One of my patients is now considering whether to have children. While this is never a simple decision for anyone, hers is made even more complicated because she has panic disorder. Although she's learned to manage her symptoms and now leads a happy and productive life, she remembers too well the pain and isolation she felt while learning to cope with panic attacks. She doesn't want to pass the disorder on to her child, and asked me what the risk of that actually happening was
I only wish there was a simple way to advise her.
We do know that people with a parent or sibling who has had an anxiety disorder are at greater risk of developing one themselves. For many years, experts debated whether this link was due to nature (a genetic predisposition that's passed from one generation to the next) or nurture (anxiety-provoking behaviors that are learned in families or are caused by stressful experiences growing up). It's now clear that these factors often interact
Much is still unknown, and the genetic factors are hardly straightforward. Researchers studying families with a history of anxiety disorders have scrutinized their genetic makeup in hopes of finding common features. Several genetic candidates have been identified. Some are variants of genes, while others are regions on chromosomes that seem similar. But none of these genetic traits appears uniformly in people with anxiety disorders. Therefore it's unlikely that there's any single "anxiety gene." Many genes probably work together to produce the disorder
So far, scientists have identified one anxiety-related gene in people. This gene, called 5-HTT, regulates serotonin, a neurotransmitter that affects mood. A variation of this gene speeds the metabolism of serotonin by neurons (nerve cells), leaving less of the chemical available in the brain. Low levels of serotonin seem to be characteristic of anxiety disorders, depression, and other mental health disorders. One study found that this genetic variation was more than three times more common in people with generalized anxiety disorder than in people who did not have the disorder. It was also more prevalent in people with obsessive-compulsive disorder
In a 2000 study in the Journal of Abnormal Psychology, researchers took blood samples from 72 people to see who had the 5-HTT gene variation. The participants then breathed a carbon dioxide?oxygen mix that causes shortness of breath, a sensation that sometimes provokes fearfulness and anxiety. The test provoked fear only among those with the genetic variation. It's important to note that none of the participants ? even those with the gene variant ? had symptoms of anxiety disorders before the experiment. Thus, the finding suggests that the 5-HTT gene variation doesn't cause anxiety by itself, but sets the stage for anxiety to develop in response to a sufficiently stressful situation
Researchers are currently investigating several other genes that may contribute to anxiety. A duplication on a region of chromosome 15 is especially common in families with high rates of panic disorder and phobia, according to a 2001 study in Cell. Potential genetic markers for panic disorder have also been found on chromosomes 1 and 11, and a possible marker for agoraphobia was found on chromosome 3.
Taken together, these findings amount to early evidence of a genetic basis for anxiety disorders. But because the study of genes related to anxiety is in its infancy, the particular genes involved and the ways in which their variations induce anxiety have yet to be uncovered. Thus far, no genetic tests are available to determine whether an individual is at higher risk for anxiety
Do anxiety disorders run in your family? Have you ever been concerned about your own risk if there is a family history of such disorders?
Anxiety and Phobias
Anxiety disorders?which include panic attacks, post-traumatic stress disorder, obsessive-compulsive disorder, and phobias?are among the most common mental illnesses, affecting about 23 million American adults. Thankfully, never before have there been so many therapies to help control anxiety. Coping With Anxiety and Phobias is a special report from Harvard Medical School that provides up-to-date information on these treatments, as well as information on the many types of anxiety disorders, their symptoms, causes, and getting a proper diagnosis.
Areyou Living With Depression or Anxiety? Connect with others with similar health concerns and issues. Click here to join the group.
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Comments: 20
We all take a risk with the gene pool when we have children. My husband did not want to pass on his bad eyesight and when he married me with my two children we had agreed not to have more children. We changed our minds and had two more children. They both wear glasses but they do not have as severe problem as my husband does.
I think there are many families where a child has anxiety problems and it just has no correlation to genetic reasons or parents with anxiety problems. Sometimes events happen and problems occur like with Post Traumatic Stress Disorder.
One friend of mine has a grandson who his highly intelligent and asks many questions and they have to be careful with their answers. He recently was asking about sink holes. He is 7 years old and is worried about sink holes. It is a problem in some areas, but here this poor kid is concerned about a potential disaster for his home. No one in the family was like this she says. It could be just the way he is.
Whether or not to have kids, though, well ... I would say yes, have them and deal with whatever happens. Science continues to get better, treatments get better, recognition of the problem is faster ... It's all a crap shoot (genetics) anyway! You might miss the anxiety and get something worse!
I do agree anxiety, panic attacks most assuredly run in my family. My mother had them, my brother has them, and I have/had panic attacks which led to agoraphobia. I basically wasted 40 years of my life in fear. What cured me was caring for another human being with Alzheimer's disease. I saw a similarity between us. That was scarey. But I understood her more because of my panic attacks and fear. They taught me to be compassionate and understandin of her (alzheimer's person). It's a shame that this horrific desease taught me to be more patient with myself. It sure was a crazy way for me to get cured of my panic and agoraphobia. I had no choice. I had to care for and not MYSELF. That's when I realized, to give your life for another human being was the greatest thing on earth one could do.
I wish more people with these aflictions would talk to others and not they are weak in other's minds.
My daughter had a brief episode of reactive depression, but does not suffer panic attacks for which I am deeply grateful. She is very self-confident and mature, so I think I must have done well.
Most of my family members consider panic attacks and depression as weakness, not an illness. They believe that getting professional help is cause for shame. I think they have bigger problems than I ever did!
Excellent article.
I do know that out of 12 siblings 11 of us have had psychological diagnoses.
I'm not sure giving up motherhood just for that reason alone is justifiable. Of the 11
siblings in my family with emotional disorders, 8 have adjusted to their difficulty and raised families. I have two sons, both have problems with alcohol, and one has been
diagnosed as bipolar. Each of my sons has a daughter. My oldest granddaughter will
graduate this spring, and my youngest starts middle school next fall. Both granddaughters seem to be self confident and show no signs of any mental disorder as yet.
I think now mental disorders are more easily diagnosed and treated. Unless your patient is unsure of how she would be able to care for a child, and I would understand
how someone with anxiety would worry about that, I would think there is probably
a heavier balance on the pro side of the argument.
As for financials, emotionally, mentally - no parent is READY for a child. No parent is PERFECT. No parent was meant to be. Things WILL come up in the process of raising a child. No parent will be in tune, emotionally, mentally or financially. Its just reality. Trying to stay sane is hard for ANY mom or father. You will lose patience, but what you do to keep your cool is what matters. For ex.. You go to good coping skills (I've been in and out of treatment centers, so I had to learn this stuff a zillion times)! :
Taking a deep breath
Reading a book
Taking a shower
Talking to someone you trust
Taking a nap (don't oversleep, it will make you depressed more).
Taking time alone for yourself
there are many good coping skills. Maybe you can give her my personal experience, that if she holds back from her goals : in fear, then she will never accomplish what she has planned for her life. You could also suggest to her, a good support system. That is always a great plan.