We don’t talk enough about the children who live with, and rely on, a family member with a mental illness. What sort of support do they need and how can we provide it?

I grew up with a mentally ill father. More than once, I woke up on the “morning after” my father was institutionalized during a mental breakdown. My father would hallucinate that someone or something was out to get him: aliens, God, the FBI, his coworkers, famous people. It was usually the culmination of months of paranoia—a hard stop on reality during which my father would scream accusations at people in public, moan and sob at the top of his lungs, and act like a trapped animal trying to elude capture if someone came near him.

My mother always found a way to trick my dad into checking into a hospital for treatment. Waking up midweek at either of my grandparents’ houses was a sure sign that something had gone wrong with my dad.

My father’s illness progressed gradually over time. He was briefly institutionalized when I was five, again when I was six, and then, lastly, when I was 12. All three times, my family welcomed back a functional, but not healed, father. Although doctors deemed him treated and sent him home, his behaviors remained bizarre and upsetting to me.

When I was younger, my father was distant, yet never disturbing. We did some of the typical father-son activities: went to football and basketball games at the local university, talked about sports, and visited his parents to have snacks and throw darts with my grandfather. But then, when I was 12, he publicly accused my family of being aliens sent to harvest his testicles.

After that, he changed forever: talking to himself in public, watching Catholic mass on TV three times daily, and amassing a basement full of unopened books, records, CDs, and videos. My father’s illness had a huge impact on who I was and how I developed as a teenager, and also on how I’ve developed as an adult.

We frequently turn our attention to mental illness in the aftermath of horrific acts. We wonder what makes people do crazy things, and how we can we prevent these tragedies. Politicians debate the issue, yet we see little movement towards a resolution. Our community members ask why there isn’t more support for identifying and treating mental health problems. Children in families with mental illness ask this same question every day.

But we don’t talk enough about the children who live with, and rely on, a family member with a mental illness. What sort of support do they need and how can we provide it?

Here are six things I think everyone should know about children in families where one or more members have a mental health condition.

1) They need to know that their loved one is not “nuts,” “crazy,” and “psycho.”

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I hated having a crazy family. I knew it was bad and I knew it made me a bad person, without even thinking about it. The media handed me much of the stigma I attached to mental illness. I saw reports on the news of a “psycho” killer on the loose. The TV roared with recorded laugh tracks when someone did something “nuts” and acted like a “loony”—words that sound silly unless you internalize them because they reflect someone responsible for your creation.

The media portrays crazy as synonymous with criminal, violent, and murderous.

I remember lying in bed the night before my father was due to come home from the hospital. I vowed to keep an eye on him. I knew he would come home and want to kill his family. The TV told me this is what crazy people do. I’d protect my mother and sister, damn it. Instead, he moped around acting confused, talking to himself, and spending all his money on useless records, CDs, and videos that sat piled and unopened in the basement. My father ignored me completely. He managed to hold down his job, but his family fell apart around him.

I turned into the one who wanted to become violent. Watching my functional yet useless-to-me-as-a-parent father enraged and embarrassed me. The homeless men on the streets of D.C. were the only other people I saw talking to themselves in public as adamantly as my father talked to himself in public and at home. I walked the halls of my school fearing I had “Son of a crazy man” written on my chest. I stood as far from my father as possible when we were in public. He didn’t seem to notice. He was busy crossing himself and muttering in a half-shout about God and the devil.

The media freely hands out stigmas, particularly for mental illness. This is unacceptable. Many successful people are managing mental illness, and most never harm a soul. Numerous friends and family members are better people because they know and love someone who has a mental health diagnosis. We should discuss mental illness as a serious topic, worthy of respect to both the people with the mental health condition and their families.

2) They feel they are alone.

Growing up, I usually felt alone. I was the only person I knew with a family like mine, except for my younger sister. I looked at my friends’ families and they seemed normal.

My father hallucinating Martians with a mission to harvest his testicles had replaced his family. He talked to himself and gestured wildly in public. I didn’t see any of my friends’ parents doing that.

My father’s life, a non-stop cycle of work, watching mass on TV, and then shopping for media, seemed different and bad compared to the lives I thought everyone else was living. I didn’t want people to know this about me.

I felt disconnected and unable to communicate with friends. I was afraid of discussing my home life, particularly my father. I always preferred to play or stay at a friend’s house. I lived in fear of being exposed as the child with a crazy father. I never brought my father up in conversation. If any of my friends ever met him, I told them my mother was planning to divorce him—something I prayed for daily. I knew it would never happen. She told me she was sticking to her wedding vows. She firmly believed we were better off as a whole family than as a single mom raising two kids on her income alone.

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I didn’t realize at the time how prevalent mental illness is. Many of my friends likely had parents with mental illness, parents with addictions, or abusive parents. If I had realized anyone had a family life like mine, I would have reached out to try to connect with someone else my age. I was alone and aloof in the solitude I created. In a high school with over a thousand students, I did my best to go unnoticed. I refused to bare my soul, express my emotions, or have anything related to a deep conversation with friends. I knew if I spoke up I might reveal my embarrassing secret—a mentally ill father. All I had to do to feel my stomach squeeze with anxiety was to imagine my peers knowing about my family. I carried the stigma of mental illness internally. No one else had to tell me I was inferior.

