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Genetic Inheritance. Sunday July 7, 2013

My mother's family carries a gene for an exotic eye shape. My sister has it; her eyes are almond shaped, tip-tilted; "faerie eyes" as a rather romantically inclined boyfriend once called them.

It skipped my mother and it skipped me, but it's come out in my eldest daughter. We've no idea where it comes from, but's it's interesting to look back in the family and try to find out.

In my father's family it's lungs. We were at my Uncle's 70th birthday party yesterday, celebrating the amazing fact that he has actually reached 70, while he sat, constantly short of breath, with his oxygen cylinder at his side. Little Max, at two, was running around the garden playing, but has just had a four day stay in hospital with his asthma. There ensued much discussion about who in the family has the lungs, how many times they have had pneumonia and who's escaped.

And then there's the other thing in my father's family. That's the illness we don't talk about. My father died from it. I've nearly died from it (twice). My sister has had a bout or two of it and it's hit at least one cousin (that I know of). The Victorians didn't seem to have the taboo that we do – they called it "Melancholia" and seemed to accept that some people were affected by it while others escaped.

But I can't be the only parent who anxiously watches their children for signs that they have inherited this melancholic gene. With two academic, ambitious, high-achieving girls, my concern is surely valid.

I try not to let it be a forbidden subject. We talk about when "Mummy is poorly" and how we manage it in the family. We talk about the importance of talking about how we're feeling and that sometimes those feelings might be a sign that we are really poorly and we might need some medicine.

Forewarned is forearmed and I want my girls to know what's happening if it ever does. I also want them to know that it is just the same as getting the lungs, the eyes, the milk allergy; it's genetic and it can be managed.

And it might not happen. But I'm going to stay vigilant – just in case.

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PWD Wed, Jul 10th 2013 @ 7:39am

Amother great post (pun intended) very interesting but also sad, I often think the same as it is similar in my family. I also have inherited another faulty gene called brugada better known as sudden death syndrome. I have my internal defibrillator fitted which will kick in when needed. I feel on good days I am very lucky as I am aware of it and it is under control just like the one we don't talk about. But as I often think when I am at the heart specialist there are always people a lot worse than myself.


Bill Andrews Wed, Jul 10th 2013 @ 7:49am

Thanks for your post Mary. Genes and depression, well, a complicated subject. I suppose, for me, there is a bit of difference between the situations described, like the eyes and lungs, and the 'depression' gene. I mean, some genes are clearly identified and known and understood. If you have gene x you'll have characteristic y. But this is not the case with depression or any psychological disorder for that matter. There may be a 'depression' gene but it's not yet been identified. I guess the new understanding about gene expression and how genes can be turned on and off by environment helps us see that it's not just a matter of having the genes, it's what sort of environment we are exposed to, interacting with the genes, that determines what happens us. I guess what I've found useful is to think about the idea of being predisposed to conditions, albeit genetic or otherwise. Then that gives me a sense of my own power because I can influence my experience. So, for example, if I'm predisposed to depression (history of depression in the family) then it'll be all the more important for me to take measures that act as an antidote to depression, like being connected with others, keeping fit, healthy and active, getting regular sleep, having goals to aim for, having mental stimulation, being stretched etc. These will help to insulate me from depression, ward it off and keeps me in charge, lessening the risk of having a depressive episode. All these measures are important for anyone who gets depressed but perhaps even more important as preventive measures for those who may have a predisposition, whether genetic or not. The understanding of gene expression means we don't have to surrender to inevitability of our genes, at least certainly not in the realm of the mind. Even conditions like cystic fibrosis, definitely genetic, have very different outcomes depending on treatment centres and approach. Eye colour, well that's definitely genetic. Depression, well, the science is not there yet but we can do much to insulate ourselves in any case. Moodscope can of course be a very useful assistant in helping us, if we use it regularly.

Anonymous Wed, Jul 10th 2013 @ 8:56am

I'm not usually driven to respond to posts, but I felt I really needed to respond to today's.
Thank you Bill Andrews for articulating what my thoughts are. The idea that psychological conditions are genetic and that for some people they may be either predisposed to depression or that depression is inevitable is perhaps a pessimistic and disempowering view point. There are so many factors in our lives that we do have influence over- the challenge is to embrace that rather than being overwhelmed by it. Only by taking ownership of our lives and being empowered (and supported) to do so will we find peace and acceptance in whatever situation we face. It is up to us as individuals to decide how we respond and manage our lives- I am not suggesting this is not challenging and when depression is in full swing it is hard to find the energy, confidence and motivation to decide to be responsible for the way we react to the challenges thrown at us.
So please forgive me when I suggest that the 'It's in my genes' argument is disempowering and negative. I would argue that as individuals empowerment to take responsibility for our decisions is the key to better mental health. And some of us will need more support than others to find it, moodscope being a part of that empowerment process for some.

