Growing up in any family can be challenging at times, but there are often special problems and challenges for families in which one or several family members have a mental illness. Members of these families often have to deal with instability or unpredictability. Often there is confusion in family roles, and children or other family members may have to take over many of the adult responsibilities, such as taking care of younger brothers and sisters or managing household duties normally managed by adults. They may even have the responsibility of taking care of the emotional or physical needs of their parents. Children and other family members in these situations do not always receive the care and nurturing they need. They may feel ashamed to talk about their situation with others and consequently may withdraw from relatives or friends who could help them or support them. Often unable to articulate their needs, even to themselves, these individuals frequently feel isolated and alone.

Individuals who cope with chronic and severe mental illness in the family may also experience other difficulties outside of their family-of-origin relationships. These may include:

Relationship difficulties:

difficulty in initiating relationships, and experiencing feelings of isolation

difficulty in romantic relationships

difficulty in maintaining friendships

difficulty with trusting self and others

difficulty balancing level of intimacy (excessive dependence or excessive avoidance)

difficulty balancing taking care of self and taking care of others

Emotional difficulties:

guilt and resentment

shame or embarrassment


fear of inheriting a family member’s mental illness

fear of discovery by one’s partner and friends

angry outbursts or repressed anger

inability to deal with life unless it is chaotic or in crisis

overly responsible or irresponsible in many areas of life such as commitments, money, alcohol, relationships, etc.

self-defeating thoughts, attitudes, and behaviors such as “My needs don’t matter; I’m not worth much; It’s no use trying.”

self-defeating themes involving a tendency to equate achievement with worth as a person, such as: ”Maybe I can matter if I can excel at something, be perfect in school, my job, my relationships. But if I fail, I’m worthless and it’s terrible.”

If you are experiencing any of these difficulties, you are not alone. It is helpful to recognize that these problematic feelings and behaviors helped you to cope and survive; and, during the more vulnerable years of childhood, they served a coping function. Your recognition that these patterns may limit your life choices as an adult is an important first step towards developing new and rewarding functional ways of relating.

How You Can Help Yourself:

1. Acknowledge that you have a family member with a mental illness and the effects this may have on you.

acknowledge previously unacceptable feelings such as anger, shame, guilt, etc.

grieve the parental or familial support you never received.

remember that you are not responsible for causing your parent’s problems or for fixing his/her condition.

2. Develop new ways of taking care of yourself.

recognize your own legitimate needs and begin taking care of them

recognize the stressors in your life, and learn ways of managing them.

replace negative thoughts with more positive statements: ”I am a worthwhile person. This truth does not depend on my successes or failures. My life has ups and downs, but my worth does not change.”

3. Develop new ways of relating to others.

recognize old unhealthy family patterns of communicating, and practice new ways of relating to parents and other family members. This may include setting and enforcing new boundaries and being respectful of your own limits.

recognize the difficulties you have with relationships, and learn new ways of relating to others.

appreciate and enjoy stability in your relationships, recognizing that relationships don’t have to be defined by crisis or dependency.

4. Explore other resources.

Educate yourself about your family member’s illness.

This can help you understand what your parent is facing and what has caused problems for your family. It can also aid in relieving your feelings of guilt, resentment, embarrassment, and shame.

Consider seeing a mental health professional.

A counselor can help you understand how a family member’s illness affects your life, and help you explore healthy ways of caring for yourself. He or she can help you learn healthier ways of relating to others and caring for your own needs.

Join a support group.

A support group that addresses your specific situation can help reduce feelings of isolation. Seeking such support can be especially helpful when family members are either uncomfortable with or refuse to acknowledge the problem.

Suggested Readings:

Carter, Rosalyn. Helping someone with mental illness: A compassionate guide for family, friends, and caregivers. New York: Three Rivers Press, 1998.

Diner, Sherry H. Nothing to be ashamed of: Growing up with mental illness in your family. New York: Lothrop, Lee & Shepard Books, 1989.

Forward, Susan. Toxic parents. New York: Bantam Books, 1990.

Greenberg, Harvey R. Emotional illness in your family: Helping your relative, helping yourself. New York: Macmillian, 1989.

Woolis, Rebecca. When someone you love has a mental illness. New York: Penguin

Putnam, 2003.