One morning in May of 2009 I woke up in the inpatient psychiatric ward of a regional medical center in western New Jersey. I had admitted myself through the ER the night before – after a suicide attempt. I would be diagnosed with major depression, general anxiety disorder, and substance abuse issues.
As I learned about the behaviors associated with my illness, I realized that I exhibited most of the behaviors related to major depression as a five-year-old child. I was fifty-six years old. This meant that I had been living with major depression for over fifty years.
All of us who are challenged with a mental illness eventually have to wrestle with the question of nature versus nurture. Did the mental illness come from my genes? Is it some sort of behavior that I learned? Here is how I have come to peace with this dichotomy.
It appeared to me that most of my behavior was learned. Even though my family has a history of alcoholism, it seemed that most of my behavior was learned maladaptive reactions to a very toxic family situation. My isolating behavior in childhood was an attempt to shield myself from a toxic family situation. My near suicidal behavior at five years old was a desire for physical sensation in a very cold physical and emotional family environment.
In recovery, I began learning skills to modify these lifelong behaviors through intense talk therapy.
One day I thought “What if these behaviors come from my genes and DNA?” The response to this thought was to look at someone with a congenital disability like blindness. There are many individuals with congenital blindness that learn to adjust and live a happy, productive life.
This pointed me back to using the skills I was learning in talk therapy. For me, even if the cause of the behavior is my genetic inheritance, just like someone who is congenitally blind, I should be able to learn the skills required for a happy and productive life.
Another concern I had was that if I accepted that my behaviors were from genetic inheritance, I might give up. My apprehension was that I might not take responsibility for my behaviors. After all, if they come from my genes, I can’t change them anymore than I can change my genes.
One final thought I had about genetic inheritance was that maybe what we are really describing is behavioral inheritance. The infant spends most of their waking hours observing the parents and those around them. They attempt to learn and imitate the physical behaviors that they perceive – walking, talking, etc.
How do we know that they are not doing the same thing with the emotional behaviors they observe? The infant assumes that the physical behaviors around them are normal and should be learned, why should they not assume the same thing about the emotional behaviors around them?
For my recovery I decided that I could not let the fact that my behaviors might be genetic in origin get in the way of my finding a happy and productive life. I would take my meds to keep me stable, but they would only provide stability. I would use that stability to concentrate on learning the skills required to learn to be at peace with myself.
I progressed through my recovery in that fashion. The meds were keeping me stable. However, once I was stable, they could not teach me the skills of self-advocacy, setting boundaries, being able to trust, and learning to discuss and deal with my emotions. That learning had to come from therapy and my use of my newly found skills in my daily life.
Then a few months ago I had a flash of insight that put it all in perspective.
At the end of the day it does not matter what the source of the behavior is. It does not make any difference if I was born with genes that caused my behavior or I learned maladaptive behaviors as a very young child.
The important factor is that it is on my plate. Since it is on my plate, I have to deal with it. Whether someone came by and served me a salad, or I went up to the salad bar and made it myself makes no difference. The operative concept is that I have the challenge now. And I am the only one who can do anything about that challenge.
The therapists can describe the healthy behaviors to me. They can reinforce my progress and point out when I go off the track. The meds can keep me stable enough to learn those healthy behaviors and consolidate my progress. However, the problem is on my plate and I have to deal with it as best as I know how.
This understanding has given me great peace. It has also been very powerful. It has helped me to realize that at the end of the day I am responsible for my successful recovery. Not the meds, not the therapists, not my genes. Me.
I now look forward to each day. I ask, “What can I learn today that will help my recovery?” That attitude is so much healthier than the more than fifty years I spent waking up each morning with an absolute dread of the new day.
