When someone in your family is struggling

Siblings often grieve quietly and put their own needs second. The “When a brother or sister is struggling” guide covers your feelings, staying close and planning for the future.

For kids and teens with a struggling parent, adult children whose roles have flipped, and families supporting a grandparent, see the “When a parent or grandparent is struggling” guide.

For limits with understanding, parenting as a team, living with an adult child, and money and boundaries, see the “When your child is struggling” guide.

Chores, money, closeness and plans can all shift when a partner, or someone you’re dating, is struggling. The “When your partner is struggling” guide covers what helps, boundaries, intimacy and when it isn’t safe.

If your partner is struggling, agree together what you’ll tell their family. If an in-law is struggling, let your partner take the lead with their own parent or sibling, and offer to back them up.

Tips

• Ask your partner before sharing anything about them
• Present a united front if relatives criticise
• Offer practical help to an unwell in-law, without taking over

Some relatives say “there’s nothing wrong” or “they just need to try harder”. SAMHSA encourages people to help others understand the facts about mental health so they don’t discriminate.

What you can do

• Share one short, trusted article, not a lecture
• Focus on what they can do: “It would mean a lot if you just asked how she’s doing.”
• Accept that some people won’t change, and limit their influence

Before the event

• Ask your relative what would make it easier
• Agree a quiet room, a signal and an exit plan
• Keep visits shorter if needed
• Brief one or two trusted relatives so they can help

At the event

• Steer conversation away from diets, weight, drinking or “so what are you doing with your life?”
• Protect sleep and routines as much as possible
• Check in quietly, not in front of everyone

Family members often want updates. Ask your relative what they’re comfortable with others knowing, and stick to it. A simple line helps: “She’s having a hard time and getting support. She’d love a card.”

NIMH suggests families offer patience and encouragement, learn triggers, watch for big mood changes, and look after themselves too. A type of therapy called family-focused therapy, which works on relationships and communication at home, has been shown to help teens and adults.

Living together

• Protect regular sleep and routines for the whole household
• Agree early warning signs together, like sleeping much less or talking very fast
• Keep the home calm during a high; argue less, set limits more

Money

• When things are calm, agree a “money plan” for highs: spending limits, a cooling-off rule, or a trusted person to check big purchases
• Keep shared savings separate if that feels safer, and agree this together

Holidays & crisis plans

• Travel and late nights can disrupt sleep; plan rest days
• Write a crisis plan together and keep copies (see “A family crisis plan”)
• DBSA runs free support groups for friends and family

NIMH says loving someone with these experiences can be stressful, and that families can unintentionally make things harder. It suggests learning about it, offering validation and patience, encouraging family therapy, taking talk of self-harm seriously, and getting counselling for yourself from a different therapist.

Conflict at home

• Validate the feeling first (“I can see you’re really hurt”), then talk about the problem
• Lower your voice when theirs rises; take a break if you need to
• Keep the same limits every time; inconsistency fuels fear of being left
• Avoid labels like “manipulative” or “dramatic”

Money, holidays & crisis

• Agree money limits in a calm moment, not in the middle of a storm
• Plan holiday visits with breaks and an exit plan
• Have a written plan for self-harm or suicide threats, including 988

Family Connections is a free, evidence-based course from the BPD Alliance that teaches families validation, “observing limits” and handling intense moments.

NIMH suggests helping your relative get and stay in treatment, remembering that their experiences feel very real to them, and being kind without accepting dangerous behaviour. It also recommends family education programs and support groups.

A 2024 Cochrane review of 26 trials found that family programs may reduce relapse in the short term, probably reduce the strain on carers, and may help families move away from a critical, tense atmosphere at home. The evidence is still limited.

Living together

• Keep the home calm, predictable and low on criticism
• Speak simply, one thing at a time
• Don’t argue about voices or beliefs; acknowledge feelings instead
• Gently support sleep, meals and routines

Money, holidays & crisis

• Help with bills and benefits paperwork, with their agreement
• Keep gatherings small and quiet, with a place to step away
• Ask your relative about a psychiatric advance directive while they’re well

Some relatives have long-standing ways of relating that can feel controlling, suspicious, cold or self-centred. These patterns usually grow from temperament and life experience. You can’t change them, but you can change how you respond.

In family life

• Focus on specific behaviours, not labels (“You interrupted me,” not “You’re a narcissist”)
• Keep conversations short and to the point when things get heated
• Decide your limits ahead of time, and keep them
• Don’t share money or living space if it leads to control or harm

Holidays

• Plan shorter visits, with your own transport
• Bring a supportive person
• It’s okay to say no to some events

When someone at home is depressed, chores, plans and conversations can grind to a halt. NAMI suggests listening for the feeling behind hurtful words, letting your relative rest, and easing them back into routines gently.

