Over a lifetime, the longest relationship typically is not with parents, partners or children, but with siblings. Research focused on these family ties identifies five types of sibling relationships: the intimate, the congenial, the loyal, the apathetic and the hostile.” But when a sibling suffers from a mental illness, the relationship can fall outside those norms. Indeed, the Alliance on Mental Illness noted:
It is now understood that mental illness in a family creates a ripple effect that can capsize well siblings and lead them to feel as though they are plummeting downward into a sea of confusion, despair, hopelessness, anger and grief.
With National Sibling Day on April 10, it seems timely to consider how the mental illness of one of your adult children might affect brothers and sisters. Among 18- to 25-year-olds, serious mental health conditions are almost double that of the general population; 75 percent of mental illnesses manifest before age 25. A federal study found that an estimated 21.4 million young adults have serious psychological distress, including depression, anxiety, bipolar disorder and schizophrenia; yet this group shows the lowest rate of health-seeking behaviors.
We likely all know families — perhaps our own — whose gatherings are often fraught with an undercurrent of tensions because of a mental illness. For observations and guidance, we called on Ken Duckworth, a psychiatrist and medical director for the National Alliance on Mental Illness.
Q. You note that mental illness changes everyone's life in fundamental ways, with unpredictable behaviors by a sibling and an increase in personal anxiety .
A. Mental illness affects every member of the family, and each one has to figure how to cope. We see a range of complicated human responses: Some people experience it as a burden, some as a calling, some as a challenge, while some want to run away. It depends on the person and his or her experience.
Q. Sometimes family members believe they can impact the condition.
A. You cannot cure a mental disorder for someone you love. Despite your best efforts, your loved one's symptoms will change for the better or for the worse; it is out of your control. You can’t predict whether a person’s schizophrenia is going to respond to medication or if a sibling is going to get sober, and that’s hard to accept.
Q. So what can a sibling do?
A. You can be a loving, supportive force for good, but that does not mean you get to control the outcome. You have to learn a Zen acceptance. If the ill person won’t see a therapist or flushes meds down the toilet, you can’t change that.
Q. In your experience what concerns siblings the most about a mentally ill brother or sister?
A. People worry about what’s going to happen in 10 or 20 years when a parent can no longer handle the care of an ill sibling. When that happens, it frequently generates a tremendous crisis in the family about how the transition will be managed. I urge families to communicate and plan ahead. Everything does not have to fall to the siblings.
Q. What about siblings who are struggling now with the family dynamic?
A. I strongly suggest finding a support group of siblings who are in the same situation. There are many out there. There’s an old Hebrew expression that applies: "Pain shared is pain halved." Isolation is bad. People feel less picked on when they realize that they are not alone or the only ones who have ever dealt with this kind of situation.
For more information, see Coping Tips for Siblings and Adult Children of Persons with Mental Illness.
Mary W. Quigley’s blog, Mothering21, tackles parenting of emerging adults and beyond.
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