How Do You Inherit Anxiety?

This is A Cure for Fear, a monthly column by Laura Turner on working, creating, and living with anxiety.

“Well, I was born feeling afraid and nervous, so one more day won’t kill me!”

Verna looks up from the newspaper, the morning sun streaming in over her rose bushes in the yard, over West Covina and Azusa beyond that, over the 210 Freeway and Mount Baldy and all the rest of the San Gabriel Mountains. Her dining table is covered with protective pads, the Los Angeles Times spread out on top of the remnants of Shanghai Rummy, which we played last night, and the Scrabble board. She cheated. “Jonk” is not a word.

It is from Verna Lee Boatright Berg that I inherited my long face, my quick hands, my fear that someday soon I will do something wrong and the world will come to a sharp end. One day I will inherit her white bone china. Inheritance comes to us in many forms, and this one wrapped its way into the inner coils of my brain; dopamine, serotonin, joy and fear.

How anxiety is passed along from generation to generation isn’t entirely understood. In the ancient world, anxiety was often classified, along with depression, under the umbrella term “melancholia.” Hippocrates chalked this up to an imbalance in bodily fluids, positing that an excess of black bile, produced by the spleen, was the source of melancholia—and that, specifically, an excess of cold bile was the fountain from which anxiety sprung. Simply get these fluids back in order, Hippocrates suggested, and your anxiety will be no more.

In some ways, our understanding of anxiety has evolved significantly from Hippocrates’s day. In others, however, we are not so far ahead. Many in the medical community still believe, for instance, that anxiety is caused by an imbalance in the body. Not bile, they now say, but brain chemistry is responsible. Increase the amount of serotonin in the brain, as happens when you take a Selective Serotonin Reuptake Inhibitor, or SSRI, and the body will eventually be restored to equilibrium. Others, from Plato to modern-day preachers, want to locate anxiety in the external world of philosophy, theology, and fear. If you are a religious person with anxiety, you could fill out a Bingo card of predictable responses from your community: “Pray about it.” “Have more faith.” “Trust in God with all your heart.” Nowhere on that card will you find a square that reads: “Conduct a thorough history of your family’s mental health in an attempt to ascertain the genetic component of your anxiety.” But that might be the best place to start.

Scientists have the work of studying the genetic components of anxiety in a way that I cannot, since I am neither a scientist nor a person able to take apart my own brain and set it before me for analysis (as much as I would sometimes like to do so). Most traits, as you likely know, are either recessive or dominant. They either elbow their way to the top or they wait for someone to get them and bring them to the front of the line. Anxiety can be such a trait, when experienced over a prolonged period of time. When it is acute, it is considered a “state,” rather than a trait. The rhyme is nice. Is anxiety state, trait, fate?

A “complex trait” is a characteristic that is not known to be either dominant or recessive. In her study “Are there anxious genes?” Dr. Deborah J. Morris-Rosendahl reminds the reader that “most traits of medical relevance, and particularly psychiatric disorders, do not follow simple mendelian inheritance.” In other words, it is not so easy as dominant and recessive. Anxiety is complicated, a dance of genes and environment colliding to make one outcome more or less likely than the other; a replication that may make you, like me, more prone to bite your nails because it soothes you as you fear your inevitable failure.

“[P]ossibly one of the most exciting genetic studies in anxiety to date,” Morris-Rosendahl writes, “has been reported by the group of [E]stivill who found an association between the duplication of part of chromosomal region 15q24-26 and irrational fears, or phobias.” (Exciting! To be excited, to be eager, to be anxious!) Chromosomal region q is the long, elegant leg of a chromosome. Let’s imagine that the knee of that leg is area 24-26, and that as you zoom in on the human body—take Verna’s body, for instance—you go through the sunspotted skin, still tanned from the walks she takes around her Los Angeles condominium; past the muscles that line her slender calf, the same calves that propelled her forward when she walked to and from school in west Texas in the 1930s; down into the cells that have divided and reproduced and made her her, since she was born into a family of sanguine women and nervous men, including her father, Early, who worked as a laborer for a WPA fence-building project until the work dried up and he moved his family west for a job at a gas station in South Los Angeles. Verna grew up there, got married, moved to the suburbs, and a few years later had my mother, whose chromosome 15 did not have a duplicate at the knee, but who, when she met and married my father, passed along to me some complex trait that is now shut up like a secret in my viscera, in my inner parts, where it is manifest in bitten nails and fear that sits between my lungs like an honored guest.

How do we inherit the things that make us us? In this case, the anxiety either stays dormant in the genes of our parents, or it does not, and either way, it springs out of our chromosomes and seizes hold of our mind, fully grown, as early as it likes. I was four when I first noticed feeling worried all the time. Nine when I had my first panic attack. Nine when my family moved across the country and a kind of bleakness made itself known at the edges of my vision. Twelve when I realized how hard Verna’s anxiety was on my mother and so, slowly, taught myself to hide my own anxiety because I didn’t want what they had.

I inherited anxiety through my faith, the one that told me I could get to heaven just by believing the right things, and so I constantly scanned my beliefs like records in a jukebox to see which was defective and could turn me out of eternal life. It was in the large church of my youth that I first heard how worrying was a sin, when my small group leader pointed me to Bible verses that enjoined me not to worry. She was naturally cheerful, blond, enthusiastic, kind. Her blue eyes were full of reassurance as she told me that worrying was a way of rejecting God. I worried anyway.

I inherited anxiety as a woman living in the world, who could never quite be enough but always wanted to try. It was the soft-shoe I performed whenever I was criticized for being too opinionated, too talkative, too much. Well into college I refrained from saying what I wanted to say, not out of an abundance of wisdom but a fear of what someone else might think of me. Jokes about redheads and their tempers inflamed yet had the effect of quieting me, because I would just prove them right if I reacted.

I learned anxiety from the way I was praised for being poised and graceful, too, and made it my inheritance. Some jagged treasures we choose for ourselves.

Anxiety is a small kingdom, tightly controlled and designed to minimize pain and discomfort. It is the kingdom of the 15th chromosome, of panic and phobia, handed down from one long-faced woman to another. Two anxieties sit at a table over coffee, picking up on the game of Shanghai Rummy they stopped playing last night, cheating at Scrabble, living seventy years apart on parallel tracks and heading into an unknown future.

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