This article appears in Summer Healthy Living 2018.

A new horror movie out this summer called “Hereditary” carries the message that mental illness runs in families. While the film is filled with scary and imaginary aspects, it may make people wonder, can mental illness be inherited?

Written and directed by Ari Aster, the supernatural, R-rated film stars Toni Collette, a woman who is trying to move forward from the death of her mother, who suffered from dissociative identity disorder (formerly known as multiple personality disorder). Her brother suffered from schizophrenia and killed himself when he was a teenager, and her children are showing signs of disturbing behaviors.

“The question of whether or not mental illness runs in families is an important one,” said mental health therapist Matt Smith of Charlotte Counseling and Wellness in Charlotte, North Carolina. “As a therapist, I always ask my clients if they know of other family members who have struggled with mental illness. Anytime someone shares with me that they have a close relative with a known mental illness, I use this as an opportunity to talk about our genetic predisposition to mental health challenges and to reinforce the idea that mental illness is not the individual’s fault.”

“Having a mental illness run in your family does not guarantee you will get it,” said Dr. Bryan Bruno, medical director at Mid City TMS, a New York-based medical center focused on treating anxiety and depression. “Although having specific genes might make you more likely to have a mental illness, it is not a guarantee. It is a combination of your genetic makeup and your environment that can cause a mental illness.”

Genetics and environment

“Some mental illness is hereditary, most notably schizophrenia and manic depressive illness (also called bipolar). However, what this means is that the ‘predisposition’ to these psychoses is hereditary. Whether the illness manifests itself depends upon whether the person suffers any environmental trauma that puts stress on their psyche,” said Beverly Hills psychiatrist Dr. Carole Lieberman, author of the relationship books “Bad Boys” and “Bad Girls.”

“For example, if someone has inherited genes for a psychosis but grows up in a very loving environment and has a stable life, their mental illness may not be triggered. But, if someone has inherited genes for a psychosis and they suffer traumas such as childhood abuse, or use marijuana or alcohol, their mental illness could well be triggered,” Lieberman said.

“Mental illness is no different from physical illness in that it strikes its victims very much against their will,” said licensed clinical social worker Raffi Bilek, Baltimore Therapy Center. “Nobody chooses to have bipolar disorder any more than they choose to have a brain tumor.”

The stigma of having a mental illness is both unfair and unfounded.

“People with mental illnesses are people like anyone else and deserve medical care and social support, just as does anyone who has cancer, ALS or any other physical disease,” Bilek said. “Realistic portrayals of mental illness in the media are helpful in bringing this truth to the public consciousness and getting people to talk about mental illness, which ultimately will lead to more awareness and better care for those in need.”

Seek professional help

​​People who think they may have a mental illness shouldn’t try to self-diagnose.

“They should seek out a mental health professional, ideally one with a doctoral degree, and they should get a second opinion because the accuracy of mental illness diagnoses between different clinicians is not as high as it should be given all the knowledge we have about diagnosis,” said psychiatrist and social scientist Dr. Omar Sultan Haque, faculty member at Harvard Medical School.