When a parent has mental illness, how to support kids

Between the long hours, many responsibilities, and lack of control, few jobs in our society are as demanding as parenting. If a parent has a mental illness like depression or anxiety, raising kids becomes even more difficult. Many parents live in secrecy, believing that they are the only ones who struggle like they do.

But parenting with mental illness is far more common than many people suspect. In a survey of U.S. parents, more than 18 percent reported having a mental illness in the past year. While a parent’s mental illness increases child’s risk for a future mental disorder, this is by no means the only possible outcome.

“Having a parent with mental illness does not always lead to clinically significant distress in a child,” says Dr. Patricia Ibeziako, associate chief of clinical services in the Department of Psychiatry and Behavioral Services at Boston Children’s Hospital. “It depends on many factors, including the type and severity of the parent’s mental illness, how long it lasts, and the age of the child.”

A parent’s mental illness affects children differently at different ages

Children are most vulnerable to the effects of a parent’s mental illness at specific stages of emotional development. The first stage starts early, from infancy until about age 5. “This is an important period of brain development when infants and toddlers form strong attachments,” says Dr. Ibeziako. But a parent with mental illness may not be able to meet their child’s need for bonding. An infant or toddler deprived of positive emotional connections may develop problems regulating their own emotions and behavior. This may play out in tantrums, trouble sleeping, regression in potty training, or bedwetting.

The next vulnerable period is adolescence. As difficult as their behavior may be at times, adolescents rely on their parents for structure and positive reinforcement. But a parent struggling with mental illness may be less attentive to their teenager’s needs. Or they may focus entirely on things their child is doing wrong without balancing negative feedback with praise. “A parent’s depression, irritability, or low frustration tolerance can cause teens to act out in disruptive ways,” says Dr. Ibeziako.

The lack of energy that depressed parents often experience may also affect their ability to pay attention to their child’s school routines. Without a parent’s support, school-aged children may struggle to get to school or after-school activities on time. Completing homework can become an overwhelming challenge.

A parent dealing with an anxiety disorder may be overprotective, depriving their child of the chance to learn problem-solving skills. Or a child who witnesses their parent’s anxious behavior may in turn develop fears and worries.

How to help kids develop positive coping skills

Despite these challenges, many children do find positive ways to cope. Parents can help.

“Many children who grow up with a parent’s mental or physical illness learn empathy and kindness. Many develop resiliency, the ability to deal with difficult circumstances,” says Dr. Ibeziako. “These characteristics often have an enduring positive impact on their relationships well into adulthood. If they have children, it can benefit the way they relate to their own kids.”

Below are concrete steps parents can take to contribute to their children’s healthy emotional development.

Practice self-compassion

“Parents with mental illness often carry a lot of shame and guilt, which doesn’t help them or their children,” says Dr. Ibeziako. She recommends that parents offset self-criticism with self-care. “There’s a direct link between a parent’s well-being and their children’s well-being.” By being kind to themselves, parents may have more emotional resources for themselves and their child. 

Let children be children

Children may miss out on carefree play if they become a mini parent for their parent and siblings. Knowing their parent is taking care of themselves can release children from feelings of responsibility so they can play without worry.

Create structure

“Children need structure to feel secure,” says Dr. Ibeziako. Without predictable routines, children may have trouble sleeping or keeping up with schoolwork. A lack of structure can also contribute to anxiety and behavioral outbursts. The CDC offers a range of suggestions for creating structure in the home. 

Speak openly with your child

Open communication — within limits — can put children’s minds at ease. “Children are very attuned to their parents,” says Dr. Ibeziako. “If they don’t know why their parent can’t get out of bed, they come up with their own story. Many conclude that their parent’s emotional struggle is somehow their fault.”

However, she warns, it’s important that parents maintain appropriate boundaries. Exposure to a parent’s disordered eating, substance abuse, or self-harm could burden children, or lead them to adopt similar behaviors.

Find outside support for your child

If a parent feels unable to talk about their mental illness, talk therapy can provide a safe space for children to talk without fear that they might hurt their parent’s feelings.

Involve another trusted adult

“The presence of a loving, stable adult in a child’s life helps build resilience,” says Dr. Ibeziako. In a two-parent household, the other parent can provide comfort, stability, and support. The other adult could also be a relative, trusted friend, sports coach, teacher, or therapist. Having appropriate social supports within the family or community can help children of parents with mental illness learn skills to overcome adversity. The positive impact can last a lifetime.

Learn more about the Department of Psychiatry and Behavioral Services.