We don’t talk, often enough, about mental health. Period. Especially, we struggle at discussing the possibilities of inheritance. Questions like: Is my mom to blame? Racism? My parents divorce? My father had Bipolar, so will I?
I think – wait for it – this is because we are all anxious about the answers. Blaming parents, unfair and unproductive. Blaming genetics, whoosh – we worry about a recapitulation of eugenics. And social oppressors are the least likely personality to admit responsibility.
Based on the research, clinical experiences, and personal point of view – I think there is an interplay of equal parts nature and nurture.1
Why?
Let’s start at the beginning of a long story shortish.
Genetics, which mostly falls under (note: mostly) – nature. Anxious expressions (style of thoughts, feelings, sensations) and degree of anxious arousal has DNA coding that plants seeds in certain folks for certain vulnerabilities more so than others. Ironically, those same folks are the best foreshadowers and preventers of disasters. They make great therapists or risk assessors.
One genetic variant, and I do call it a genetic variant despite some scholars calling it a genetic defectiveness – MTHFR – has been linked with increased likelihood for anxiety, depression, and possible forms of schizophrenia.2 We are not quite sure what is happening at the molecular and cellular level for persons who are MTHFR carrying, yet I have faith that colleagues of mine – like those at the brilliant Genetics Society of the UK,3 will someday answer the details that I am craving for clients and myself (a carrier of MTHFR). Yet even as a carrier there are specific heterozygous versus homozygous, ie level of potency and dominance that impacts risks.4
From working with an amazing yet sadly retired holistic practitioner, Dr. Kuhns of Monarch Integrative Medicine, I learned that MTHFR risks are likely linked to how we MTHFRers’ process folate. Basically, MTHFRers do not process it very well. Dr. Kuhn’s suggested for me and persons who are also MTHF positive: make sure you are getting folate in natural, concentrated modes. Think, green leafy veggies. Otherwise, we risk clogging our cells w/ synthetic forms (like folic acid, found as the folate in many oral vitamins or processed foods) neither as concentrated nor as easy to use for our MTHFR cells to utilize.
Folate deficiency leaves people physically exhausted and exacerbates mental health issues – wait for it, that include poor sleep, elevated depression and ANXIETY! Boom.3 NOW, just when you want to blame your genes – don’t forget about a poor diet – for everything…genetics has a component that combines enviro-social factors termed epigenetics.
Epigenetics is an emerging behavioral-science intersection re: the way we live as means of influencing our genes. As a second generation removed from Holocaust-refugees, like we can also see in studies on brains of proceeding generations of African-Americans with ties to slavery – genes rewires from systemic atrocities.4 Poor immune systems, elevated risks for forms of trauma brain wiring, heightened reactivity, cortisol levels, and excessive distrust may be programmed into our DNA.
Brain structure, epigentics leads the NATURE v NURTURE discussion to brain structure. The greatest school lecture I ever sat in on, sitting alongside my entire graduate class at Smith College, opened with professors stating, “This will be the most important lecture while you are a student, here.” At that, I rolled my eyes at the grandiosity. Dang. In hindsight, it is the single most referenced lecture in my clinical care. The lecture’s mission was twofold: to educate on the Limbic system part of the brain (specifically the hippocampus and amygdala) and how they relate to human interactions.
The hippocampus, which I remember sits under the amygdala, and supplies smarts and communication to work with other wiser or language filled parts of our brain, recalled for its smarty “campus” in the name…well, it becomes suffocated by our sometimes-drama-queen amygdala. Sexist of me to use that language, although she is – after all – just a very reactive and easily triggered part of the brain brought into human evolution to protect us.
The amygdala activates when sensing a threat. This happens in less than milliseconds. The amygdala is ace of then producing fight, flight, freeze, fawn, fix or fixate modes of decision making plus the coordinating stress hormonal rush.
