is genetic now get over it." I have family members (close ones, in fact) who won't speak to me because I'm callous and superficial and coddled and selfish because I had anorexia. And sought treatment. Expensive treatment (a lot of which I paid for). And quit my job and moved home and was temporarily disabled as my mind and body healed.

Yeah, yeah, anorexia is biological, he says. But I share many of your genes and I'm not anorexic, so stop wallowing in your silliness.

This particular relative isn't alone in his thinking. It more closely echoes those of many Americans, as elaborated in recent research in the journal Social Science and Medicine. The study, titled "An Uncertain Revolution: Why the Rise of a Genetic Model of Mental Illness Has Not Increased Tolerance," looks at the peculiar cognitive dissonance that exists in the field of mental illness and brain disease.

“In the case of schizophrenia, genetic arguments are associated with fears regarding violence,” Schnittker said. “In fact, attributing schizophrenia to genes is no different from attributing it to bad character — either way Americans see those with schizophrenia as ‘damaged’ in some essential way and, therefore, likely to be violent. However, when applied to depression, genetic arguments have very different connotations: they are associated with social acceptance. If you imagine that someone’s depression is a genetic problem, the condition seems more real and less blameworthy: it’s in their genes, they’re not weak, so I should accept them for who they are.”

Schnittker’s study also shows that genetic arguments are associated with recommending medical treatment but are not associated with the perceived likelihood of improvement.

The message that doesn't get out, then, is that your biology isn't ultimately your destiny. I can't control that I had anorexia, that I was wired to respond to food deprivation differently than many people, that I find starvation calming and soothing. But I can learn to override those brain signals that purr starve, starve when I sense them coming. I can learn to monitor my food intake to make sure I'm eating enough. And my exercise to make sure that I'm not overdoing it.

This study only underlines why I continue to do what I do.

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9 comments:

Lisa said...

I'm sorry your family gives you flack. Right after I began treatment for my OCD, my dad commented about my uncle's depression, saying he just needed to "pull himself up by his bootstraps." His understanding has changed, however, but it's taken effort on both our parts. I haven't even tried to convince the rest of his side of the family.

Ai Lu said...

I wonder, too, if part of the reason why Americans haven't responded more compassionately to those of us with biologically-based mental illness is because we have a long history of discriminating against people because of their genes, even before we had a scientific view of genetics. Many of the arguments for racism against darker-skinned people came from an ideology of genetic determinism. If you had African or Native American or Asian genes, the argument went, too bad for you: you were physically, intellectually, and morally inferior to people of European descent, who had better take every precaution necessary to avoid mating with you and thereby propagating your genes.

Although our views on race may be more sophisticated now than in the 18th and 19th centuries, we still tend to take such a deterministic view on genes, as if genes were our destiny, the beginning and end of our stories. Fortunately, most geneticists recognize that it is the interaction of genes and environment that produce a given outcome, not one or the other -- though, as you pointed out, scientific understanding of a phenomenon does not translate into compassion on a societal level!

In my family there is also a history of mental illness, and similar to your family, a lot of judgment regarding who "has it worst," who is "wackiest," who managed to avoid the "bad" genes, etc. Behind this, I think that fear is the main motivator: those of us who are slightly better off still feel as if we are at the brink of something worse, and seeing our relatives who are not doing so well can be a stark reminder of how thin the line is between well/not well.

That said, GOOD FOR YOU FOR SEEKING TREATMENT despite their naysaying. Who wouldn't want all of their relatives to be healthy and happy, I ask? Not everyone has the same path towards wellness, either; for some, it means the right combination of meds, for others, weight maintenance. I'm sorry that your family failed to recognize that you were doing something good for yourself.

Cammy said...

My family tree is also pretty "loaded," two women on my maternal side have died from EDs, alcoholism is common on both sides, one brother is being treated for OCD right now, and the other has had food issues in the past.

I think that scientific literacy is a major, major problem in our society. Many people simply have, at best, a very simple grasp of inheritance and genetics. It's not as simple as inheriting an "anorexia gene" or a "depression gene," there are multiple biological and environmental factors that come into play. It's complex, and people prefer simple answers, so it's easy to incorrectly blame EDs and other mental conditions on fad diets, superficial priorities, or just overall weakness. Sad, but true. That's why there is a need for people like you, who have good communication skills and care enough to educate people!

Jane said...

Interesting post, Carrie. Maybe you've already come across Michele Crisafulli's study that suggested giving people genetic/biology info lessened blame toward people with anorexia? So it seems like explaining things using the genetic model doesn't always yield negative perceptions.
http://psychcentral.com/news/2008/01/09/perception-of-anorexia-differs/1763.html
I'm inclined to agree with you that giving a full picture of disorder--both predisposing factors and potential for recovery--is important. I'm glad you do what you do too.

Carrie Arnold said...

For the record, most of my family is very supportive, or so caught up in their own melodrama that they really don't give a rip.

And Jane, been there, done that. I'll email you and fill you in a bit on the backstory, which is WAY to private for me to put up on the web. This person is just immature can't get beyond his own emotional, toddler feelings toward the whole situation.

Jane said...

: ( So sorry to hear that, Carrie, but glad that you have so many supportive people in your life and your family.

Carrie Arnold said...

Thanks for that, Jane. We'll have to do coffee sometime, now that I'm permanently in the area.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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