Children of Mentally Unwell Parents: 3 Paths Forward

Research explores how the children of mentally ill parents cope with parenthood.

Posted Mar 25, 2019

Mental illness is a global health issue — and the majority who are struggling do not receive treatment.  While the mentally unwell have a tough road ahead of them, so too do their children.  Research shows that children of mentally ill parents are more likely to suffer from anxiety, depression, aggression, oppositional behavior, and social isolation. When put into context, however, it makes sense. These children often face unpredictability in their home lives.  Mentally unwell parents also tend to be more negative and critical than parents without mental illness. Moreover, these youngsters also feel a greater sense of responsibility and worry, as they try to support their parents as they try to cope. They may also feel shame when their parents are symptomatic.

Growing up with a mentally unwell parent often casts a long shadow.  As these children develop into adults, they continue to struggle.  Research reveals that there are considerable long-term effects for these “adult children,” often revolving around feeling unsafe, uncertain, and stigmatized.  Their troubled relationship with their parent may leave them with an emotional void. They might also encounter trouble establishing an intimate relationship with a romantic partner.  The effects are indeed wide-ranging, with various studies finding that adult children have comparatively lower levels of self-esteem, more psychological and social problems, and a higher rate of incarceration.  And in keeping with this overall picture, nearly two-thirds of adult children of mentally unwell parents experience their own mental health issues.

While research points to the burdens that adult children of mentally unwell parents carry, research has also found that children demonstrate resilience in the face of parental mental illness — protective factors that are adaptive.  Some studies show that these children find ways to support their parents, giving them some feeling of agency and control in their predicament.  At the same time, caring for a family member who is mentally ill can help bring families closer and lead to independence.  Resilient children of the mentally unwell often exhibit high intelligence, problem-solving abilities, sociability, self-insight, and the capacity to regulate their emotions.

Of particular concern, the problems that are experienced by children with a mentally unwell parent can be passed on to the next generation.  Technically speaking, this is referred to as “toxic inheritances.”  Violence, pathology, and shame can become intergenerational. Put another way, growing up with a mentally unwell parent can affect not only personal development but also future parenting.

How do adult children of mentally unwell parents fare as parents themselves?  This was the focus of a new study led by Pamela Patrick of Monash University in Australia.  In order to investigate this question, the research team recruited participants who had at least one parent with a mental illness and at least one child.  They conducted open-ended interviews with the participants about their philosophies of and experiences with parenting, and then examined their narratives for themes.  What did the team find?  They uncovered three major themes, all of which had sub-themes:

1. ’This Is Me’

This theme wove together adult children’s narratives about their need to be different from their parents.  There were three sub-themes:

A) I Got to Do It My Own Way—Being Authentic

The majority of participants expressed intentionally parenting their children differently than their parents had parented them.  As one participant said:

“I didn’t want to parent the way that my parents had. So I’ve really had to be deliberate about, you know, how I want it to be, what relationship I want to have with my children and what I want that to look like…”

At the same time, some participants reported positive aspects of their parents’ parenting style. For example, they described their parent trying to be active and involved despite the limitations of their condition.  There were also descriptions of parents who were the glue or anchor of their families.

B) Know You Are Important to Me.  Participants prioritized supporting their children emotionally, and having a strong emotional connection with them.  As part of this effort, it was important to adult children that their home environment be one of open communication.  The authors note that this may have grown out of the secrecy and confusion surrounding their parent’s mental illness.  Growing up, and when parents were struggling, participants reported that they tried to make sense of the situation by themselves or were sent to live with extended family without a sufficient explanation as to why.  In light of these circumstances, one participant remarked of her relationship with her daughter:

“We can talk about all sorts of things, whether it’s the good things or bad things, having a very open communication, I guess where she sort of feels that if something’s gone wrong or she’s unhappy or any of those sorts of things that we can talk about those things and that I’ll support her and I’ll do what I can to help things get better.”

This sub-theme also refers to participants actively nurturing and supporting their children’s individuality.  Several adult children recalled that their mentally ill parent could be extremely controlling, in terms of how they dressed, the extracurricular activities they took part in, and the friends they could have.  Thus, participants felt that as children they had to both hide certain things from their parents, and very often put on an act for them in order to successfully navigate the situation. 

