Why You Need to Know Your Family's Mental Health History

When I see a client or patient for an initial evaluation, one of the most important things I ask about is family history. I ask whether any first-degree relatives (mother, father, siblings, children) and second-degree relatives (aunts, uncles, grandparents, cousins) currently have, or have had mental health issues.

The mental health issues I specifically ask about include:

• ADHD
• Depression
• Bipolar disorder
• Anxiety
• Panic attacks
• Substance abuse
• Alcoholism
• Attempted or committed suicide
• Schizophrenia
• Seizure disorder
• Dementia/Alzheimer's
• Any inpatient mental health treatment

Why is it so important I ask about this? Because studies have shown a majority of mental health disorders are inheritable. This means that if your parents have a certain disorder, there is an increased chance you may have that disorder as well.

ADHD, for example, has a heritability rate of 75 percent. This means that if you have ADHD, there is a 75 percent chance that you inherited an ADHD gene or genes from at least one of your parents (Rietveld et al. 2004). Schizophrenia has a heritability rate of 64 percent, and bipolar disorder has a heritability rate of 59 percent (Lichtenstein et al. 2009). Knowing your family's mental health history gives you and your clinician a great advantage in determining a diagnosis and course of treatment.

When asking your family about mental health history, you shouldn't only ask if anyone was ever diagnosed with a mental health disorder; it's also important to ask if there was anyone in the family that just "didn't seem quite right" or seemed "off." Remember, in some families, seeking help for mental health issues was, and still is, unheard of.

Your family may feel very uncomfortable when asked about a relative's suicide, they may get angry when asked about it, or they may refuse to talk about it at all. That is understandable. Remember, again, that mental health issues just weren't talked about as openly as they are today. Many times they were a source of shame for a family. Acknowledge and respect your family's wishes, but also be firm about needing to know this information for your own health.

If you do not have access to your biological family's mental health/medical records, try to gather up as much information as possible. Talk with people that knew your family. Look into getting adoption records unsealed. Any information you can gather is helpful.

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