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[Download the NAMI fact sheet on coping tips for siblings and adult children.]

Coping Tips for Siblings and Adult Children of Persons with Mental Illness

If you find it difficult to come to terms with the challenges presented by your sibling's or parent's mental illness, you are not alone: there are many others who share your difficulty. Most siblings and adult children of people living with psychiatric disorders find that mental illness in a brother, sister or parent is a tragic event that changes everyone's life in many fundamental ways. Strange, unpredictable behaviors in a loved one can be devastating, and your own personal anxiety can increase as you struggle with each illness episode and worry about the future. It seems impossible at first, but most siblings and adult children find that over time they do gain the knowledge and skills to cope with the challenges resulting from the mental illness effectively. They find that they have strengths they never knew they had, and they are able to meet situations that they never anticipated facing.

The best starting place for  learning to cope is to educate yourself; find out as much information as possible about mental illness by reading and by talking with others experiencing similar difficulties. NAMI has a variety of resources available for you: books, pamphlets, fact sheets and other resources available about different illnesses, treatments and issues you may have to deal with. NAMI has an educational program developed specifically for family members of individuals living with mental illness. The NAMI Family-to-Family Program is a 12-session course that teaches families facts about the illnesses, skills necessary to navigate the challenging episodes and how to find support for the future. NAMI also provides support groups for family members of individuals living with mental illness. These groups provide reminders about the need for you to take care of yourself so that you can continue to face the issues presented by the illnesses.

To find information about support groups and Family-to-Family classes in your area contact your NAMI State Organization or NAMI Affiliate. If you need information on how to contact them visit the NAMI website at www.nami.org or call the NAMI HelpLine at 1 (800) 950-6264. You will find a wide array of information and links to other resources when you visit the NAMI website.

The following are some things to consider:

1. Basic principles

  • You cannot cure a mental disorder for someone you love.
  • No one is to blame for the one you love developing the disorder.
  • Mental disorders affect more than the person who is ill; they affect everyone who cares about them.
  • Despite your best efforts, your loved one's symptoms will change for the better or sometimes for the worse; it is out of your control.
  • It is important to learn to separate the disorder and it’s symptoms from the person that you love.
  • If you feel anger and resentment, direct that negative energy toward the illness, not the person that you love.
  • Remember that it often quite  difficult for the person you love to accept their disorder. This is a process you too may contend with.  Acceptance of the disorder by all concerned may be helpful, but it is not necessary.

2. Strategies and Realities

  • Psychotic symptoms such as hallucinations and delusions have little or nothing to do with reality, so it is not beneficial to discuss them with your family member or try to “talk them out of” a belief that is the result of disturbed thinking.
  • It is not realistic to believe that it is possible to “fix” a biological disorder such as diabetes, high blood pressure, schizophrenia or bipolar disorder with talk. However, addressing social complications is often helpful.
  • You will likely encounter variable ability of people to talk about this. with you some people are quite open and sophisticated others less so.  Unlike medical conditions which typically bring out sympathy and casseroles for hospitalization, the community will  likely be mixed in how they provide support for you and your loved one. 
  • Acknowledge the remarkable courage and strengths your sibling or parents may show when dealing with a mental disorder.
  • Grief issues for siblings are often common and powerful.  Dealing with responsibilities as parents age and pass is also another challenge to get support and advice on.
  • After denial, sadness, and anger over learning about your loved one’s mental disorder comes acceptance. Acceptance and understanding of the disorder itself yields compassion for the person you love.
  • The symptoms presented by the disorder may change over time and circumstance.  This can make expectations of your loved one a challenge—stay flexible.
  • If you are involved with your loved one’s treatment, with your loved one’s permission you should request the actual diagnosis and its explanation from the mental health treatment team to deepen your understanding of their condition.
  • Mental health professionals have varied degrees of expertise and competence. If your loved one isn’t getting what they need, assess your ability to engage with them to see how a case manager or other professional can help.
  • Unusual and uncharacteristic behavior is a symptom of the disorder. Don't take it personally.
  • Don't be afraid to ask your sibling or parent if he or she is thinking about hurting him- or herself. The possibility of suicide is a real concern, and asking about it will not give them the idea. See if they have safety plan to address these concerns.

3. Self Care and Balancing your needs with that of your loved one

  • Be sure to prioritize your own self care. Exercise, good rest and nutrition, loving relationships, spiritual or religious support, support groups and hobbies are common avenues to support self care.
  • You are not a paid professional caseworker. Your role is to be a sibling or child, not a parent or caseworker.  
  • The needs of the ill person do not always have to come first; often this is just not possible..
  • It is important to establish boundaries and to set clear limits for you.
  • It is natural for you to experience a variety of emotions such as grief, guilt, fear, anger, sadness, hurt, confusion and more. You, not the person with the disorder, are responsible for your own feelings.  Getting psychotherapy support can often be quite helpful for these experiences.
  • You are not alone. Sharing your thoughts and feelings in a support group has been helpful and enlightening for many. NAMI has thousands of support groups across the nation.  The shared experience found in support groups reduces isolation and stress.

Reviewed by Ken Duckworth, M.D., Darcy Gruttadaro and Teri Brister, May 2013


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