Throughout childhood and into adolescence, our personalities and characteristics are shaped by our interactions with the people around us. Some of the behaviours that we learn from our environment are easy to spot – the accent that you talk with is probably very similar to the accent of your family, for example. Others are harder to define.
Research suggest that these early relationships could be critical in understanding the development of mental illness, providing hope to protect young people by offering support to parents and caregivers.
We spoke to researchers working with families to improve childhood mental health and discuss the steps being taken to prevent mental health problems in the next generation before they are able to take hold.
Exploring the emergence of eating disorders
When studying the early origins of any illness or behaviour, it can be difficult to separate the role of our genes from the role of our environment. This is an important distinction to make, as whilst our genetic material is fixed from the point of conception, our environmental influences are variable – providing an opportunity for early intervention. It’s a problem MQ fellow Dr Clare Llewellyn has been tackling in her studies looking at why children differ in weight.
Llewellyn’s previous research has shown that both our genetic makeup and the actions of our parents have an important influence on the way our appetite develops in childhood. “We find that genes predispose individuals to certain eating behaviours but the environment can act like a volume control,” said Llewellyn. “For example, children with parents who are very restrictive over the types and amounts of food they are allowed to eat, tend to have more avid appetites in later life – they go after the foods they weren’t previously allowed. We also see the opposite, where pressuring children to eat more can lead to an even poorer appetite as they become stressed around meal times.”
Llewellyn is now expanding her studies to investigate the potential origins of eating disorders with her MQ project. “I find it staggering that we know so little about the early feeding and eating behaviours of people living with eating disorders, particularly when you consider that around 50% of anorexia nervosa sufferers say they were aware of their symptoms before they turned 16 and for 10-20% of sufferers this age is 10.” Llewellyn ultimately hopes to assist families during the early stages of parenthood. “This is about finding the best possible feeding strategies to promote a healthy relationship with food. If we understand better, we can develop guidelines and ensure parents are fully informed.”
Giving parents these tools could help young people like Lexi, who was diagnosed with anorexia nervosa when she was 14 years old. “It used to take me two hours to eat a meal. My body went into ‘menopause’ and my period stopped for 9 months. It wasn’t until I saw my mum cry about it that I realised I had a problem.”
Lexi says she’s learnt to live with her condition: “I don’t believe you ever fully recover. But with research, we can stop mental illness before it starts so that less people suffer with it in the first place.”
Identifying depression in pregnancy and beyond
Depression is one of the most common mental health problems in new parents, with an estimated 13% of mothers affected by postnatal depression and up to 10% of fathers displaying depressive symptoms in the months following childbirth. Low mood in either parent can have detrimental effects on the social and emotional development of a child and has been correlated with a range of mental health conditions in later life, including anxiety, various mood disorders and elevated levels of stress.
It is important to emphasise that the vast majority of children born to parents with depression will spend their lives happy and healthy. However, it is clear that early identification and treatment of parental depression can provide enormous benefits for the family as a whole. This viewpoint is echoed by Paul Ramchandani, Professor of Child and Adolescent Mental Health at Imperial College London. “The key thing for me is for people to have timely access to effective treatment, and that they know where to go for that help,” said Ramchandani. “I’d be delighted if expectant parents were asked by their usual health professionals how they were, and whether they had any problems or worries with their mood.”
This is a view shared by Mark Williams, a father who experienced postnatal depression after the birth of his first son and struggled for years without treatment. “If I had been screened early enough, I think I would have managed it so much better – I didn’t even know men could get postnatal depression. I want people – and particularly fathers – to know that there is help out there.”
Treating mental illnesses with the family in mind
As evidence accumulates in support of parental interventions, a new problem is formed – how can these findings be transferred to the clinic? Dr Adrian Falkov, senior psychiatrist at the Northshore Kidspace in Sydney, Australia, is the driving force behind The Family Model, an innovative therapeutic framework that strives to improve the treatment of parental mental health conditions by shifting the balance away from the individual in order to support the family as a whole.
The Family Model aims to provide patients and their relatives with a shared understanding of the impacts a mental illness can have on a family. “A mother with postnatal depression may find it difficult to establish a positive relationship with her infant,” describes Falkov. “She may also struggle to explain her emotional needs to her partner, which can in turn lead to conflict. This can then compound her symptoms and further impact her relationships with her child and her partner.” By working through the consequences of mental illness with the family in mind, parents can lessen the impact that their illness has on their children as they receive the treatment they require to return to full health.
Evidence suggests that even small changes in parent behaviour can provide lasting benefits to the mental health of a child. This provides us with hope for the future as we aim to improve the wellbeing of generations to come. The more that we know about the early environmental factors involved in the onset of mental illness, the easier it will become to support parents, providing them with the tools required to give their children the best possible start in life.
Last updated: 11 January 2018