Should Depressed People Avoid Having Children?
Comedian Sarah Silverman, who routinely courts controversy with her edgy humor, recently made an attention-getting statement of a more intimate nature: because of her personal and family history of depression, she declared that she would not have biological children, to avoid passing her mental problems to the next generation. “I don’t want kids,” she said on The Conversation with Amanda de Cadenet. “I know that I have this depression and that it’s in my family. Every family has their stuff but, for me, I just don’t feel strong enough to see that in a child.”
Pundits across the Internet praised Silverman for her honesty and sense of responsibility, duly citing research that shows that depression is deeply heritable. People with a parent or sibling with major depression are two to three times more likely than average to develop it themselves.
But what the commenters didn’t mention is that the same genes that can cause depression may also encourage the sensitivity and sensibility that gives Silverman her creative talent. Indeed, some research suggests that the same exact genetics that might lead to depression can also lead to mental superhealth, depending on whether a person endured high stress in early childhood or had a calmer, more nurturing environment.
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Atlantic writer David Dobbs has called such genes “orchid genes.” Like the finicky flowers, they thrive and outshine ordinary plants when grown in the perfect conditions, but otherwise rapidly wilt and die. In contrast, he describes “dandelion genes,” which allow healthy development, whether the setting is harsh or bountiful.
Some of the genes involved in risk for attention deficit hyperactivity disorder (ADHD), addiction and depression seem to share this quality, leading to vulnerability if early life is difficult but otherwise providing advantages. A recent study found also that people who had genes associated with better memory — a powerful aid to learning and intelligence — were more likely to suffer post-traumatic stress disorder after trauma, compared with those without the same genetic variants. People with better memories had more flashbacks.
Focus on just the bad-environment results, and you see only vulnerability. Focus on the good-environment results, and you see that the risk alleles [or gene variants] usually produce better results than the protective ones. Securely raised 7-year-old boys with the DRD4 risk allele for ADHD, for instance, show fewer symptoms than their securely raised protective-allele peers. Non-abused teenagers with that same risk allele show lower rates of conduct disorder. Non-abused teens with the risky serotonin-transporter [gene variant] suffer less depression than do non-abused teens with the protective allele.
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Basically, whether a gene is “good” or “bad” depends on where it “lives” and how it is “raised.” And I would argue that even when people with orchid genes don’t have the benefit of a good early environment, their innate sensitivity to their condition can still often allow talent to flourish.
Artists and writers have long noted a correlation between mood disorders and creativity. A recent study of 300,000 Swedish families affected by psychiatric disorders found that people with bipolar disorder are overrepresented in creative professions. That same study showed that healthy relatives of people with schizophrenia are more likely to have creative careers, a finding that supports earlier research suggesting that the genes that lead to schizophrenia in certain conditions or combinations may produce heightened creativity in others.
A similar phenomenon can be seen in autism. Notoriously, many of the most successful people in computer science and engineering have traits similar to those seen in people with high-functioning autism — or they have the condition itself. Relatives of people with autism are more likely to be engineers, mathematicians or computer scientists, compared with the families of non-autistic people. One study found that students majoring in technical professions were more likely to have autistic relatives, while those majoring in humanities were more likely to have depressed, addicted or bipolar family members.
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This means that if you eliminate the genes that carry these mental-health risks, you may also do away with their associated benefits. The research suggests strongly that the genes associated with our most tragic psychological conditions may also carry the potential for our greatest talents and skills.
And so, while I wouldn’t presume to advise anyone about their personal reproductive decisions, I don’t think it’s necessarily “more responsible” for people with depression or other brain differences to forgo having children. Obviously, someone who cannot function due to psychiatric disease should not set out to become pregnant, and people whose conditions are untreatable or unbearable to them may want to prevent any possibility of passing on the same kind of suffering. But we should remember that, contrary to claims that the dark poet Sylvia Plath would have inevitably become insufferably twee if given Prozac, successfully treating depression or any such condition does not erase or eliminate genius, merely pain.
Consequently, as we as a society get better at identifying the genes that contribute to depressive, schizophrenic or autistic traits, we need to consider not just disabilities but potential. By selecting against our “worst” genes, we may run the risk of losing our greatest gifts.
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Maia Szalavitz is a health writer for TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland‘s Facebook page and on Twitter at @TIMEHealthland.
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