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The genetics of mental illness are complicated.

Genetic vulnerability does not confer a guarantee of illness.

Trauma and adversity can act like a dam — an obstacle to healthy development.

When I see patients with serious mental health issues, they often speak of their genetic burden: “My father had bipolar disorder”, “my grandmother was schizophrenic”, “my aunt has severe depression”. My patients feel their psychiatric destiny weighing them down, as though there is no hope for recovery or cure in light of their heredity. But the genetics of all psychiatric diagnoses are complex and not easy to understand, even for doctors and scientists. I try to explain it like this:

Psychological development is like a river flowing along its course. From birth, our psychological maturation runs along healthy developmental lines like a river. Unimpeded, the river flows smoothly, and genetic predispositions towards illness may not be realized. A baby born into a family with emotionally healthy parents in a financially secure position, in a neighborhood without conflict, in a part of the........

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