"From Machon Puah"

Mental Illness and Shidduchim

We continue this week with the subject of mental illness and shidduchim: must a person reveal information regarding mental illness before entering into a shidduch?
[Before we continue, it is important to clarify that our aim is not to answer specific questions in this column, but rather to raise awareness of the subject, especially for those who may be unfamiliar with the issues.]
Last week’s column dealt with a possible shidduch with someone who had suffered an episode of mental illness; this week I would like to discuss the family.
Many people are very wary when hearing that someone in the family of a potential shidduch suffered from mental illness; they consider this to be reason to call the shidduch off. And, indeed, there is some basis for this fear. Schizophrenia, for instance, is a serious mental illness characterized by a disintegration of the thinking- process, a loss of contact with reality, and emotional unresponsiveness. It most commonly manifests as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, along with significant social or occupational dysfunction. Onset of symptoms typically occurs in young adulthood, and diagnosis is based on the patient’s self-reported experiences and observed behavior; no laboratory test for schizophrenia currently exists.
There are many possible causes of schizophrenia: studies suggest that genetics, early environment, neurobiology, psychological and social processes are important contributory factors. While it is clear that in certain cases there is a genetic element to mental illness, it is an over-simplification to say that this is the only factor.
As an example: Schizophrenia affects 1-1.5% of the general population, but if one has a sibling with the illness, the risk rate increases eight-fold. When dealing with a child born to parents who both suffer from schizophrenia, the incidence rises to about 40%. With identical twins - where one is schizophrenic - the chance of the second twin also becoming schizophrenic is approximately 50%.
These numbers are indeed high, but the situation is even more complicated: in the case of identical twins, with identical genes, one would expect the rates to be 100%. And with two schizophrenic parents it would seem that the rates ought to be 100% as well. Obviously, then, it is difficult to blame genetics alone. Someone with mental illness in their family is therefore not necessarily genetically destined to suffer from the disease, and need not automatically be considered a poor prospect for a shidduch.
Practically speaking, those affected need to speak with a professional as to their exact medical situation, and then consult with a Rabbi in order to determine whether their specific circumstances need to be revealed within the context of shidduchim.

• Other "From Machon Puah"
• Supervision - is it really necessary?
• Training Supervisors
• Supervision - Who are the Supervisors