As one participant stated: “I learnt that if I was cold towards and distant towards her, it would make her angry, so I would pretend to be what she wanted me to be, so I would pretend that I enjoyed doing the dance and the pageants and all that sort of stuff that she wanted me to do even though I hated it. I would do them because if I didn’t it was worse.”

C) Call Me Boring If You Must—Prioritizing Routines and Stability

This sub-theme reflected adult children’s emphasis on having a stable home life.  Participants recognized that their parent’s mental illness meant growing up with unpredictability and uncertainty, giving rise to fear and anxiety.  Consider how one participant put things:

“What I’m very conscious of doing is that I want my kids to know what they’re coming home to every single day. I never want them to feel like they’re coming home from school and . . . I remember for me, standing at the bottom of the driveway going: “Oh God, what’s happening today?” Like they (children) always know that I pick them up from school, I’m sitting right there, I’m here every day, we do the same thing every day. Yes, they get yelled at because they leave their lunchboxes at school or there’s rotting fruit, again! But it’s the same thing, screaming about the apples and it’s the same every day and as boring as it seems to them sometimes there’s so much safety and stability in that.”

2. ‘A Whole New World’

The second theme, ‘a whole new world’ was made up of four sub-themes, reflecting that parenthood gave adult children the opportunity to see themselves in a new way. The four sub-themes were:

A) “Softened as a Person”—Capacity to Love and Be Loved

This theme capture participants’ sentiment that parenthood was a “steep learning curve,” but that it also provided an opportunity to heal from their own childhood.  One participant, for example, expressed that as a child she was anger ridden about her chaotic family life, which resulted from her father’s bipolar disorder.  The tumult was so difficult, she fled the home at age 16, and became “numb” towards her parents and her experiences.  Once she became a mother, however, she was able to see herself in a new light:

“I just feel like I’ve softened as well as a person. Like I said, I had a very angry childhood, kinda mellowed once I moved out and that’s really where a lot of the processing and finding myself really happened. But I guess it [parenthood] shows me that there is a very strong capacity in me to love and be very attached to someone and I guess that would evoke strength in me.”

B) My Window to the World—Social Connectedness

The authors noted that the sole male participant in the study said parenthood gave him a new way to connect with others:

“Like my son comes and says: “dad, I’ve just joined the museum society. Will you come along with me to the first meeting they’re having next week, with me?” And I said: “yeah I’d love to.” And having done that and been along to the museum society, I’ve made friends there, would you believe? That I would never have met otherwise. That was through him, right? I’ve met other people that I am now friends with, whom I’m learning things from as well. And we’re talking as fathers—father to father—but my son instigated it. So yeah, I’m linking to other groups and sociability.”

C) It Takes Two to Tango—Co-Parenting and Complementing Each Other’s Roles

Half of the participants referred to co-parenting, and the experience of depending on their co-parent.  This was counterintuitive for some participants, as they had to be highly independent as children in order to cope with their situations.  Others spoke of making “proactive decisions” so that their children were able to have meaningful access to both parents. One participant contemplated: “I think also I don’t want to take on too much, like at the moment, me and my husband both work part-time, three days a week and then we share the care of the kids, so that was something that we decided on before we even had kids, that that was going to be our plan because I want them to have a close relationship with their dad because I didn’t get that and I also want us to have work-life balance, so that we’re not too stressed out. So I’m very conscious of not taking on too much.”

D) “Marching to the Beat I Drum”—Being Kind to Myself

This sub-theme underscored adult children’s need to be kind to themselves, and to rid themselves of society’s expectations:   A participant opined: “I think I have the attitude that: “you know what, it’s okay to just do it the way that I think is best.” I think its also as I get older, I feel like its less about other people and more important to march to the beat of your own drums. I think that’s also been incorporated into my parenting mantra . . . “you know what, if this is just not how most people do it, it’s okay, it's working for my family, it works for me.”

3. ‘Because of You’

This theme captured the participants’ reflections about the challenges they faced as parents as a direct result of their growing up with a mentally ill parent.  It consisted of four sub-themes.

A) Whom Do I follow?

