4.3 Relationship changes

A Family Guide to Concurrent Disorders - Part II: The impact on families

On this page:

• The family member with concurrent disorders
• Parents
• Siblings
• Helping children cope

The family member with concurrent disorders

The person with concurrent disorders will often feel that family members are invading his or her personal life. Resentment about being overprotected may lead to anger, rebellion and acting out. These behaviours may increase the risk that the mental health problems will worsen or that the person will end up in unsafe situations. The cycle of the family’s preoccupation and the loved one’s reaction then repeats itself. This costs everyone in terms of time, physical and emotional energy, and quality of life.

Parents

Parents of children with mental health disorders often feel a great sense of loss and sadness when they see the changes in their child. Family members may have to change their expectations for their loved one regarding education, career paths, marriage and children. This can involve emotional pain, a sense of loss, grief, sadness and anger. The grieving process is similar to the one experienced by those who have had a loved one die, or who must adjust to a serious chronic physical illness in a loved one.

The whole family—we had so many other problems to face, you know? I remember feeling grief and frustration and a sense of tremendous loss, for my daughter and for her potential.

Siblings

Siblings may worry about developing mental health problems, substance problems or both. They may worry about the stress and strain that their parents are enduring, and may take on the burden of trying to make up for what their parents have lost in their other child. At the same time, brothers or sisters sometimes resent the time that parents spend with their sibling. They may become angry to the point of acting out or distancing themselves from family and friends.

I remember being teased as a child because I was so serious, so sombre—and people told me that I acted like a middle-aged woman, a lot older than I actually was. It was impossible to explain to other people—like, you go to school after not sleeping all night, and after the police were at your house because of your sister’s psychotic episode, and no one thought of dinner or anything like that because she overdosed and your parents had to go to the emergency room with her, and then you go to school the next day and it’s like, all the expectations are still on you. But you don't tell anybody anything, you just carry on as usual. You can't talk to anybody about it. Nobody will understand . . . .

Siblings may also experience anger, hostility or verbal or physical aggression from their brother or sister. These behaviours can evoke shock, dismay, fear and a sense of abandonment and rejection. Sometimes, children may feel like they have lost their best friend. They may feel guilty that they have a better life than their brother or sister.

Helping children cope

Parents can help their other children by:

• assuring children that behaviours such as aggression are symptoms of the illness and shouldn't be taken personally
• sharing feelings and encouraging children to talk about how they feel and how their brother’s or sister’s problems are affecting them
• explaining that family members often feel uncomfortable, embarrassed or ashamed of their relative’s behaviours, symptoms and diagnosis
• if appropriate, discussing the issue of stigma and why it happens, as well as effective ways to deal with it (see Chapter 6 for more information about stigma)
• helping siblings learn about substance use and mental health problems and how these interact with and affect each other
• spending time alone with siblings, talking and doing enjoyable activities
• helping children build a new relationship with their brother or sister and creating unique ways of being with their sibling.

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