A Lethal Inheritance: A Mother Uncovers the Science Behind Three Generations of Mental Illness
“A Lethal Inheritance: A Mother Uncovers the Science Behind Three Generations of Mental Illness should be read with a healthy dose of caution and not as a single-source reference on the science of mental illness or health. One’s genetic inheritance may not, in fact, be lethal, and labels can be dangerous and counterproductive. As the author herself notes, ‘The information contained in this book is designed to educate and inform, but it is not intended as medical advice.’”
In the face of growing criticism among professionals and consumers over the fifth edition of “the psychiatrists’ Bible,” the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), slated for publication in 2013, Victoria Costello’s book comes at an interesting time.
A Lethal Inheritance itself is interesting because the personal story she shares is compelling and relevant, but it is also of interest because it operates from within a framework of psychiatric “labeling” that is at the heart of numerous concerns surrounding the DSM-5.
Ms. Costello centers her narrative on the experiences of her two sons and other family members, all of whom have been challenged mentally and emotionally. Her older son was diagnosed as “schizophrenic” in his teen years, and her younger son received a diagnosis of anxiety and bipolar depression also as a teenager. Both were medicated with various psychotropic drugs in addition to other treatments including talk therapy and in the case of the older son, hospitalization. Ms. Costello then faced her own “dual depression” and alcohol dependency, for which she, too, was treated with psychiatric medication.
The family’s wrenching experience—which ultimately had positive outcomes for author Costello and her two children—frames her exploration of “the science behind three generations of mental illness.”
But those familiar with reservations swirling around the DSM-5, and anyone with an a priori resistance to our culture’s propensity for pathologizing everything from childbirth to sadness and grief, will likely find the book’s reference to science rather facile, and its claim to having uncovered the science of mental illness a bit grandiose.
Ms. Costello is aware of the controversy surrounding the DSM-5 and of differing views on treatment options for those suffering from depression or other clinical diagnoses relating to mental health, but she gives such divergent opinions short shrift, while acknowledging that “consumers’ voices are rarely heard in this debate.”
She frequently cites proponents of antipsychotic medication without seeking expert opinion from physicians on the other side of the argument. For example, one clearly pro-med researcher is quoted as saying, “It’s unacceptable to wait for patients to slide into madness, though it’s impossible to predict with any certainty which will. You’ve got to do something.” Just the word madness and alluding to a slippery slope is enough to send shivers down the spines of a good many parents as well as adult patients seeking relief from psychic pain.
Ms. Costello is also quick to refer to several studies that have questionable sample sizes and, one suspects, methodologies. But perhaps the most disturbing aspect of her book, which claims to uncover science just when the DSM-5 is being criticized for its lack of scientific rigor, is her flagrant use of the very labels that are now being called into question. Here is a telling sentence: “Even knowing that schizophrenia manifests in strange and subtle behaviors long before its formal onset, I was still amazed as anyone reading recent studies that document early psychotic symptoms in children as young as twelve and even five years of age.”
In one of numerous text boxes offering concise information about extraordinarily complex states of being, one finds labels like schizophrenia and Pediatric Bipolar Disorder dangerously oversimplified. Pretty nearly everyone at some stage of their lives comes perilously close to be diagnosed psychotic.
One doesn’t want to diminish altogether the information shared in this heavily referenced book. Ms. Costello has shown courage in sharing her family’s story; the fact that they each found relief and were able to return to productive lives through a combination of interventions, including medication, will encourage parents grappling with how to help their troubled children.
At the same time, A Lethal Inheritance: A Mother Uncovers the Science Behind Three Generations of Mental Illness should be read with a healthy dose of caution and not as a single-source reference on the science of mental illness or health. One’s genetic inheritance may not, in fact, be lethal, and labels can be dangerous and counterproductive.
As the author herself notes, “The information contained in this book is designed to educate and inform, but it is not intended as medical advice.”