The Effects of Complex Mental Illness on Siblings

A complex mental illness inevitably impacts everyone in the family. Siblings indirectly affected by their brother or sister’s severe mental illness may experience a complicated range of emotions, many of which are disturbing and stressful and may require extra effort to overcome. While parental support can be helpful, individual and family counseling may be needed in these situations to help siblings cope with their own mental health challenges.

When a child of any age is diagnosed with a complex mental illness like delusional disorder, bipolar disorder, or schizophrenia, it can change a parent’s life forever. They may continue to shoulder significant caregiving responsibilities long after their son or daughter reaches adulthood.

This can put an emotional, physical, and financial strain on the entire family. Brothers and sisters of the person with the mental health disorder are often among those most gravely and deeply impacted, which is not always acknowledged or understood by parents or even by the siblings themselves. This is especially true when siblings are children or adolescents.

When the Siblings Are Children


If you as a parent are spending a lot of time caring for the sibling with the mental health problems, your other children may feel neglected or forgotten. Older siblings might understand that their brother or sister requires more care than usual. But it is asking a lot to expect younger children to adopt this more mature perspective.

Children who witness an older brother or sister battling a severe mental illness may experience great stress and anxiety. Their exposure to the behaviors such conditions can cause can be extremely confusing and upsetting. They likely won’t understand the true nature of mental illness, and consequently they may assume their brother or sister doesn’t love them anymore or is intentionally trying to make them scared or unhappy.

Caring for a son or daughter with a complex mental illness is time consuming. But if you have other children in the home, you must recognize that their sibling’s mental illness can have a dramatic impact on their health and emotional states. They need your time and attention, too, and if you simply assume they’re fine you may miss important signs of their distress.

Kids exposed to difficult family situations need consistent and empathic attention from their moms and dads. In cases like this, you can explain that their brother or sister is sick and isn’t really trying to be scary or mean. Children may not comprehend all the complexities of mental illness, but your reassurances and expressions of love can help ease their fears and dramatically reduce their sense of confusion and uncertainty.

As a supplement to your support, your kids could also benefit from regular visits with a pediatric counselor. Even if they haven’t been showing outward indications of anxiety lately, they are likely experiencing it at least on occasion. Counselors who work with children have a deep understanding of how kids respond to stress, and they can help their young patients develop coping strategies that will guide them through the hardest times.

When the Siblings Are Adolescents


Adolescent children are more capable of understanding the complexity of severe mental illness than younger children. But that understanding may be accompanied by fears that you as a parent should anticipate and address.

Teens are old enough to understand the genetic factors involved in mental illness, and they may fear that someday they will suffer from the same illness as their older sibling. You can proactively soothe such concerns by telling your adolescent children more about how mental illness develops, so they will understand that genetic factors alone aren’t enough to cause mental health disorders in most cases.

Adolescent children should be able to handle the facts. An honest approach that explains the situation in more detail is better than offering patronizing and facile reassurances that won’t answer their questions. Adolescents are smart enough to see through such a strategy, and they may become even more worried if they think you’re trying to hide something from them.

For teens affected by a sibling’s mental illness, counseling can be highly beneficial. Individual and family therapy sessions offer valuable opportunities for adolescents to talk about their fears, along with any other emotions they might be experiencing, in a supportive and non-judgmental setting. Teens are often reluctant to open up and express themselves truthfully in front of their parents, which is why individual therapy can act as an essential outlet for teens who need to talk about stressful events in their lives.

In many cases, older children are likely to experience feelings of shame, embarrassment, or resentment directed at their sibling. This can in turn generate feelings of guilt and self-recrimination. Skilled and experienced therapists can help teen siblings come to terms with all the complicated emotions they’ve been feeling, while helping them understand that such emotions are a natural response to difficult circumstances and not something inappropriate or disgraceful.

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When the Siblings Are Adults


If you’re an adult with a sister or brother who has a complex mental illness, you may feel it is your responsibility to help your parents deal with the fallout. You might believe it is your duty to offer your services as a part-time caretaker, or to provide financial assistance when it’s needed. You may be making an extra effort to provide emotional support and comfort when your mom or dad is feeling discouraged, depressed, or overwhelmed.

This is an admirable attitude. Your involvement can undoubtedly help ease the physical, emotional, and financial demands on your parents, which put their health and welfare at risk if they were left to shoulder all the responsibilities alone.

While your parents will appreciate your help and support, your sibling with the complex mental illness will appreciate it just as much if not more. Severe mental illness can leave those who have it feeling isolated and misunderstood, which can lead to depression that renders them incapable of taking action to help themselves. During these times of crisis, you can act as a voice of encouragement and a source of hope, providing unconditional love and practical assistance when both are desperately needed.

But if you choose to become more fully involved in your sibling’s life, as both a caregiver and confidante, this can put you under enormous stress. In fact, the burden may be even greater on you than it is on your parents, since you’ve cast yourself in a dual role. You may also have unresolved issues of shame, embarrassment, or guilt left over from your adolescent years, if your sibling’s mental illness was a factor back then.

No matter how independent or self-sufficient you think you’ve become, you may still gain great benefit from therapy that will let you explore your feelings honestly and without apology or judgment. Counseling could be your salvation, at a time when you’ve taken on significant responsibilities in addition to trying to manage your own life.

Facing the Challenges of Complex Mental Illness as a Family


When someone you love has a complex mental illness, you will be affected, and probably quite deeply. If that person is a brother or sister, you won’t be able to shield yourself from their problems, which will touch you as an individual while shaping or altering overall family dynamics in profound and sometimes troubling ways.

This reality must be acknowledged and addressed, both individually and collectively. Parents caring for a child with a complex mental illness should strive to create a stable and emotionally engaged home environment, where their other children will feel valued, respected, and loved. Everyone should be encouraged to talk about their feelings, with no concern about being criticized or judged. When children and adolescents ask questions they should be answered honestly, with no evasions or attempts to protect them from the truth.

If you’re an adult sibling of someone with complex mental health issues, you have a role to play in helping everyone cope as well. Even if you aren’t around the family home as much, your caring contributions can help protect and preserve healthy family dynamics.

Families affected by complex mental illness will face some daunting challenges. As long as everyone pulls together, motivated by love and mutual caring, these challenges can be successfully met. Individual counseling and family therapy can act as a lifeline for each member of the family, including brothers or sisters of any age who’ve shared the hardships experienced by siblings struggling to overcome life-altering medical conditions.

If you’re concerned about a loved one and believe they may need residential care, we can help. BrightQuest offers long-term treatment for people struggling with schizoaffective disorders, schizophrenia, and severe bipolar as well as co-occurring substance use disorders and process addictions. Contact us to learn more about our renowned program and how we can help you or your loved one start the journey toward recovery.