Question:

Hi Dr. Raj,

My father was diagnosed Schizophrenic; does this mean I will be Schizophrenic?

Answer:

Let’s begin with what Schizophrenia is; Schizophrenia is a mental illness that presents as a few different subtypes; it belongs to the group of disorders we refer to as “Psychotic Disorders”; what psychosis simply means is “a break with reality”; thus, if someone is experiencing auditory hallucinations (hearing voices without any stimulus in the environment) or believes that the FBI or CIA is following them when they are not, we would say that he or she is “psychotic”; Schizophrenia has an incidence rate of 1% world wide; what this means is you can take 1% of any population and estimate what the expected number of individuals with Schizophrenia would be; thus, it a very serious and not so uncommon mental illness.

Now, let’s turn to understanding how it works if your parents have certain diseases and what that means for you; we inherit 50% of our genetic material from each of our parents; the body uses this as a blueprint to build proteins that the body needs similar to how an architect uses a blueprint when building a house; you can imagine that if there is an error in the blueprint that then will carry over to an error in the house and cause a problem; well, in the same way, if we have an error in the blueprint that the cells of our body use, it can cause a problem as well; so, in regards to Schizophrenia, there are problems in the “blueprint” that the body is uses; however, just having the error in the blueprint does not seem to always cause the disease; if you take two identical twins (same exact blueprint) that have parents with Schizophrenia, you will find about 50% of the twins get the disease even though they both have the exact same blueprint.

Thus, what this means is that you need both the problem with the blueprint as well an environmental factor which then triggers the disease; we are not clear as to the exact nature of the triggers but stress in general seems to bring out our vulnerabilities; so to answer your question, you do have a genetic risk or predisposition greater than someone who does not have a Schizophrenic parent; however, even with the genetic predisposition, you are not necessarily going to get the disease; I would suggest developing a good working relationship with a therapist with whom you can learn coping strategies to prevent stress in your life from building up.

Do you remember, that old question about which straw broke the camels back; the usual answer is “The last one”; but if you really think about it, it’s the SUM TOTAL of all the straws. Thus, don’t let the straws of your life accumulate.

Question:

My parents ignored me when I was growing up, and I just want someone to love me. If I have a baby to love me, will that satisfy my need, even though I am only 18?

Answer:

First of all, the answer is not searching for something to “love you” but to understand why it is that you don’t feel loved; my understanding of the mind says to me that your lack of feeling loved is based on your experiences in early childhood; the question now becomes, “Would a child be the vehicle to love?”

My answer to this would be no.

You must learn to love yourself even though at times you don’t understand yourself; in my opinion, you can never find love outside of yourself.

Having an infant is not about wanting to be loved by him or her; it’s about providing unconditional love TO THEM; this will difficult if you are looking for the same thing the infant is looking for, which is essentially “wanting to be loved”.

I would suggest to you to explore (with a therapist) just how your parents ignoring you impacted you; understanding this will allow you to heal the place that you don’t feel loved and will one day lead to a life that most importantly will be more fulfilling.

Question:

Kat writes: My 13 y/o niece was just started on Prozac. She seems to have some anxiety and maybe OCD.  What are your thoughts on young teenagers taking antidepressants?

Answer:

Dear Kat,   Prozac is approved for use in pediatric patients with major depressive disorder (MDD) and obsessive compulsive disorder (OCD).  Selective serotonin reuptake inhibitors (SSRIs) can restore the balance of certain brain chemicals that regulate mood. When these brain chemicals are in proper balance, the symptoms MDD and OCD may be relieved.   Antidepressants are used to relieve the obsessive thoughts and subsequent compulsive behaviors in those who have OCD. By increasing the level of serotonin in the brain, antidepressants help to regulate the communication between different parts of the brain. One thing to keep in mind is that there is the following black box warning with Prozac:    Suicidality in Children and Adolescents— Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Prozac or any other antidepressant in a child or adolescent must balance this risk with the clinical need. With that said, In one 13-week clinical trial in pediatric patients (N=103). Prozac produced a statistically significantly greater mean change from baseline to endpoint than did placebo as measured by the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS).   I suggest that you and your niece work closely with a child psychiatrist in setting up an appropriate treatment plan that may include some therapeutic element.