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Approaching and Discussing Mental Health History with Family

An elderly woman with white hair and glasses receives a hug from a young child with blonde hair in pigtails, both smiling warmly.

The Why:

Whether you are just starting or are in the midst of your psychotherapy journey, learning about your family’s mental health history can provide excellent information and insight. 

As science advances and more studies are completed towards further understanding mental health illnesses and diagnoses, there is a strong indication that mental illness is inherited or passed down genetically. This reveals that if an individual’s parents or biological relatives have a particular mental illness, there is a higher-than-average chance that their direct biological relatives have the same mental illness. While in many scenarios it may be easiest or most accessible to gather information about first-degree biological relatives (ex. mother, father, siblings, or children), if possible, it can be helpful to broaden the scope to second-degree biological relatives or those from previous generations (ex. aunts, uncles, grandparents, cousins), as well. Such information about second-degree relatives or those of previous generations may additionally point to clinical explanations for why certain symptoms or diagnoses are present and/or why one may be more susceptible to them. For example, ADHD, autism, bipolar disorder, schizophrenia, and depression all tend to run within the same biological families/lineage (National Institutes of Health, 2013; Sarkis, 2011). 

If you are adopted and/or don’t have direct access to biological family members to discuss these topics, any information that you can gather can be informative, whether that be through adoption records or anyone that may know or have known your biological family and relatives.

All of this is not to say that mental illness is strictly a result of genetic factors, as environmental components are also significant in the development of a disorder. However, without taking genetic factors into consideration, one may not have the full story to understand their symptoms and what may be present.

Tips for Starting the Conversation:

While it has improved in recent years, the stigma around mental health and seeking support is still present. Therefore, engaging with immediate or second-degree family members about their mental health history can feel like an uncomfortable or daunting task. It is doable though! To help with approaching family members about this inherently vulnerable topic and the process overall, below are some tips and strategies:

1. Advise the family member(s) that the conversation needs to be had so you can gather your full medical history, both from a physical and mental health perspective. If comfortable, you can let them know that it is helpful in relation to your mental health therapeutic support. If you anticipate it will be more inviting, you can also mention that it is needed in relation to the intake process with a new primary care provider. It additionally may be helpful to say that by sharing this information with you and being as honest as possible in the process, they are ultimately taking care of you.

2. Aim to keep the conversation focused on receiving factual information versus propelling into a discussion on family issues or “calling anybody out” about their behavior, etc. Due to the stigma and the vulnerability required in talking about one’s mental health, if the conversation veers off the facts one can quickly become defensive or feel as though they are being attacked.

3. Possible questions to ask could be: Has anyone been diagnosed with a mental illness? Has anyone been diagnosed with depression or anxiety? Was there anyone in the family who was “troubled”? Was there anyone in the family that seemed “off,” and if so, what did that look like? (This last question can be a nice middle ground in case you think the idea of mental illness itself might make them defensive.)

4. If previous relatives/generations have a history of suicide or suicidal ideation, this may be an uncomfortable topic for them to talk about and they may refuse to discuss further. If that is the case, it is best to acknowledge and validate your family member’s thoughts/feelings about it. If you feel that there is room for the conversation to continue, advise them that knowing this information is important for your overall health.

Although discussing one’s mental health or the family’s mental health history can be a delicate topic, this experience may not only bring you and your family closer together, but it can provide valuable information that everyone can benefit from both in the short and long term.



Why you need know your familys mental health history

Common Genetic Factors Found

Inheriting Mental Disorders

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