Creating Room to Thrive

Supporting Siblings of Teens with Mental Health Issues

Apr 13, 2025

When one child's mental health challenges reshape your family, how do you help all your children thrive?

Last week, we walked through the toll of mental health challenges on siblings, and considered ways to support these often overlooked family members. We talked about supporting siblings through focused parental attention and by providing space for them to express emotions. Today, I want to talk about two other important pieces: educating siblings about health challenges and supporting siblings to engage in their own pursuits.

Isaiah’s Challenge: Growing Up with a Neurodiverse Brother

After my friend Esther shared her son Ben’s story of navigating ADHD, a sensory-processing disorder, crippling anxiety and more, I wanted to explore a missing piece. I wanted to hear more about her older son, Isaiah. Ben’s frequent meltdowns became part of the landscape of Isaiah’s childhood, which left its own scars.

Esther said, “Growing up with [Ben’s outbursts] was really hard for Isaiah. The boys used to be closer when they were younger, but the more the meltdowns happened, they grew farther apart.”

This is how I imagine Isaiah as a kid during one of Ben’s meltdowns - trying to find some peace and quiet.

When Ben and Isaiah were young, Esther used methods from the book The Connected Child, which talks about the impact of trauma on adopted kids and offers ways to bond with a child. Esther and her husband, James, learned that discipline wouldn’t help Ben during his anxiety-driven outbursts; rather, they learned to help Ben regulate his brain to calm down.

Even though these methods soothed Ben, it was hard for Isaiah to understand his parents’ reasoning. Esther said, “When Ben had a meltdown, we would give him a massage or put him in the bathtub, or just do something to connect with him. Sometimes we gave him a smoothie, because cold exposure helps anxiety.1 So Isaiah watched this, and he’d be like, ‘Okay, he’s having a meltdown and he’s getting rewarded for it.’ That was his perception. I think that caused a lot of resentment.”

When the boys moved into adolescence, the gap between them grew. As Ben struggled in the transition to high school, his outbursts multiplied.

Isaiah, a junior, felt embarrassed by his freshman brother’s explosions, especially when his friends witnessed them. “Isaiah was like, ‘What’s your problem? You’re in high school, dude,’” says Esther.

Two years later, as Ben has matured and learned more tools for self-regulation, the brothers’ relationship has improved. But Esther still senses the distance between them.

Educating Teens About Mental Health

I asked Esther what she did as a parent to support Isaiah in the wake of Ben’s challenges.

First, Esther and James worked to help Isaiah understand that Ben's behavior wasn't attention-seeking. They explained that his brother's episodes were actually symptoms of complex neurological conditions and mental health challenges that Ben couldn't control.

Esther says, “Ben probably had more trauma because he was in an orphanage and got less one-on-one attention when he was a baby. I explained to Isaiah, as simply as I could, that Ben’s neurological pathways kept getting flooded. I wanted him to see the connection. After those conversations, I know Isaiah understood it a bit more. We tried to affirm his feelings that this was hard.”

There’s a beautiful scene in Harriet Brown’s memoir, Brave Girl Eating, where she has a conversation with her daughter Emma about her older daughter Kitty’s eating disorder. It’s one in which they talk openly about anorexia in a way that ten-year-old Emma can understand, and also subtly addresses Emma’s concerns.

“Emma’s room is dark and quiet, with two closed doors between her and Kitty’s radiating misery. Yet I know Emma is hyperconscious of the drama playing out across the hall. I sit beside her on the bed, as I’ve done every night since she was a toddler. This is our talking time, in the dark, just the two of us. I want to help her process what’s happening, but I don’t want to make everything revolve around Kitty. So I try to follow her lead.

Tonight she wants to talk about anorexia. ‘Is Kitty going to get better?’ she asks.
‘Yes,’ I promise, hoping it’s true.
‘Are you taking care of her?’