Julia Wed, Jul 10th 2013 @ 9:09am

This is a very sad and serious post which actually took my breath away momentarily. Melancholia is not widely used nowadays in medical terminology and I have never associated it with death. Surely (and Mary,you can put me right on this) depression/ melancholia is not a physical cause of death?
I think I know what you are saying without using the word that caused the deaths but as Bill perfectly sets out in his post, no gene has been found to be the sole cause of depression and depression is not a direct cause of death. We don't die from melancholia; it's not a physical illness which is out of our control like muscular dystrophy or some forms of cancer. It might seem that it's out of our control mentally but there is not the inevitability or likelihood that death will occur. Death leading indirectly from depression is extremely rare; I honestly have never heard that melancholia/ depression in itself causes death.
That said, I totally understand your worries and concern for your daughters but I am not sure you need to worry in exactly the same way a mother would worry about an inherited physical disease where statistically the gene is passed on in a life threatening way.
I have found this blog quite worrying...probably not the right word and I know you did your best to explain Mary.

Julia Wed, Jul 10th 2013 @ 9:10am


Loretta Wed, Jul 10th 2013 @ 9:45am

I agree with the three contributors above. When Mary says she nearly died twice from 'melancholia' I wondered whether this was a euphemism for 'attempted suicide'.

Julia Wed, Jul 10th 2013 @ 10:01am

I think it must have been Loretta. Which is what I was trying to get at in my post. I normally enjoy Mary's blogs but this one I did not! I think its misleading and may cause unnecessary and misguided worry. I know this wasn't Mary's intention though.
What she says is simply not medically accurate.

Zoe Wed, Jul 10th 2013 @ 11:11am

Thank you for your post Mary. I to am vigilant for my daughter and attempt to equip her with the insight and skills to know when she needs help. I have struggled with fluctuations in my hormones and seratonin and well being as has my Mother and my Grandmother did before me.

And yes it can kill.

I am suprised at the resistance to the concept of familial patterns of mental health conditions. Having worked in the field of Mental Health and Autism for some time I think Bill is partially right when he refers to a predisposition that we can actively compensate for. Family history is an important part of our assessment process in establishing susceptability and resiliency.

Not medically understood is not the same as medically inaccurrate.

Thank you

Julia Wed, Jul 10th 2013 @ 11:39am

Hi Zoe
Would you please explain how exactly depression can kill? I think it would help me to know as well as other Moodscopers.
Thank you

Anonymous Wed, Jul 10th 2013 @ 11:42am

I don't disagree that there are familial patterns- I just question whether it is nature or nurture-
and I personally don't agree it is nature alone (genes)- The environment we are exposed to, as a developing baby in the womb to early childhood experiences to adult life challenges, all have a major, (and I would argue greater, role in shaping our psychological mindset and way we as individuals react to challenges in our lives. If a child is living with either or both parents who are experiencing depression it is not surprising that they may be at greater risk of depression as a result of the environment they are being exposed to. Whether they are predisposed to becoming depressed or that depression is inevitable because it is in the genes is questionable. There is much we can change and influence; knowing and believing that can be empowering. To feel it is inevitable because there is a pattern in our families is already giving up on the ability to beat depression.
the whole issue is hugely complex with so many interconnecting factors/ issues, with more research in fields such as psychoneuroimmunology we may get a better understanding of the relationship between the psychological physical changes in peoples blood chemistry (e.g heightened inflammatory response causing changes in mood regulating hormones)
Is depression in the genes alone? - personally I don't think it is. Do I have the power to change the unhealthy psychological patterns I have formed over the years and are a result of my childhood etc - Damn right I can! - (its just difficult and I need a good support network to help me do that). But the moment I believe its in the genes and that's just the way it is - I've lost my battle to change and take responsibility for my life. I am not empowered, encouraged or hopeful.

Julia Wed, Jul 10th 2013 @ 12:05pm

Do you think that the Moodscope community or even a small part of it might empower you or more important, provide the support network you need right now? In my opinion, if you can write so eloquently and make such sense, you could possibly direct all your obvious skills into helping yourself as well as others!
But what I really want to say is that if there is anything you can think of which we can do to help, please say. Honestly we are here to help each other. You have made a really helpful contribution to Moodscope which although ended on a sad note, certainly provided some very encouraging helpful information for us. It's our turn to help you now.

Anonymous Wed, Jul 10th 2013 @ 12:32pm

Hi Julia, your offer of support is truly welcomed and appreciated- although I think you have misunderstood my meaning.. and perhaps my punctuation didn't help- :-) My last sentences were supposed to convey that if I was to start believing depression is in my genes and not something I can influence I would feel disempowered discouraged and unhopeful-

but as it is I don't subscribe to that view and that is what keeps me feeling empowered and encouraged and hopeful for change- even if it is challenging-
thank you for your concern & thought - and apologies for the misunderstanding

Julia Wed, Jul 10th 2013 @ 12:39pm

Oh stupid me. I've just re read it. Am so pleased anyway!

