More threads by David Baxter PhD

David Baxter PhD

Late Founder
"Well Sibling" Syndrome: Siblings of the Children With Severe Mental Illness
May 25, 2007

When a child has a severe neurobiological brain disorder such as bipolar disorder, schizoaffective disorder, or schizophrenia, strain is placed on the entire family. An inordinate amount of time, energy and commitment is made on the parents' part in order to care for the ill child.

The well brothers and sisters of the ill child can be directly affected emotionally, and even physically, by the behaviors of the ill child. Dealing with physical threats and abuse at the hands of their ill brother or sister, they may be left feeling emotionally battle-scarred. And because of the drain on their parents' emotions and energies from caring for the ill child, these well siblings can be left feeling neglected, with their own emotional needs left unfullfilled.

These sisters and brothers of a child whose illness affects his/her brain, thoughts, behaviors and actions, may suffer profoundly from this stressful, often chaotic, family environment in which the ill child takes center stage.

Researchers are finally starting to look at what they're calling the "well sibling" syndrome.

American RadioWorks has an audio article (and the transcript) on this subject with interviews with parents and children describing the difficulties they face, the guilt, stress, depression and the resulting Post Traumatic Stress Disorder (PTSD) that some of the well siblings end up with. Mentioned are the siblings' fears that they may catch the illness their brother or sister has, and the very real possibility that after their parents can no longer care for their sibling, that task will fall to them.

Also interviewed in the show are Diane Marsh who wrote Troubled Journey: Coming to Terms with the Mental Illness of a Sibling or Parent with co-author Rex Dickens, himself the brother of three mentally-ill siblings, Clea Simon, who wrote the memoir, Madhouse: Growing up with a Mentally Ill Brother and Sister, and Pamela Spiro Wagner and Carolyn Spiro, identical twins who co-authored Divided Minds: Twin Sisters and their Journey through Schizophrenia.

Read about it, or listen to the audio: A Burden to Be Well: Sisters and Brothers of the Mentally Ill.

More Information on Schizophrenia - Family impact



Thanks so much for this article and the refrences.My half brother was diagnosed as paranoid schizophrenia in 1989. He lived with our mother until her death in 2005.I moved him near me as my mother requested. He relapsed when he stopped his medication.I had to step away for the sake of my two small kids and my marriage.I am dealing with lots of guilt concerning not being able to follow my mom's last wishes.I hope to find some peace by reading some of the material listed.Again thanks so much.(I am an x nurse who is very interested in psy/counseling/mental health).

David Baxter PhD

Late Founder
The bottom line is that you cannot help someone who doesn't want help, at least until he becomes so decompensated that he meets the criteria for involuntary treatment or he commits some sort of crime.

It is unconscionable to me that we as a society have created this situation but that is simply the way things are at the moment.


You did the best you could, xnurse. I'm sure your mother would not have wished you to subjugate the well-being of your children because of a promise made to her. As Dr. Baxter said, it's just not possible to help one who will not help himself, or allow others to help him. It's a sad truth.


A warm welcome to you, xnurse!

It is very sad but there are times when we have to step back and place our loved ones in the hands of higher powers because there is nothing we can do otherwise. It is true that we have to put our own oxygen mask on first.

I have been there many, many times myself.

It is not completely hopeless though. We can as a group of people who have lived the experience and those who are our friends, make changes. When all seems lost we can become powerful advocates so that future generations will not suffer as we have. The Schizophrenia Society has been instrumental in changing mental health laws so that those who are too sick to recognize they are ill can get access to the treatment they need. Community Treatment Orders (CTO) were one of the major changes that took place with Brian's Law in Ontario in 2000.

The Schizophrenia Society and the Canadian Psychiatric Association were the only organizations to fight for and support CTO's. Every other organization wrote position papers opposing CTO's.

Aside form the difficult advocacy work of changing mental health laws there are other areas of need that can be supported and can make a difference in the lives of people with schizophrenia.

The future will be better.



Thank you so much for this post! I'm am the sibling of someone who has Multiple Sclerosis and doctors are now saying she had this even as a very young child. She tells me her previous diagnosis of Bipolar Disorder was retracted and docs are saying her issues with mental illness are all explained by her multiple sclerosis due to lesions in both her grey and white matter. I have no way of confirming if this is true or not, but it does make some sense.

I fought PTSD. One of the most difficult things for me was figuring out how to get people around me to understand that I need support and learning how to accept support. I was so used to pretending I didn't need any help because I wasn't allowed to have needs of my own. I've had to try to figure out what healthy boundaries are and I've had to put a lot of effort into not shouldering a disproportionate amount of blame, not only regarding my sibling, but in every relationship.
It is good someone is taking the time to examine the impact of children that are raised in a family of mental illness
How the child that is not ill is so easily overlooked their fears their emotions never examined
I do hope now the emphasis is helping the family as a whole not just the individual
I know that is not happening as often as one would like but it should be the way it works
The whole family is in need of support to keep them together as a unit.
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