This sub-theme referred to participants’ feelings of loss and confusion when it came to parenting.  Some expressed that they lacked a reference point, which made them anxious that they would continue the pattern of poor parenting in their new roles as caregivers.  Consider the statement made by one participant: “It’s like I know what should be done but it’s difficult to control myself, I swear. I used to blame it; maybe I still do on my past. Like I cannot break from the patterns that my parents—how my parents raised me.”

This sub-theme also spoke to how adult children’s experiences of assuming caretaking responsibilities at a young age influenced their current parenting styles.  One participant said:

“I have noticed that my experiences from when I was little have come through, in that, like when my sister was four and when mum first got unwell, she (sister) was having really bad tantrums and she’d be really hard to get ready for kinder, and trying to get her dressed in the morning and brush her hair was awful and I just did whatever I could do to make her happy because I didn’t want her to have a tantrum and also I knew that she was much younger than me and it was harder for her to lose mum and I think that comes through now with my daughter sometimes. I would just give in to her own way too easily because I don’t want her to get upset and have a tantrum, so maybe I’m a bit of a pushover sometimes.”

B) My Childhood vs. Yours—Challenging to Render Emotional Support

Sometimes adult children had difficulty being supportive and communicative parents.  More specifically, while they prioritized these components of good parenting, they sometimes felt their children’s problems were trivial by comparison to what they had to cope with as youngsters.  A participant reflected:

“I guess it’s all the emotional stuff, you know, like naming feelings and recognizing feelings. I mean that’s something that I’ve read multiple times but I still can find it really hard to really kinda sit and go: “ohh okay, so you’re feeling pretty sad about this right now”, I guess because sometimes I feel like I went through really tough times and I can tend to at times get a little bit impatient with people. I feel like: “you don’t even know what tough is” and I kinda have to remind myself that everybody obviously has their tough parts and not to be too impatient but sometimes I do say to my daughter: “really? You don’t realize just how much you actually have . . . If you had even a tiny bit of what my life was like or what some of their friend’s lives are like . . . ” you know, like you really do have it pretty good.”

C) I Just Know Too Much—Experiences Guided Their Choice of Career

Some participants reported that their childhood experiences inspired them to pursue careers in the helping professions, including social work, counseling, and child protective services.  While adult children felt that their personal experiences were an asset when working with vulnerable families, they also admitted that the ongoing exposure to childhood maltreatment was difficult.  At the same time, their work made them adamantly protective of their children, making it hard to entrust their children in others’ care.  One participant stated:

“I think the things I find more challenging are like when she’s away as well, and I wouldn’t say that I have separation anxiety or anything to that extreme but yeah, for me it’s more what other people do with her and what goes on in other people’s houses and those things. I think those have been the hardest for me. I’m not sure if that’s something from mum or even a little bit from work or all of those things combined, but that’s probably been the hardest, yeah. I do get a little bit worried when I probably shouldn’t.”

D) I Wish I Had My Family Tree for Support—Lack of Informal Supports

This sub-theme spoke to adult children’s unmet wish for support from their own family.  While they reported having partners, co-workers and friends who were supportive, they could not turn to their own families for help and sharing.  In some cases, participants’ parents could not be trusted to help with childcare.  In other cases, adult children scaled back their involvement with their parents once they had children, especially if their mentally ill parent was still volatile and/or abusive.  They described this decision as exceedingly difficult, because it left them without the opportunity to share their experience of parenthood with their own parents — and their children had to forgo a relationship with their grandparents.  As one adult child put things:

“One of the biggest challenges I’ve had is probably directly related to my childhood is the complete lack of support. I’ve been very much on my own as a parent. My husband and I have been very much on our own. I didn’t have, like my best friend’s just had a baby and she’s very close to her mother and watching her be supported and propped up and having that stuff—I never had any of that. So not having any family support when you have kids is really hard, there’s no break. Even tiny stuff, like having someone to ring and go: “is this normal?” . . . Because when you’re parenting, none of it is normal, none of it makes any sense and it would have been nice to have someone to call . . . ”


“We Are More than Our Parents’ Mental Illness”: Narratives from Adult Children.  Pamela M. Patrick, Andrea E. Reupert and Louise A. McLeanMarch 2019.  International Journal of Environmental Research and Public Health 16(5):839.