Siblings share toys, they may share clothes, do they also share mental illnesses?
I am the youngest of five children born to two teachers. The five of us, four girls and one boy, were born and raised on a small boarding high school campus where my parents worked. Our house was always filled with tension from their work and so mental health was not a dinner subject. My siblings and I did not want to bring up our individual struggles and add to their stress levels.
This all changed 10 years ago when my older sister was diagnosed with Bipolar Disorder. Since that day, mental health has become a recurring topic. In my house it was always clear that the five of us were nervous children, but once we took a closer look it became clear that it was more than just nerves.
Despite being young, it was clear to me that my sister had difficulties. I overheard arguments I couldn’t comprehend and witnessed moments where the tension was palpable. At eight years old I knew that I had to be “easy,” so that my parents could focus on larger issues.
As I and my anxiety have grown I have wondered: Would I face the same struggles if my siblings needed less attention?
Mental Illness: A Family Affair
Stress is social: It can interact with genes and hereditary traits in a way that causes siblings to experience their own mental health issues due to their siblings’ struggles (Dimitroff et al 2017).
Although parents may not consciously place the burden of caregiving onto their children, they may feel responsible for helping their parents with their siblings with mental health problems. Siblings are more likely to help in closer familial structures, alleviating family caregivers’ sense of feeling burdened (Horwitz and Reinhard, 1995). This, however, can increase siblings’ experiences of stigma and their own sense of being burdened.
These emotional, cognitive, and occasionally physical burdens lead to even higher stress levels as the siblings have even less time for themselves (Kulisch, Engelhardt-Lohrke, and Jagla-Franke 2024). These high stress levels then incite siblings’ own mental health struggles especially as their needs are not met at home and they absorb the stress of their family members, especially that of the parents.
It was found that siblings of children with chronic health conditions (SCCHCs) experienced a lower quality of life compared to siblings of healthy children (Kulisch et al. 2024). This makes sense, they are experiencing increased stress, feelings of confusion and lack of attention. While a degree of the stress experienced is simply from observing medical treatments, it is also that they are grasping the diagnosis which in itself leads to reduced attention and more frequent family conflicts (Kulisch et al. 2024).
Consequently, siblings of those diagnosed with mental health problems tend to suffer from above average social and general anxiety as well as increased behavior problems (Lukens, Thorning, and Lohrer 2002; Kulisch et al. 2024). They may also engage in destructive behavior such as tantrums and bullying.
Supporting Siblings
Parents need to recognize that when one of their children receives a mental health diagnosis, their siblings are also affected and they deserve and even require attention as well, even if the house is already busy enough.
One way to support these siblings and their struggles is early prevention as well as helping develop coping mechanisms. Kulisch et al. describe different coping methods such as :
- Optimism and predictive control
- Vicarious control via trust in treatment and medical staff
- Interpretative control to gain understanding of the condition at hand
Teaching coping skills early, whether that be by psychologist, parents, social workers, teachers, etc. will help siblings of a mentally ill patient best understand what strategies help. They found that predictive control coping led to better cognitive functioning and more frequent positive emotions (Kulisch et al. 2024).
Understanding coping strategies and teaching them to these siblings will allow them the space to understand the situation can lead to a better quality of life (Kulisch et al. 2024).
Families cannot continue to ignore these conversations and rather they must be proactive and recognize that if one child is experiencing a mental health problem, they must then provide space and support for their other children.
Schools are also beginning to normalize and teach about the importance of understanding mental health. By normalizing conversations about mental health in schools, they can better integrate these topics into more spaces. This will allow kids to feel more comfortable going to trusted adults to work through these tough situations at home.
Bibliography:
Birtchnell, John. 1974. “Is there a scientifically acceptable alternative to the epidemiological study of familial factors in mental illness?” Social Science & Medicine. Retrieved March 7, 2024 (https://doi.org/10.1016/0037-7856(74)90079-1).
Dimitroff, Stephanie J. Kardan, Omid. Necka, Elizabeth A. Decety, Jean. Berman, Marc G. Norman, Greg J. 2017. “Physiological dynamics of stress contagion.” National Library of Medicine. Retrieved March 25, 2024 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522461/).
Horwitz, Allan V.; Reinhard, Susan C. 1995. “Ethnic Differences in Caregiving Duties and Burdens Among Parents and Siblings of Persons with Severe Mental Illnesses.” Journal of Health and Social Behavior. Retrieved February 15, 2024 (https://doi.org/10.2307/2137221).
Kulisch, L. K., Engelhardt-Lohrke, C., & Jagla-Franke, M. 2024. “Coping behaviours among siblings of children with chronic health conditions.” Advances in Mental Health. Retrieved April 19, 2024 (https://doi.org/10.1080/18387357.2024.2329092).
Ma, N., Roberts, R., Winefield, H., & Furber, G. 2020. “A dimensional approach to the mental health of siblings of children with mental health problems: a 20-year systematic review.” Journal of Family Studies. Retrieved April 19, 2024 (https://doi.org/10.1080/13229400.2017.1375966).
