When a brother or sister is struggling

Some siblings work hard to be no trouble at all. They hide bad grades, sad days or their own worries. From the outside they look fine. Inside, they may feel alone.

Siblings may cook, babysit, calm arguments or keep an eye on their brother or sister. Research describes siblings feeling they had to make up for the illness.

See the “Growing up too fast” guide for more.

Some siblings feel guilty, wondering if they caused the illness or could make it worse. Others feel guilty for being well. You did not cause your sibling’s struggles.

Siblings can end up carrying messages, keeping secrets or calming everyone down. It’s okay to step back and say, “I love you both, but I can’t be in the middle.”

Many siblings grieve the relationship they used to have, even though their brother or sister is still here. That grief is real, and it can come and go.

It’s common to wonder whether you’ll go through something similar. If this worry is on your mind, talk to a clinical provider or counsellor. They can help you understand your own health without guessing.

Siblings in research also describe positives, like more compassion, closer bonds and gratitude.

• Do low-pressure things together: a walk, a game, a show
• Send a meme or a memory, with no need to reply
• Text about everyday stuff, not just how they’re feeling

Stick up for them when others make hurtful comments. SAMHSA encourages people to help others understand the facts about mental health so they don’t discriminate.

Back up your parents’ or your sibling’s care plan, rather than taking sides in arguments. Offer one specific help, like a ride to an appointment.

If your sibling tells you they want to hurt themselves or someone else, tell a trusted adult or call or text 988. It isn’t betrayal. It’s care.

See the “Helping someone who may be suicidal” and “Supporting someone who self-harms” guides.

• “I’ve missed hanging out. Want to grab food this week?”
• “I’m not here to fix anything. I just want to know how you are.”
• “You don’t seem like yourself. I’m here if you want to talk.”

SAMHSA suggests letting someone know you care, asking questions and listening to their ideas.

Old sibling patterns can flare up fast. Use “I” statements (“I feel worried when you don’t answer”), and agree that either of you can pause and come back later.

Ask what helps on hard days, and what makes things worse. Some people want company; others want space and a quiet check-in.

Talk to a trusted adult, friend or counsellor about how you feel. You can say, “I know everyone is busy with my brother, but I need some help too.”

Keep doing the things you enjoy. Having your own life isn’t selfish. It helps you stay strong, and it shows your sibling that life goes on.

Research found that confusion about what was going on made things harder for siblings. Ask a parent or another adult to explain what your brother or sister is going through, in words that make sense to you.

• Ask how they are, and really listen
• Don’t make them a babysitter, messenger or secret-keeper
• Explain, at their level, what their sibling is going through
• Spend one-on-one time with each child

The 2023 review found that limited communication and confusion about mental illness added to siblings’ distress. Simple, honest explanations, repeated as children grow, help.

Siblings felt most vulnerable when an illness started and when it came back. Check in with your other children more during those times.

See the “When your child is struggling” guide for more on the whole family.

Decide what you can realistically offer, and what you can’t. Offering less, and keeping it up, is better than promising everything and burning out.

The “Sharing the load” worksheet in the “When someone in your family is struggling” guide can help.

NAMI suggests asking your loved one about a psychiatric advance directive: a legal document they write while well, saying what care they would want if they later become too unwell to decide.

With their permission, ask their providers to speak with you too, so you know the plan and who to contact.

NAMI warns against leaving all the caretaking to one person to “spare” others. If you have several siblings, share tasks based on what each person can manage.

NAMI Family Support Groups are for any adult whose loved one has symptoms of a mental health condition, including brothers and sisters. They are led by family members with lived experience, and many meet online.

NAMI Family-to-Family is a free, 8-session class for family members, and DBSA runs groups for friends and family of people living with depression or bipolar.

• Your sibling has hurt themselves, or you think they might
• Your sibling is violent, or someone at home is afraid
• Your sibling seems out of touch with reality
• Your sibling talks about death, suicide or not wanting to be here

• Immediate danger: 911
• Mental health or suicide crisis: call or text 988, any time
• Text support: text HOME to 741741
• Kids and teens who don’t feel safe at home: Childhelp, call or text 1-800-422-4453
• Support for family members: NAMI Family Caregiver HelpLine, 1-800-950-6264, press 4 (weekdays, 10 a.m. to 10 p.m. ET; not a crisis line)

findahelpline.com lists free, confidential helplines in many countries, including for young people. If anyone is in immediate danger, call your local emergency number.