Julia Wed, Jul 10th 2013 @ 12:50pm

I expect you are busy which is why you haven't replied.
However I assume you will check the blog page again today after making such a bold statement, particularly saying "And yes it can kill!"
I am sure many of us will welcome hearing from you again with a medical explanation to back up your statement that depression can kill.
You will understand that many of us will be very worried reading your post but until we know the facts, we should all continue to feel safe in the knowledge that as Bill and Anonymous plus others have written today, we as depressed or whatever, people, can look forward to a life which is ultimately in our power to change if need be and a long one at that!

Windflower Wed, Jul 10th 2013 @ 2:43pm

I am sad because I was adopted and no nothing of my fathers side. My birth mothers father was also adopted.

Julia Wed, Jul 10th 2013 @ 4:43pm

Oh dear. I am sorry you feel sad. From what I read there are many people in the same situation as you Windflower. Are there organisations that can help you? Good luck.

keentwoevolve Wed, Jul 10th 2013 @ 5:58pm

Yes the environment around cells has now been determined by biologists to be controlling wether genes in the cell are activated or not. The cell nucleus was thought to be the thing in control of gene activation but now it has been determined that it is the environment which interacts with the cell. An easy to read book which explains this and gives HOPE to ''predetermined'' outcomes and genetic conditions is called ''the biology of belief" by Bruce Lipton. He can also be seen on Youtube talking about this phenomenon. A great read for the non scientific person.

Anonymous Thu, Jul 11th 2013 @ 1:44am

My pdoc recently recommended that i consider genetic testing as it can reveal markers that affect metabolism of psych meds as well as other things.

I also have anxiety and so need to be cautious about things that might feed an episode.

I was going to have hubs do it first....

Mary Blackhurst Hill Thu, Jul 11th 2013 @ 8:03pm

Brilliant reply, Bill. Of course you are right and my children are experiencing a very different up-bringing to mine. And how insightful to say how important it is to stay connected, to look after one's physicality and have goals etc. My prayer is that my children will stay mentally healthy throughout their lives - but that they will also have understanding and compassion towards people who are not so lucky.

Mary Blackhurst Hill Thu, Jul 11th 2013 @ 8:55pm

Oh gosh, I didn't mean to upset and worry so many people! What a can of worms this post has seemed to opened. My apologies. All I meant to say, I suppose, is that we don't talk about mental health issues in the same free way we discuss other illnesses in the family (whether inherited genetically or not)
Yes, my father committed suicide (and that's certainly not talked about), and I personally find it helpful to think that he died of his illness just as he might have died of cancer. These days there is much more treatment available for both depression and for cancer. In 1967 things were different.
We don't have to be the victim of our genes (yes, Bruce Lipton's The Biology of Belief is fascinating, isn't it), but it's surely sensible to be responsible. I love Bill Andrew's comments. Let's look after our mental health just as we look after our physical health. My cry is to let them both be valid talking points.

Julia Fri, Jul 12th 2013 @ 8:10am

Hello Mary
Had I known you were the "Mary" writing the blog, I would have questioned the writer more sympathetically. The internet can be cruel can't it. When we don't know the person behind some comments, we or I feel we can sound off and write things we wouldn't normally write to someone we know.
I always like your posts (and didn't realise you write blogs too; there's another Mary who writes them too isn't there?) Mary (I mean replies) and agree with your comments. I was so very very surprised to realise that you had written this one. I'm glad I checked back this morning (actually to see if Zoe had replied!).
I don't know what else to say! Apart from this...When I'm low and have had a run of bad nights with no deep sleep, my logical brain kicks in big time and it was the logic of the medical explanation/correlation between depression and death that was annoying me. I can't see it and that's what I was getting at. The gene issue was explained by others.
I am so sorry Mary that you have had this sorrow in your life. You come across as such a lovely person. These things shouldn't happen to someone like you. But I always think mental health issues seem to affect nice people. Now there's possibly a very illogical, statistically unproven statmement!

Anonymous Sat, Jul 13th 2013 @ 12:53pm

I'm shocked to read that your questioning the fact that depression kills.
Suicidal thoughts and feelings are part of the disordered and unhealthy thinking pattern of depression, so obviously if the person didn't suffer the illness of depression their thinking wouldn't lead them to such an act. The people with depression who take their own lives are not doing so from a position of well being but severe illness in their thinking pattern a very cruel and lonely death indeed, that is a very dangerous potential side effect of the illness.

Anonymous Sat, Jul 13th 2013 @ 6:21pm

Don't be shocked. I hope you have enjoyed this beautiful sunny day Anonymous.

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