What are the effects of a person’s mental illness on their children? It has been argued that their burdens have often been often overlooked and/or insufficiently responded to. In recent years, however, researchers have made greater strides in better understanding the experiences and needs of those who grew up with a mentally unwell parent.
Consider the work of Anna Källquist and Martin Salzmann-Erikson, Swedish researchers, who sought to expand insights into this topic. They had three guiding questions for their study:
- What experiences do adults, who grew up with a parent with serious mental illness, have from childhood?
- How is adult life affected by the experience of growing up with a parent with serious mental illness?
- How do adults, who grew up with a parent with serious mental illness, reflect on the support that they received during their childhood and as adults?
In order to pursue these lines of inquiry, the authors performed a meta-synthesis of the qualitative literature on this topic. They combed five databases in search of studies that met the following criteria: (a) the study was qualitative, (b) the study was empirical, (c) the participants were between the ages of 18 and 64, (d) the participants had a parent with a serious mental illness (psychosis, depression, and/or bipolar disorder), and (e) the article was written in English, German, Swedish or Norwegian. In the end, they pooled 14 studies and analyzed them for themes.
What did the researchers find? Their analysis yielded the following four themes, each containing sub-themes. The following is a selective overview of their results.
Theme 1: Growing Up in a Dysfunctional Home Environment
A different parent. The adult children in this study knew from their first years at school that their parents were different from the others. They sensed a problem, but didn’t know about or understand the illness — and didn’t separate the parent and the illness. It was when they met their friends’ parents that they realized just how different their own parents really were.
The illness and its effect on the parental role. Participants reported that it was hard to have a good relationship with their parents and that the illness got in the way of being a good parent. They stated that their parents ignored their needs for love, care, protection, and attention.
Reversed roles and responsibility. Participants reported that growing up, they felt the burden of feeling responsible for the family’s well-being. They felt more in control of their lives than their parents did.
Do not talk about the illness. Adult children recalled staying silent about their parents’ condition and were even explicitly told by their parents not to discuss it with others. Participants felt embarrassed by their parents’ differences and didn’t confide in others for fear of rejection and to protect their parent.
Inability to comprehend the situation. When others asked about their parents, the participants didn’t know what to say. The situation was not explained to them, which caused further confusion about their own reality.
Theme 2: The Child’s Feelings and Thoughts
Fear and guilt. Participants reflected that they were often worried for their parents, and their potential for self-harm. They also withstood anger and abuse at the hands of their parents, leaving them fearful — especially when psychosis was involved.
Alienation. As children, they felt isolated from their family as well as their peers and the larger society. They felt ashamed, alone, and different from “normal” people. People also made fun of them and their parents.
Theme 3: The Need for Support
The children’s contact with persons other than the sick parent. Participants described the great importance of other adults in their life, who provided support and help. They were grandparents, family friends, neighbors, and teachers, who they felt were their rescuers.
Health care and support groups. The adult children viewed health care services in a negative light. They witnessed their parent being taken away to the hospital without so much as an explanation.
Theme 4: The Lingering Effects in Adult Life
Relationships with the parent. As adults, the participants felt they had to take care of their parents. This demanding role led to guilt, anger, and isolation from their peers. Participants struggled with setting both physical and emotional boundaries and found therapy helpful in this regard.
Relationships with others. Participants had difficulty around trust and intimacy, and found having a functional intimate relationship hard to maintain.
Health and personal growth. Participants feared inheriting their parents’ illness. Some struggled with depression and anxiety. For those with a psychotic parent feared, because of nature and nurture, becoming psychotic themselves.
Growing up with a mentally ill parent is extremely difficult and heartbreaking. Hopefully, greater understanding can lead to much-needed support and empathy for those who are struggling with this challenge.