Having children if you have a mental illness

In keeping with my series on pregnancy and mental health, this week I will discuss some of the important questions a couple should ask themselves when they decide whether or not to have children at all.

Deciding to have children is a big step for any couple and those who have a history of mental illness have a few added difficulties to surmount along the way.

First is the question of the genetic risk to the child. What are the chances that the baby will inherit the same illness its mother or father experiences?

As with any health problem, this is a question that needs to be addressed. All mental illnesses have some genetic component to them, which means that any children born to an affected parent will risk inheriting the same illness at some point in their lives.

For example, if one parent has depression, the child is up to three times more likely to also develop depression than a child with no close relatives who are depressed. Likewise, if one parent suffers from bipolar disorder, a child has a 25 per cent chance of developing the illness compared with a one or two per cent risk in the general population.

At this point, many decide they still want to have children and deal with any health problems as they arise. Being aware of the risk from the beginning will often make it easier to spot an illness developing and get help when it's needed.

Risking a relapse of symptoms during pregnancy or the postpartum period is another thing for these individuals to consider. Setting up a support network and close physician monitoring are crucial throughout the pregnancy and first year of the child's life.

Some decide the genetic risk is too great, but would still like to be parents. Adoption may be a good choice in these situations.

Once the genetic risk has been determined and discussed, it is important to examine parenting ability. For some people, simply coping with their mental illness on a daily basis is very difficult. If this is the case, adding a child to the mix might be too much.

Individuals who already have an extremely difficult time handling stress may find that the inevitable responsibility and stress of raising a child is more than they can bear. For these people, even adoption may not be advisable.

Before deciding whether to have a child, speak with a doctor or read some parenting books to get an idea of what to expect.

Many people surround themselves with loving, supportive family and community services and are able to cope with both their own mental illness and the added stress. Given the right circumstances, many thrive and are excellent, devoted parents.

The key is to think ahead and make sure the necessary resources and support are in place. Understanding vulnerability and being willing to seek help when necessary are important for any new parent.


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