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Are Some People Born to Be Unhappy?


The question of inheritance in those prone to depression was brought up in a previous article. It's beginning to appear very likely that this "genetic connection" may well extend beyond depression, and that other forms of depression probably also have genetic backgrounds. An article published in the Archives of General Psychiatry's December 2002 issue probed deeper into this question. Written by a large contingent of researchers led by Qiang Fu it tackled the question of genetic factors underlying several possibly interrelated conditions as indicated in its title "Shared Genetic Risk of Major Depression, Alcohol Dependence, and Marijuana Dependence: Contribution of Antisocial Personality Disorder in Men." An interesting approach was used in order to obtain appropriate controls. The objective was to locate enough twins for the comparison, so the researchers utilized the Vietnam Era Twin Registry of male veteran twins. They then contacted eligible twins from the Registry in 1992 and were able to obtain appropriate responses from 3360 pairs out of an original count of 5150 pairs. Of these, 1868 were identical twins. The questions were designed to determine the occurrence of lifetime antisocial personality disorder, major depression, alcohol dependence, and marijuana dependence as described in the third edition of the Diagnostic and Statistical Manual of Mental Disorders. Observing that their literature research on the "role of antisocial personality disorder as a confounding factor" in the genetic approach to the other three conditions had "received insufficient attention," they set out to base their investigation on the concept that there was a "failure to consider the comorbidity between major depression and antisocial personality disorder."

depression The results in this study were carefully worked out utilizing recognized statistical analysis procedures. The main concept, that there is a decided genetic relationship involved in these variations of mental disorder, was shown to be statistically significant. This took the following form:

o If someone has a history of antisocial personality disorder or major depression there is an increased risk for lifetime alcohol dependence, severe alcohol dependence, or marijuana dependence.

o Apparently, the relationships between the conditions were not merely due to the presence of one mental state leading to another. Results backed up the original hypothesis that genetic effects, which are associated with antisocial personality disorder, do make a significant contribution to the genetic correlations between major depression and alcohol dependence and between major depression and marijuana dependence.

o On the other hand, there was no statistical evidence for the residual genetic correlations between major depression and alcohol dependence and between major depression and marijuana dependence.

Most of us tend to believe that if an individual behaves in a decided antisocial manner it's this antisocial pattern that leads to overindulgence in such things as excessive drinking, smoking, use of marijuana and other drugs, promiscuity, etc. However, studies such as this one are bringing into focus a new aspect, the idea that genetic background plays a decided role in determining whether an individual will go on to lifetime dependence or will eventually overcome the disability. In the past major depression was given prime importance as a contributor to alcohol and marijuana dependence. These findings back the concept that this importance has been overstated because the investigators failed to control for the genetic role played by antisocial personality disorder.

Where, therefore, should we place the blame when youngsters demonstrate distinct patterns of behavior that go against our social and moral grain? If genetics play a decided role in determining who will pass out of a growth phase, then it behooves us to make every attempt to spot the deviation early, and to provide the means to prevent extension of this behavior pattern for a lifetime. Evidently, incarceration of such individuals in jail, or a mental institution will not alter an underlying genetic trait. Blaming their parents, teachers, or social acquaintances for their deviant behavior achieves nothing. Until science can find a way to alter the genetic makeup of humans without creating monstrosities, we will have to rely on recognizing these defects as early as possible in order to intervene with appropriate preventive and active therapy.

Socially, I must declare,
My attitude is only fair,
Some have said it's really scanty,
Others think it's truly anti,
But why should I get all the blame?
Why must I bear all the shame?
After all, the fault's not mine,
My genes are bad, but I'm just fine.

behavior medicine

Cartoons and Poems following each article are created and copyrighted by Dr. Ackerman and cannot be copied or reproduced without his permission. Copyright © 2009 by Marvin Ackerman, M.D.


Many substance abusers are indeed depressed, and may need drug and alcohol recovery programs to help them out.

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Relax! Itís Only Your Doctorís Waiting Room, Not the ER: Or How to Get Along With and Understand Your Doctor is an insightful but irreverent intrusion into the complexities of modern day medicine. Listen to an interview with Dr. Ackerman

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