A Concordia University study links low structure and inconsistency at home with heightened stress-hormone responses and later anxiety and depression symptoms among children of parents with bipolar disorder.
Children who grow up with a parent who has bipolar disorder may carry more than genetic risk into adulthood. A Concordia University-led study suggests that the atmosphere at home, especially when it is marked by low structure, inconsistency and unpredictability, may shape stress biology in ways that are linked to later anxiety and depression, according to findings published in Psychoneuroendocrinology.
The research followed 132 young people, including 68 with a parent who had bipolar disorder and 64 whose parents had no history of an affective disorder. When the participants were children, their parents described the level of organisation, support and control in the home. Roughly 12 years later, the young people returned for saliva testing and mental health assessment. The study found that those who had grown up in less structured homes tended to show a stronger cortisol awakening response, the natural rise in the stress hormone cortisol during the first hour after waking, in late adolescence and young adulthood.
That heightened stress response was then associated with more symptoms of depression and anxiety. Participants who had developed an affective disorder themselves, including major depressive disorder or bipolar disorder, showed a higher cortisol awakening response than both the high-risk offspring who had not developed such a disorder and the control group, according to the report from Concordia and Psychoneuroendocrinology.
Lead author Mark Ellenbogen said the results point beyond genetics alone. Speaking through Concordia’s release, Ellenbogen said the team believes children in these families do not go on to develop mental disorders because of heredity by itself, but also because stressful home conditions may alter the body’s stress-regulation system. The researchers argue that the findings support the idea that a disorganised or inconsistent family environment can increase vulnerability over time through lasting changes in stress hormone function.
The study adds to earlier research suggesting that children of parents with severe mental illness often experience poorer home conditions. Work in the Danish High Risk and Resilience Study, VIA 11, found that 11-year-old children born to parents with schizophrenia or bipolar disorder had lower stimulation and support at home than control children, with more living in inadequate environments. A separate review in Neuroscience and Biobehavioural Reviews also found that offspring of parents with depressive and bipolar disorders often show altered basal and reactive cortisol levels, pointing to possible dysregulation of the hypothalamic-pituitary-adrenal axis, the system that controls the body’s stress response.
The new findings stop short of proving cause and effect, and the authors stress that home environment should not be treated as the sole explanation for later mental health problems. But the results strengthen the case for prevention efforts aimed at helping families build more predictable routines, clearer organisation and greater stability. Ellenbogen and colleagues said they are preparing a randomised trial of a new prevention programme, Reducing Unwanted Stress in the Home, or RUSH, for families in which a parent has an affective disorder.
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