both sides of my family have mental illness in them, my dad's side of the family have 3 generations of bipolar (manic depression), both sides have eating disorders and my mum's side have problems with anxiety. the idea of genetic vulnerability for mental illness has been highly contested amongst the experts, the idea of nature vs nurture in terms of behaviour, whether negative behaviours and patterns of thought are primarily inherited or whether they are learnt has been a topic of conversation for a long time. the results are still suprisingly vague and inconclusive.
however, if you have a family history of mental illness where does that leave you when you chose to procreate?
this is a question that i have thought about probably more than most. my family is an interesting case in point in that certain aspects of the nature vs nurture debate. i did not know about my father's family history until i was 11 and my granny had an almost fatal complication caused by her medication. my granny was one of the first people to be put on lithium in the 1960's and it undoubtably saved her from a life of institutions. it worked very well and she went from having compleatly out of control bipolar 1 to having pretty much controlled bipolar for majority of the rest of her life. she had very few manic episodes whilst on lithium and from what i can gather they were normally due to not taking the lithium properly, non-compliance in terms of medication is very common for a variety of reasons with patients with bipolar. however, when she was in her early 80's, her lithium levels were no longer being properly monitored by her GP and due to natural loss of body mass in old age, the lithium levels in her body rose and she was poisoned by the medication that she relied upon to keep her stable. the problem with lithium is that the theraputic dose tends to be very close to the toxicity level and regular monitoring is essential to ensure that the lithium levels in the body do not reach toxic levels which would be potentially lethal. therefore suddenly my granny had to be taken off the medication and suddenly, we had a serious problem. my parent's had to explain to us (my siblings and myself) what had happened before we were born and hence, what was now happening to granny. my aunt has since been diagnosed with bipolar as well. it is also likely that my paternal greatgrandmother also had bipolar.
i was 15 when my mental health problems came to a head, a lovely mixture of an eating disorder, OCD and borderline personality disorder...what a mess.
this leads me to my wondering about whether or not it is fair for me to bring a child into the world knowing the potential genetic inheritance my child could have. my parent's discussed their having children before we were born but for them they only had one generation of bipolar to factor in. they didn't really make the connection with my great grandmother, my aunt hadn't been diagnosed and they didn't know about my nannie who letter admitted she had anorexia. however, i have all that history, my own history and the fact that potentially i could still be diagnosed with bipolar. the average age of onset for symptoms is 23, the age i am now and the average age of diagnosis is 40. the difference between BPD and bipolar is very subtle, it's not uncommon for one to be misdiagnosed and the other diagnosis be the correct one. this frightens me hugely, i desperatly don't want to turn into my grandmother, the images of her in a manic state towards the end of her life will stay with me for the duration of mine. my own history has been bad enough. ive spent a large amount of my later teens until now in and out of hospital.
i would love children, it's actually the only thing i have ever been sure of in my entire life. this is compleatly individual and everyone is different. for me, i struggle to believe that my life can have meaning if i cannot have children. this is only me, i know many people who don't feel this way and i don't believe that having children is the only thing that can bring meaning to someones life, nor do i believe that without children someone's life is worth less. however there are people who the last thing they should do is have children and the thing that frightens me is that maybe genetically that is the column i fall into?
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