Parents with depression and anxiety disorders – What is the risk of also being affected as a child?

“Anyone who has mentally ill parents has a high risk of becoming ill themselves!” You have certainly come across this statement before and it is very unsettling for many children of affected parents. But is this really the case? And if so, are genes more responsible or the parental environment in which we grow up? Let’s take a look at two very common disorders – depression and anxiety disorders:

What are symptoms of depression and anxiety disorders?

First of all, it is important to delineate at what point low mood and anxiety develop into mental illness. Depression is characterized by:

  • Depressed mood
  • Loss of interest
  • Lack of drive

Accompanied by other symptoms such as:

  • Sleep disturbances
  • Feelings of guilt
  • Difficulty concentrating
  • Low self-esteem
  • Loss or increase of appetite
  • Suicidal thoughts

A diagnosis is made when two of the main criteria and two of the other symptoms are present for a period of at least 14 days. Anxiety disorders are characterized by:

  • Inner restlessness
  • Difficulty concentrating
  • Irritability
  • Palpitations
  • Shortness of breath
  • Trembling

Anxiety is basically something that protects us from danger and is essential for survival. It only becomes a disease when it occurs even in harmless situations and leads to restrictions and suffering.Important: Anxiety disorders are the most common mental illness, depression is only half as common – however, over the course of a lifetime, one in five people in Germany is affected .

How do mental illnesses basically develop?

In the next step, it is worth taking a look at the general development of mental illnesses. Why do some people fall ill and others don’t? Basically, it can be said that an illness arises from an imbalance of stress and coping strategies. The factors that can influence the variety of coping strategies as well as the individual perception of stress are as follows:

Biological risk factors

Genetic disposition, pregnancy and birth complications, brain damage.

Psychosocial risk factors

Familial: loss of caregivers, early parenthoodInteractional: conflicts with caregivers, frequent disputes between parents, adverse attachment behaviors, communication difficulties, maltreatmentSocial risk factors: Low socioeconomic status, critical life circumstances The more of the above factors are present, the higher the risk of developing a mental illness and at the same time not being able to develop sufficient coping strategies.

How parents pass on anxiety and depression to their children

As has now become clear, both genetic factors and environmental conditions can be responsible for the development of a mental illness – in which parents can in principle be involved both times. But which outweighs the others? It is worthwhile to take a look at the current state of studies for both disorders:


In a study published in 2022 by Michigan State University, which was conducted on the heritability of depression, children who grew up with their biological parents and children who grew up in patchwork families with a stepparent (mostly stepfathers) were used. The research team led by Alexandra Burt found that children from patchwork families were significantly more likely to be affected by depression. There was also little difference in the affectedness of half-siblings within these patchwork households, who were not always genetically related to the parent suffering from depression. The study provides a hint that family circumstances may outweigh genetics, but there are also some recent studies that prove that factors such as stress or trauma can permanently alter the genetic makeup and be passed on to offspring. For example, sites on the genome have been found to be associated with major depression. These findings underscore twin studies. Here, it was observed that in half of the twin pairs with at least one parent suffering from depression, both were affected by depression themselves. These two examples of the current state of findings clearly underline that there needs to be further research into the causal factors and that, according to current knowledge, both the environment and the genes may be responsible for the transmission of depression. However, it is undisputed that children who grow up with a depressed parent have a three to five times higher risk of developing the disease themselves. If both parents are affected, the probability increases even further.

Anxiety disorders

Researchers also agree that children whose parents suffer from an anxiety disorder are more likely to become ill themselves than children whose parents do not. The peculiarity of this disorder is: the transmission is to a large extent gender-specific! Researchers at Dalhousie University in Canada found that fathers primarily pass on their fears to their sons and mothers to their daughters – fears of the opposite-sex parent actually have hardly any effect on the offspring. The reason for this appears to be learning experiences from the example of the same-sex parent. In addition, an overly controlling and protective behavior of the fearful parent also has negative effects and prevents the children from becoming independent and self-determined as well as from making a variety of experiences. This can also quickly create a vicious cycle of overprotection, growing behavioral deficits, and anxiety on the part of the children. These observations suggest that the family environment is more important than genetics in the development of anxiety disorders. Other meta-analyses also yield results of only moderate heritability, which is underscored by widely varying numbers of affected children among anxiety disorder subtypes.

What can affected parents do now?

Very important: They can do a lot! As should have already become clear, environmental factors are very important in both depression and anxiety disorders. So, as a parent, if you notice that they are suffering from depression or anxiety disorders, get support early – Anything that helps you will also help their children and protect them from becoming ill. Professional helpers can give them advice on how to deal with their children and, if necessary, advise other caregivers on what tasks they can take away from them. With children who are still very young, it can be beneficial if a person who is not ill takes care of them in certain situations and radiates security. It is also very important that children do not take on a helping role that overburdens them because they themselves still lack the right problem-solving strategies. With older children, they can talk very well about their own illness, since they notice anyway that something is wrong and usually experience it as relieving when it is dealt with openly.

  • Federal Ministry of Education and Research:, accessed 08/02/2023.
  • Burt, Alexandra; Clark, Angus & Neiderhiser, Jenae M. (2022). Illuminating the origins of the intergenerational transmission of psychopathology with a novel genetically informed design. Development and Psychopathology.
  • Caspar, Franz; Pjanic, Irena & Westermann, Stefan: Clinical psychology. Wiesbaden, 2018.
  • Dilling, Horst et al: ICD-10: International classification of mental disorders. Göttingen, 2015.
  • Lenz, Albert: Strengthening children of mentally ill parents. Göttingen, 2022.
  • Pavlova, Barbara et al. (2022). Sex-Specific Transmission of Anxiety Disorders From Parents to Offspring. JAMA Netw Open, Issue 5.
  • Rupprecht, Rainer; Kellner, Michael: Anxiety disorders. Stuttgart, 2012.
  • Schulte-Körne, Gerd & Allgaier, Antje-Kathrin (2008). Genetics of depressive disorders. Child and adolescent psychiatry and psychotherapy, issue 1.
  • Wagner, Elisabeth: Understanding mental disorders. Berlin, 2021.
Dr. med. Kjell R. Brolund-Spaether
Ärztlicher Direktor und Chefarzt Dr. med. Kjell R. Brolund-Spaether
Dr. med. Kjell R. Brolund-Spaether ist renommierter Facharzt für Psychiatrie und Psychotherapie, bei dem stets der Mensch im Mittelpunkt steht: Dank seiner individuell abgestimmten, ganzheitlichen Behandlungspläne verbessert und personalisiert er die psychiatrische Versorgung kontinuierlich. Seine umfassende Expertise in der psychotherapeutischen und medikamentengestützten Behandlung erlangte er durch sein Studium der Humanmedizin an der Christian-Albrechts-Universität in Kiel, spezialisierte Weiterbildungen sowie seine langjährige Erfahrung in führenden Positionen. Seit 2019 ist Dr. med. Brolund-Spaether als Chefarzt und seit 2023 als Ärztlicher Direktor der LIMES Schlosskliniken AG tätig. 2024 trat er unserem Vorstand bei.

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