The relationship between mental illness and family is a complicated and interconnected one. On the one hand, when one member of a family is troubled, the upset usually ripples throughout, causing distress in the entire family system. On the other hand, when the family system is disturbed, individual members may develop their own symptoms, or their own vulnerabilities are triggered. Many times, problems in and between the adult members of a family cause or exacerbate individual problems. For example, when the relationship between parents is highly contentious, consistently angry or deeply frustrated, children are inevitably affected. By the same token, when one parent suffers from psychiatric disorders or severe personality disorders -- depression, panic disorders, antisocial personality disorders, for example -- or when they engage in addictive behaviors, other members feel the impact. No matter how much the parents may try to protect their children from their conflicts and disturbances, children are by their very nature sensitive to their parents' internal and actual experiences. In many cases, it's not so easy to disguise the fact that one is deeply angry, disappointed or distressed. Some parents communicate their troubles directly, in what they say. But many more communicate indirectly, through their parenting. Frequently, the result is parenting that is abusive, neglectful, flagrantly inconsistent and unpredictable. All this can, and does, cause the child pain. And when the trouble and pain are incessant, a child may develop emotional or behavior problems in response. Or whatever internal difficulties or biological vulnerabilities a child carries become exacerbated. When children develop symptoms, parents often feel that they are to blame, In addition to feelings of guilt, if they must seek outside help, they frequently feel shame. They worry that others will blame them as well. In fact, most parents want their children to be happy and well adjusted. When they see that their child is pained, they are themselves pained. This adds to the upset that a child's troubles cause within the family. Living with someone who has a mental disorder -- someone who is sick -- is never easy. No matter what the illness, there is always guilt, anger and confusion. Sometimes there are feelings of desperation. And from time to time, mental illness escalates into crisis: someone makes a suicide attempt and must be hospitalized; someone is arrested for speeding and drunk driving during a manic episode; a behaviorally disordered child sets a fire. Moreover, each psychiatric and personality disorder carries with it its own characteristic strain that can be felt throughout the family. Living with someone who has an eating disorder necessarily means that there are power struggles that often erupt into tantrums or angry outbursts around the dinner table. While a depressed person may seem lost and dismally unhappy, his disorder exerts profound strain on the others around him. He cannot go out because he feels so bad. He cannot help with chores in the house because he has no energy. In addition, other people's feelings, their anger, distress, joy, and pain, are often squeezed out by the overbearing weight of another person's depression. Although all mental disorders bring with them their own stresses, perhaps the most perplexing and heartbreaking is schizophrenia. It often happens that, once a person develops schizophrenia, no matter at what age, she reverts back to the care of her parents. Even if she has been out of the family home and living on her own, after her first psychotic break, chances are that she will return home. Beyond the practical matter of caring for an adult with severe mental illness, parents usually also contend with deep feelings of guilt. Even though we now know that schizophrenia is an illness of the brain just as hypertension is an illness of the cardiovascular system, it wasn't too long ago that people commonly referred to the "schizophrenogenic mother," the mother who literally drove her child crazy. Still, today, many parents look on the disease and wonder mournfully what they could have done differently to prevent their child's breakdown. It is not hard to understand that parents would want to make sense of a disease that can be so catastrophic, especially since there are no clear explanations. Yet schizophrenia is no one's fault; no stress is so extreme as to bring on a psychotic episode on its own. Many a parent's dreams, hopes and visions for their children dissolve with that child's first psychotic break with reality. A child with schizophrenia will probably never be independent, nor will he be capable of having a mature, enduring love relationship or of holding a good job. A large part of living with a mentally ill child involves coming to terms with the reality of the illness. Many families faced with the challenge of managing and living with mentally ill family members find guidance and solace through family therapy or support groups. Yet it must be noted that when all is said and done, most psychiatric disorders are very responsive to treatment. Getting better with the help of the right treatment is more often the rule than the exception, for both the person with the disorder and his family. But good results cannot happen if care is not sought. Last Updated: 9/23/2002
The Johns Hopkins University 1996-2003. All rights reserved. This information is not intended to provide advice on personal medical matters, nor is it intended to be a substitute for consultation. | 
