How often does the topic of family mental health history come up while sitting around the dinner table? I am guessing not very often! What about your family’s medical history? This topic may feel a bit more comfortable but also tends to not be discussed.
Did you know that Thanksgiving was also National Family History Day? This is a designated day sponsored by the U.S. Department of Health and Human Services where the Surgeon General encourages families to talk about and take a record of their family-health-history.
Many years ago at a family gathering, I was catching up with relatives shortly after an emergency hospitalization and surgery for appendicitis. I thought it was a big deal at the time, since I never had a major surgery, nor was familiar with any family history of appendicitis. After starting the conversation, I was surprised when several family members casually started talking about similar experiences around the same age! I had no idea others in the family shared the same medical issue, nor had any information such as statistics to normalize how common the procedure was. While the family medical health information was helpful after the fact, it would have been even more helpful to know beforehand. I was not aware what symptoms to look out for and no knowledge at the time on preventative care or treatment options. Family health histories topics generally do not seem to be discussed within many families until after someone is in the hospital or goes to treatment.
I reflect on how often in routine intake sessions one is asked about their family medical and mental health history. While one may be familiar with the health history of family members closest to them, how accurate is the self-report? My Family Health Portrait is a great tool to collect information about your family’s health history. It is a free online tool that can be shared with other family members and also your doctor.
Knowledge is important when it comes to your family’s medical history. Since knowing is not enough, it is important to get early screening and take preventative measures to reduce your risk.
1. Know Your Family’s Health History
This includes medical health, mental health, and chemical health histories. Do you know if there is a family history of things such as diabetes, cancer, high blood pressure, heart disease, or obesity? Is there a history of a specific medical condition such as breast cancer with a first degree relative such as your mother or sister? How about histories among second-degree relatives (e.g. aunts, uncles, grandparents, cousins?) What about early onset to a specific medical or mental health diagnosis? Ask about areas such as ADHD, autism, eating disorders, substance use, depression, anxiety, panic, OCD, bipolar, and schizophrenia.
2. Act on What You Know
The chances of you developing a similar condition increases so it is important to be aware of early risk factors and act on the information that you know through preventative care and early intervention. Lifestyle changes and early screening can be great places to start. Scheduling routine medical visits and seeking out supports such as counseling at the first signs of concern makes a big difference. You are in the driver’s seat of your health–Don’t ignore that “check engine” signal!
But How Do I Talk to My Family About Their Medical, Mental, and/ or Chemical Health History?
Take the First Step to Start a Conversation About Your Family Health History. While it may be difficult to start a conversation or feel uncomfortable, taking the first step to start an open dialogue is important. The information that you are asking can benefit both you and your close relatives.
Begin to Open up About Your Mental Health and/ or Substance Misuse with Supportive Family. Sharing your struggles with mental health or substance misuse can help normalize the struggles we share and allow opportunities for families to provide support. Family members may not be aware of your experience, nor know how to help. Self-disclosure with a trusted family support can be a great source of encouragement and an ally in the time of crisis. While you may experience fear of judgment with self-disclosures, finding a safe and trusted person is a great place to start practicing vulnerability.
1. Seek Out a Good Opportunity When Disclosing-to-Others.
This includes when you are feeling well overall, when the disclosure serves a purpose (such as to share and gather family health histories), and when the timing feels right to you. It can be difficult to open up about sensitive topics, especially when there are “family secrets” such as family members being committed to a mental/ medical institution or “taboo” subjects such as family histories of abuse or addictions.
2. Ask Questions and Keep a Record.
Ask biological parents and first-degree relatives about which medical conditions (or symptoms) they have experienced, when first diagnosed, and at what age. Do the same for mental health and substance use. Ask about ancestry. Pay special attention to chronic medical diseases or conditions such as heart disease, cancers, diabetes, high blood pressure, and high cholesterol. Asking the ages and causes of death can be an important source of information. Being aware of patterns of early death and factors involved such as completed suicide or drug overdose can make a difference in awareness and treatment.
3. Notice Cues That Others May Not be Ready to Have a Conversation.
Some family members may take time to develop a level of comfort to talk about family health histories. They may struggle with how to respond, or may not know how to respond. That is OK. It is important to respect their boundaries. Providing information on reputable medical, mental health, and substance resources such as the following can be a helpful way to learn more and can be shared with family as a way to start communication.
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