When people talk about constructing a family medical history, they expect to hear about cancer, heart disease, and other chronic conditions. But there is value in knowing about mental health as well, and it can be helpful to gather a family history of depression, alcoholism, suicide, anxiety, and other challenges. Talking about these conditions isn't always as easy as discussing who had cancer, though. Chicago-based clinical psychologist John Mayer, Ph.D., specializes in treating families and shares some insight on how to broach these sensitive topics.
Do you find that certain types of mental health conditions (like depression, anxiety, bipolar) tend to have family connections?
Yes, but, the root cause of these conditions — whether they are caused by genetics or by upbringing — is still not known for certain in mental health research. Consider this: Up until the child’s world expands socially, which is typically middle school, the parents are the child’s whole world.
So, every reaction, action, feeling, attitude, perception of the parents is being absorbed by the child. How could mental health issues not be transmitted to the child?
What's the value in knowing a family mental health history? How would that help an individual?
Obviously, I believe in people’s ability to change— that is my profession — so the benefit of knowing your family mental health history is to help change those conditions that may be present in you and to prevent conditions that were and are present in your family from being present in your life. Family history therefore can serve as a “goal post” to evaluate those mental health potentials inside you.
The correlation between mental health conditions and physical health conditions is intricately interwoven. We psychologists use physical symptoms as an assessment of mental health conditions. This is a reason why seeing a psychologist as a first stop in assessing your mental health concerns is important because we have the training and expertise to assess mental health conditions thoroughly in a holistic way.
For someone seeking to create a mental health history, what advice would you give on getting started with these kinds of conversations?
First, be sensitive about how you ask the questions. Choose your language carefully. For example, don’t start out with: “Did Dad ever spend time in a mental hospital?” Instead, ask: “Did Dad ever do things that made you worry about his feelings?” Second, be indirect. Ask around the issue rather than directly about some behaviors you are concerned about: “Why do you think Mom never drove?”
What are some challenges to keep in mind when collecting this information, and how can someone minimize or eliminate those challenges?
People have stigmas about mental health, so that is a huge challenge. Also, people feel that their mental health is secret or confidential and thus we are not socialized to talk openly about these issues. You need to build trust and rapport first when collecting mental health histories, even when it is from a very close relative or parent.
In general, what's your top piece of advice for someone undertaking this kind of effort?
Be patient. This most often can’t be done in one time, or like a checklist. Develop a trust and rapport with everyone you are going to ask for information and guarantee their privacy and confidentiality.