Mental illness can affect anyone at any age, but we know those who have family members with mental illnesses are more likely to develop an illness themselves. And, it seems, Bruce Springsteen is no exception. The iconic rocker revealed in a new interview that he has both a family and personal history with mental illness—and he’s very careful about how he takes care of his mental health as a result.
Springsteen, 69, told Esquire that his father was diagnosed with paranoid schizophrenia as an adult, and that he personally had what Esquire calls a "breakdown" at age 32 and again in his 60s, which included symptoms of "agitated depression." Although Springsteen doesn't disclose too much else about his personal mental health issues, he shared that he’s been in therapy for more than three decades—and that he’s worried about receiving a diagnosis like his father’s.
"I have come close enough to [mental illness] where I know I am not completely well myself," he said. "I’ve had to deal with a lot of it over the years, and I’m on a variety of medications that keep me on an even keel; otherwise I can swing rather dramatically and…just..the wheels can come off a little bit. So we have to watch, in our family. I have to watch my kids, and I’ve been lucky there. It ran in my family going way before my dad."
In fact, many people who have close family members with a mental illness wonder if that could affect the chances that they'll eventually be diagnosed with one too.
Yes, mental illness can run in your family thanks to both your environment and your genetics.
"If you have a family history of mental illness, you’re at a higher risk of developing it yourself," Farha Abbasi, M.D., an assistant professor of psychiatry at Michigan State University, tells SELF. "But that doesn’t mean that you will."
The exact cause of mental illnesses isn't well understood, but we know that social, genetic, and environmental factors all play a role, Aubrey Moe, Ph.D., a psychologist at The Ohio State University Wexner Medical Center, tells SELF. “While there is a hereditary component, it’s only one piece, and it’s hard to say in any [one] particular case if someone’s genetics or environment contributed," she explains. "Typically, it’s an interaction of both."
That means it’s entirely likely that you may have a family history of depression, anxiety, schizophrenia, or bipolar disorder but never develop a mental illness yourself. Or you might be at an increased risk for developing a mental illness due to family history but only have noticeable symptoms appear when they're triggered by a specific event (such as losing your job or the death of someone close to you) or when you're under extreme stress.
Having family members with mental illnesses isn't a guarantee that you'll develop one, too. But there are a few important ways to prepare for the possibility.
There’s no blood test that determines whether or not you’re carrying a gene that increases your risk for a certain mental health condition, Dr. Abbasi says. You simply need to know your family history.
So, the first step, of course, is encouraging your older family members to be open about any mental health issues they deal with or that their family members may have experienced. Considering the stigma mental illness has had in the past and still has today, it's understandable that your parents or older family members may not feel particularly comfortable talking about it. But treat mental illness like you would any other health condition—like heart disease or cancer—and specifically ask about it when discussing your family's medical history with them.
And, as with those other conditions, having as much detail as possible about the mental illnesses that run in your family is crucial. "You have to understand your risk and gather as much information as you can, like what illness runs in your family, how it presents, and how severe it has been," Dr. Abbasi says. “Having that awareness is half the battle.”
From there, you can educate yourself and your immediate family about the symptoms of the mental health issues that run in your family, Moe says. That way, if you do start exhibiting symptoms, you and your family will know what to look for and will be able to jump into action earlier on. For example, "if it's a condition like schizophrenia, you might not notice the symptoms, but family members may be able to pick up on it," Christian Kohler, M.D., clinical director of the Neuropsychiatry/Schizophrenia Research Center at the University of Pennsylvania, tells SELF. They can then encourage you to seek help if you start to show symptoms that even you may not realize could be a sign of an underlying issue, he explains.
It's also a good idea to share these details with your doctor and/or mental health professional (if you work with one) so they can also be on the lookout for symptoms of those mental illnesses that you might miss, like changes in your sleep, eating, or physical activity patterns. Additionally, keeping up those basic self-care practices—eating well, exercising regularly, and getting regular, good sleep—is an especially important part of keeping you healthy, Dr. Abbasi says. That also means being aware of your alcohol and drug use, given that both can either contribute to or exacerbate mental health issues, Dr. Moe says.
If your family history of mental illness is strong and you’re especially concerned, it’s perfectly OK to undergo preventive therapy to help you form healthy coping skills for stresses that will inevitably come up in the future, Dr. Abbasi says. “It doesn’t mean you won’t be faced with struggles or won’t develop a mental health issue, but it can help you function and cope better if you do develop symptoms or are faced with stress,” she says. However, be aware that mental health treatment without a specific diagnosis (or even if you have one, in some cases) may not be covered by insurance.
And finally, it doesn’t hurt to think about next steps, Dr. Abbasi says. Indeed, it's helpful to have a plan in place for what you'll do and which mental health professionals you'll talk to if you do start to notice any symptoms in yourself or your children.