Living together

• Share chores fairly and lower the bar for now
• Invite them to small things: a walk, a meal, a drive
• Don’t take withdrawal personally; it’s often part of the low mood

Money & holidays

• Help with bills and paperwork if they fall behind
• Holidays can deepen low mood; keep plans small and flexible

Finding out a family member self-harms can be frightening. Your calm, caring response matters more than having the right words. Focus on the feelings behind it, not just the injury.

At home

• Keep a basic first-aid kit and know when to seek medical care
• Talk with their therapist about making the home safer, without “searching” in ways that break trust
• Make sure brothers and sisters have someone to talk to as well
• Avoid punishments or ultimatums

Family therapy helps family members understand each other, communicate better and support someone’s treatment. It is often led by a licensed marriage and family therapist, and can include parents, children, siblings, grandparents, other relatives and close friends.

When a mental health condition is involved, therapy usually includes teaching the family about the condition and its treatment. Short-term family therapy is often around 12 sessions; longer work is possible for ongoing needs.

NAMI Family-to-Family is a free, 8-session class for family, significant others and friends of people with mental health conditions. NAMI describes it as evidence-based: research shows it improves the coping and problem-solving of the people closest to someone with a mental health condition.

It’s also available in Spanish (De Familia a Familia de NAMI). Classes are run by local NAMI affiliates, so dates vary.

These groups are for any adult whose loved one has experienced symptoms of a mental health condition. They are led by family members with lived experience, last 60 to 90 minutes, and meet weekly, every other week or monthly, depending on location.

NAMI Basics is a free education program for parents and caregivers of young people aged 22 and under who are experiencing mental health symptoms. It is taught by trained parents with similar experience, in person or online, and there is a self-paced OnDemand version available 24/7.

Family Connections is a free, evidence-based program for families of people with borderline personality or chronic emotional ups and downs. It teaches skills based on DBT: validation, observing limits, handling intense moments, problem-solving and self-care.

It runs mainly on Zoom, in formats such as 12 weekly two-hour classes. Groups are led by trained leaders and peers with lived experience.

The Depression and Bipolar Support Alliance offers groups for friends and family of someone living with depression or bipolar. It also runs free weekly 90-minute online groups for parents and caregivers, split by the age of their child, plus a group for families with a recent diagnosis.

This free, confidential line offers caregiver-led support, tools and guidance at every stage. Call 1-800-950-6264 and press 4, Monday to Friday, 10 a.m. to 10 p.m. Eastern Time.

You might resent reminding your partner about appointments, then feel guilty. NAMI says this kind of guilt is untrue and unhelpful. Noticing feelings without judging them lowers stress and helps you choose how to act.

DBSA lists feelings many families have: helpless, overwhelmed, hurt, angry, guilty, ashamed, sad and scared. All of them are normal.

NAMI suggests working old enjoyable activities back into your life, like a standing monthly lunch with friends. Widening your support network also takes pressure off your relative, and may reduce resentment on both sides.

Basics that help

• Move your body most days
• Protect your sleep
• Try slow breathing or relaxation when conflict flares
• Write down one good thing each day, however small

NAMI says the idea that you should be able to solve everything by yourself is false. Support groups, a counsellor of your own, and the NAMI Family Caregiver HelpLine are all there for you.

Ask for specific help: a meal on Thursday, a ride to an appointment, someone to sit with your relative while you rest. A shared calendar or group chat turns “let me know if you need anything” into real support.

For more on caregiver burnout and respite, see the “Caregiver stress & burnout” and “Caring for yourself as a long-term carer” guides.

Call 911 if

• A life is in danger right now
• Someone has been seriously hurt
• Someone is violent or threatening violence

For a mental health or suicide crisis, call or text 988, any time. You can call for advice about a family member, too. Ask whether a mobile crisis team can come out where you live.

If the early warning signs you agreed on are showing, act sooner rather than later. Call their therapist or provider (with their permission, or simply to share what you’re noticing), and go over your family crisis plan together.

The NAMI Family Caregiver HelpLine connects you with a trained volunteer who has cared for a loved one too: call 1-800-950-6264 and press 4, Monday to Friday, 10 a.m. to 10 p.m. Eastern Time. It is not a crisis line.

NAMI Family Support Groups and Family-to-Family classes, DBSA family groups and the BPD Alliance’s Family Connections are all free. See “Family therapy & programs” above.

• Abuse of an older adult: Eldercare Locator, 1-800-677-1116, can connect you to Adult Protective Services
• Child abuse worries: Childhelp, call or text 1-800-422-4453 (24/7)
• Domestic violence: National Domestic Violence Hotline, 1-800-799-7233 (24/7)
• Teens and young adults in relationships: love is respect, 1-866-331-9474 or text LOVEIS to 22522

findahelpline.com lists free, confidential helplines in many countries, searchable by country and topic, including support for family members. If anyone is in immediate danger, call your local emergency number.