While we can thank our favorite drama-queen for their service, every time it is activated – research shows – this part of the brain grows or even swells. Sitting structurally on top of the hippocampus, it overwhelms and stifles that part of the brain’s ability to – put bluntly – think clearly or work effectively.
Traumatized folks may end up on an ALL-DRAMA-QUEEN, ALL-THE-TIME STATION. Think Heavy Metal 365. Great in increments, torturous as an only choice. We end up in a vicious cycle of too easily, too often activating the drama-queen before any other part of us has a chance to speak, let alone fully function.5,6
If our brain is exposed too often to trauma or family drama-queens, especially during our most vulnerable young years, our brains may be nurtured into what we might imagine is mere brain structural nature variance, alone. But it’s not just structure based on inheritance, it is structure shifting and a hyperactive amygdala for traumatic reasons.
NATURE v NUTURE. So hard to tell, exactly. See why I love to keep it complicated?
After all, we know with confidence about the brain what is on par with our knowledge of the vast universe. It just so happens that while the universe heads in an infinitely expanding direction – our brains head into an infinite minutiae, smaller and smaller bits of nuance, the more we explore and discover.
Which brings me to the foundation for the nurture explanation: to a certain degree, as a human (at least I think I am – therefore I am?) and a mental health provider, I believe nurturance is the most significant factor in mental health and brain develop. We coin this the biopsychosocial model of human conditioning. Regarding anxiety expressions and intensity and frequency of reactivity, we learn a lot from the previous generation in terms of how and why protect oneself (and long before we are verbal enough to explain what is happening).
I am most responsible for my personal growth and nurturance of calming energy.
However, as we age, and this usually hits us as early as six or seven years old, we begin a cognitive sharpening period of self-sustainability. The smart enough and brave among us, likely will have the ability to be soothed by hobbies, spirituality, mentors, nature, or education in order to rewire the brain for optimal health.
That is really good news.
Hear me out and give credit to neuroplasticity, aka brain flexibility over the entire lifespan. The brain changes and repairs and grows profoundly the younger we are, yet – it is a misconception to believe otherwise – our brain continues the capacity for neuroplasticity (especially the wisdom parts of our brain) throughout our lives.7
Good news, bad news:
At forty-four, I was a hot mess till last week.
But, with a few intentional lifestyle choices, health care consultations, plus ongoing mindful education – I am a work in progress to be less anxious (w/ decreased intensity and frequency) since learning as an adult – I am most responsible for my personal growth and nurturance of calming energy.
- Freeman, Daniel, and Jason Freeman, ‘Nature or nurture?’, Anxiety: A Very Short Introduction, Very Short Introductions (Oxford, 2012; online edn, Oxford Academic, 24 Sept. 2013), https://doi.org/10.1093/actrade/9780199567157.003.0003, accessed 10 Oct. 2023.
- Cooper, Jarrod. Understanding How Your MTHF Gene Mutation Can Play a Part in Anxiety Disorder and Other Mental Health Conditions. https://advancedfunctionalmedicine.com.au/mthfr-gene-mutation-anxiety-disorder/ , accessed 10 Oct 2023
- Genetics Society of the UK General Website
- Moll S and Varga E. Homocysteine and MTHFR Mutations. https://www.ahajournals.org/doi/10.1161/circulationaha.114.013311#:~:text=Some%20people%20have%20a%20genetic,for%20the%20mutation(s). acessed 10 Oct 2023.
- Amygdala. https://www.physio-pedia.com/Amygdala Accessed 10 Oct 2023.
- Holland K. Amygdala Hijack: When Emotion Takes Over. https://www.healthline.com/health/stress/amygdala-hijack Accessed 10 Oct 2023.
- Cherry K. What is Neuroplasticity? https://www.verywellmind.com/what-is-brain-plasticity-2794886#:~:text=Plasticity%20is%20ongoing%20throughout%20life,of%20damage%20to%20the%20brain. accessed 10 Oct 2023.
ANXIETY ANSWERS 