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In May's T3 Newsletter, I shared a little about my family's history of mental illness. And more in depth on the Parents Talk Truth Blog. As a recovering alcoholic and the child of two alcoholics, I fret sometimes thinking of my children's genetics. From the moment they were born I wondered if I'd have to be the one to put them in rehab or hospitalize them for a mental illness. Dr. Stephen Preas has educated me so much about the genetics involved in alcoholism and mental illness. I wanted him to put in simple terms what's involved when our family closets are full of skeletons---or bottles of booze.
Stephen Preas, M.D. has been practicing psychiatry for over 20 years and is the Medical Director for Promedica Psychiatry Group in Metro Atlanta. He's a frequent guest on the Teens Talk Truth programs and contributor to the T3-Newsletter.
TTT: Have scientists been able to find a gene that flags a person as an alcoholic or having that predisposition?
SP,M.D.: They've done a lot of research on identifying genetic markers. As it turns out, some of them, they think, are specific to alcoholism. If you have this DRD2A1, it has a very high correlation with alcoholism and if you're an alcoholic because of this gene it would be one treatment, but if you're an alcoholic for some other reason, it might be a different treatment. The reason that it's not clear is that the genes for just about all mental illness are very, very multi-determined. An example is: if you have the gene that allows you to metabolize alcohol very easily, then you can drink a lot of alcohol because you metabolize it and you don't have much of a hangover. And you're more likely to become an alcoholic because you just keep guzzling the stuff. Whereas if you're a person who can only handle one drink and you're passed out or sick, you're less likely to become an alcoholic because you just can't drink! But, you can also have all the risk factors against you and still turn out okay because of the way you were raised (not being exposed to alcohol). What may happen is that once we already figure out you've got the disease, we'll run the genome to best determine your treatment.
TTT: How might the treatment differ?
SP, M.D.: There is some belief that once they've identified that you have the DRD2A1 gene, then it means you need medication to correct a chemical imbalance as part of your treatment for alcoholism. If you don't have it, you might be one of those people who could go through terrible withdrawal, come out the other end and have a lot of psychological reasons to never drink again.
TTT: I read that pleasurable reactions to sweet substances and to alcohol are regulated by the same part of the brain.Some studies indicate that people who have a significant preference for sweets become alcoholic. What is the connection between those parts of the brain?
SP, M.D. :There is one receptor that seems to be particularly sensitive to both opioids and sugars or carbohydrates. Biochemically, sugar is not that much different than alcohol. Sugar is C12H22O11 and alcohol is C2H5OH . So it's just a little bit bigger molecule, but they're very similar.
TTT: What is the connection between children with ADHD and developing Bi-polar Disorder later?
S.P., M.D.: The connection that we know, is that risk for one seems to raise the risk for the other. The way it's playing out most clearly is we think we're determining that some kids who are early on diagnosed with ADHD, actually have the early signs of Bipolar. They weren't strictly speaking ADHD, they just looked like it and instead they were Bipolar. And if we'd been lucky enough to know this, we might've treated that instead of going down the ADHD treatment path. Whether or not there is any actual similarity to the diseases genetically, I don't think so. It's really more right now an issue of recognizing which one you've got.
TTT: Since genetic testing is out of the question for most of us, how would we look at our family tree and assess the risk for our children to become alcoholic or mentally ill?
SP, M.D.: You count the relatives. How many relatives have ever had to go to jail or prison? That's a way "off the chart" thing, that's not a bell curve, most people don't have so much trouble with the law that they go to prison. How many people do you know who have alcoholism or drug addiction? It's okay for you to make the diagnosis. Even if Uncle Fred says he's not an alcoholic, you know every time you see him he's drinking too much.
It's the same thing for mental illness: anybody that's just-weird, they don't develop well, they don't get along with people go on the tree. You add them all up and the higher the number, the more likely you are to be at risk. What you're doing is taking a snapshot of the gene pool.
TTT: What are some traits we might notice in our children that would portend them becoming alcoholics or addicts?
SP, M.D.:
A characteristic that seems to put kids at great risk for addiction is early-on evidence of aggression and impulsivity. There is a gene called the "novelty" gene; they like new stuff, they like stimulation, they like excitement. Evel Knievel and Christopher Columbus were explorers and these folks don't freak out doing 800 MPH, they love it. A little bit closer to home are people who are willing to be venture capitalists! These are the kids who you need to expose to activities that are safe, but exciting like white water rafting or flying lessons.
TTT: As always, thank you Dr. Preas for a wealth of knowledge on this topic!
 If you'd like to hear more of Dr. Preas' expertise you can order a copy of his CD, "Self and Self Esteem, Is There A Hole in Your Bucket?" from the Teens Talk Truth Online Store. This CD discusses developing good boundaries and the difference between self esteem and a sense of self. | |
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