Keep this in mind if you know a child with a family member with a mental health problem. These children need to know their situation isn’t unique; many others have experienced mental illness or live with someone who has. They know they’ve been dealt an unfair hand. You can’t change that, but you can provide comfort and understanding. My mother used to say that my sister and I were dealing with something that wasn’t fair for kids. That was true. I felt like she understood me when she made statements like that. Empathy goes a long way for helping children in families with mental illness.

3) They need free access to behavioral health services.

I saw a counselor for a number of years. My mother demanded I attend the meetings at first. As an adult, I am appreciative that she did. I know it cost money she didn’t have. At the time, I was angry and confused at everything. It wasn’t until afterward that I realized the value in seeing the counselor. He was truly my only outlet for emotions. We teach children to go to their parents or a teacher if something is bothering them. If you are in a family with mental illness, you learn to keep your thoughts to yourself. You don’t want to risk having your feelings invalidated by a maniacal laugh or an accusation that you are an alien.

In middle school, I called a helpline. The guy answering the call thought I was a liar when I described my father’s actions. He told me nothing I said made sense. I hung up feeling empty, because if the person staffing a helpline couldn’t acknowledge my situation, it proved my family life was shameful and wrong.

As an adult, I found out these helplines are often staffed by volunteers, most likely taking social work courses in college. Helpline volunteers need training to handle calls from children such as myself. Never tell a child from a family with mental health problems that what they have seen or heard doesn’t make sense. Of course it doesn’t. We must help children deal with how to process the odd acts and the pain their family situation causes. Validating their situation is the first step toward accomplishing this.

Children witnessing mental illness up close and personal do not feel like they can share their life with others. Often things aren’t all right, but you won’t find out just by asking. Mental health care services by trained professionals should be the norm for children with mental illness in the family, ideally free of charge. Without mental health interventions, we increase the likelihood that the children will struggle with a mental health challenge themselves. Heredity already increases this risk. Social and economic costs increase exponentially when we fail to treat an illness at the onset—mental healthcare for a child should be proactive, and can be preventative.

4) Simple things mean the world to them.

Children with a family member who has a mood disorder or other mental health condition fantasize about being “normal.” For me, this meant having a dad who came home and threw a baseball with me. Or better yet, a dad who took me to baseball games, called me “slugger,” and told me how proud he was of me, but didn’t cross himself and utter to God while we sat in the bleachers. I was fully invested in the most prominent cliché about American fatherhood, and I certainly wasn’t seeing examples of my father portrayed in cartoons or sitcoms.

Families with mentally ill members need a sense of normalcy. Community support systems need to include an understanding of the trauma these children are going through. Our focus should shift from what we consider normal to how a family with mental illness might define normal. Children going home to unstable or destructive parents need outside support so they can focus their energy on constructive tasks and find their talents. They want understanding and love.

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5) They don’t trust stabilitythey crave the excitement of drama.

You quickly get used to a series of peaks and valleys when you live with mentally ill family members: the adrenaline rush of watching your father screaming that the FBI is after him as he refuses to come inside the house; the thrill of a car ride when your father tells you he might get reassigned to an office in outer space, as he swerves through rush hour traffic; waking up every day unsure what to expect. These adrenaline rushes become addictive.

I realized in my mid-30s that I was living a cycle of adrenaline-fueled drama. I could never sit still and accept the current situation. If things were okay, I’d have to get drunk and destroy something. I’m less than two years out of an abusive relationship with alcohol—one that stunted my professional and personal growth almost as much as growing up with a father with mental illness. I pressed the reset button on progress every time I chose to get drunk. I found comfort in the whirlwind of negative activity that followed a binge drinking session that might end with me sleeping in the backseat of my car.

If things were bad, I’d have to stay up all night worrying about what was next. My mind was stuck on finding the drama in every situation. I reflect on my childhood and I can see where this started: fretting over the next breakdown, experiencing the adrenaline rush of watching my father start speaking in tongues in the middle of the mall, and knowing that any calm moment was just the prelude to the next screaming match between my parents.

Youth in these families develop a craving for drama. We don’t have the right to judge these children. We have the responsibility to understand that a child might continually act out in school, commit crimes to end up in juvenile detention, set fires, or create lists of people they would like to see harmed. These children spend a lot of time contemplating their fate. Will they suffer from the same illness as their parent? This question swirled in my head and rung in my ears as I grew up. I made a number of poor decisions with the mindset that insanity might be my destiny, so why worry about the future.

6) They need exposure to adults who behave like adults.

One of the most confusing things for me was leaving the family and not realizing what a responsible adult male is supposed to do. I graduated high school into a great abyss of confusion. My male role model taught me everything I didn’t want to be, but I had no clue how to go about finding what I wanted to be. Yes, I had years of counseling that was comforting during the time I was in it. But I did not have a roadmap or even a trail of breadcrumbs to follow a path to becoming a responsible adult. I had fear and uncertainty.

Children without suitable adult role models at home need to see how adults take on their duties and responsibilities. We need to connect children, especially once they are teenagers, with role models through school and after-school programs. We should be proactive in offering our advice and experience to children in mentally ill families.

We are all part of raising the future, whether our children are from families with mental illness or not. We need to have a generation that stops passing along the stigma of mental illness. We need to remove the belief that being mentally ill means you aren’t a part of the “normal” piece of society. We can do this by publicly saying that someone can successfully manage mental illness and have a great life, and by not blaming what goes wrong on “crazy” people.

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