Will you take care of me? That’s what I hear in Emma’s anxious question. ‘Always and forever,’ I say.
We sit quietly for a few minutes. Then Emma says, ‘I can see the anorexia in my mind. It’s like a cartoon person, but it’s not funny.’
‘No,’ I say. ‘It’s not funny.’
‘It’s wearing all black and has spiky hair.’

“Blond hair, like Kitty?’
‘No, dark hair,’ she says. And suddenly I can picture it too, faceless. A walking black hole that sucks everything into its open, aching mouth. Including a lot of Emma’s life” (Brown 149-150).

As we provide spaces to have honest conversations about mental health, we help our teens process their sibling’s symptomatic behavior. We also want to emphasize to our children that their sibling’s health challenges are not their fault nor their responsibility to fix. By normalizing discussions about mental health conditions, just as we would talk about physical illnesses, we release our family from unnecessary shame. Sometimes those conversations come naturally. Sometimes we may rely on a therapist, a wise friend, or a book for guidance. I recommend this helpful article from Social Work Today for more ideas.

Supporting Teens in Finding Outside Interests

Sometimes when parents care for teens with health challenges, we may find it harder to help other children in the home pursue sports and hobbies. We probably have limited emotional capacity and energy after supporting our struggling teen. We may face financial constraints from therapy and treatment costs. Leaving our teen unsupervised might feel risky. Logistically, it might be impossible to coordinate chauffeur duties to therapy and doctors, along with baseball games and piano lessons.

Yet when we actively encourage siblings to pursue activities beyond our home’s walls, we give them vital space to grow and thrive in their own right. When siblings engage in hobbies, they find an outlet for stress and anxiety, a way to disconnect from the daily challenges associated with their sibling’s mental health issues. Whether it’s sports, music, clubs, or crafts, these activities provide a space for self-expression, identity development, and a sense of accomplishment. Learning new skills and achieving goals leads to improved self-esteem and confidence. It also provides a way for siblings to bond with peers and adults outside the home.

Sports, Faith, and Selling Shoes

As Isaiah grew, Esther eagerly looked for opportunities to help him succeed, regardless of Ben’s challenges. She and her husband encouraged Isaiah’s interest in baseball and basketball, signing him up for local leagues and cheering him on at his games. James also took Isaiah to watch professional games.

When Isaiah didn’t connect with teens at their church youth group, Esther took action. She found a youth group at another church which fit Isaiah better. When Isaiah was fourteen, Esther found a weeklong Christian sports camp for him and invited a close family friend, so Isaiah wouldn’t have to go alone. Both experiences gave Isaiah a place, apart from his family, to explore his beliefs, develop new friendships, and broaden his horizons.

Esther also noticed Isaiah’s entrepreneur tendencies and created opportunities for him. “Later in high school, Isaiah built up a shoe business. He bought shoes at thrift stores and sold them on eBay. A few years earlier, I thought he’d like that kind of thing, so I took him and his friend to their first event, called SneakerCon. It’s a big conference where people have booths and sell sneakers, they buy and trade shoes. That’s where Isaiah’s interest first developed.”

Today, Isaiah is a freshman in college, pursuing a business major and playing basketball informally. Esther feels that she and James have a healthy, close relationship with Isaiah. She also thinks that the shift of Isaiah living away from home has helped improve his relationship with his brother.

Not all of us are as gifted as Esther in supporting our teen’s interests in such active, creative ways. I know I feel intimidated by her abilities! But I also appreciate her modeling of what’s possible.

Conclusion

When mental health challenges affect one teen, siblings often become the overlooked members of the family. But there is hope; we can help these kids thrive, despite our family’s challenges. Like Esther and James, we can teach our kids about mental health conditions while also helping them invest in outside interests. By helping them understand their sibling’s behavior as symptoms rather than choices, we reduce resentment. By supporting their involvement in activities outside the home, we help our kids discover places that bring joy. As we give siblings space to express their emotions, they have room to breathe.

None of this is easy: many of us are already stretched thin. Each family will find unique ways to put these principles into action. As each family member develops healthier ways to cope with a loved one’s mental health challenges, our families become stronger together.