Frequently Asked Questions and Answers - From Sons/Daughters

Common Questions from People who's Parents have schizophrenia

The following are questions commonly posted on our discussion boards, along with answers and advice from responding members. In many cases, member answers have been expanded on from other sources, and relevant links have been addedfor more information. These answers are meant only as a helpful guide and a resource for further information; each individual situation is unique and may need a tailored solution. Your relative's treating psychiatrist is always a good person to ask when you have specific questions pertaining to your own case.

If you don't find what you're looking for here, please visit the Schizophrenia Offspring Discussion Board (see the righthand menu column on the homepage ) and post your question. Our members are usually very generous with their advice and support. The questions in this FAQ section are geared mainly towards older teenage and adult offspring; however, there is a special subsection in the Offspring Discussion Boards for adolescents.

Index of Questions

My mother/father is becoming more paranoid and acting odd - is this schizophrenia? Could it be something else?
What are my chances of inheriting schizophrenia from my parent? What are the chances that I could pass it on to my own children?
Do children of parents with schizophrenia have a higher incidence of other, related psychiatric conditions?
What common issues/concerns do children of parents with schizophrenia deal with, and how do they cope?
I am a student/I have a full-time job/I live far away. How can I make sure my parent is taking care of themselves?
What if my parent wants to come live with me?
Deciding to obtain guardianship or power of attorney
Is my parent eligible for disability aid or health insurance?
How can I help a parent (or older family member) who's depressed?
Living with a mentally ill parent is affecting my own thoughts - I have to remind myself who's delusional! Is this common?
How do I explain to my children about Grandma/Grandpa's illness? Should I keep them from visiting?

My mother/father is becoming more paranoid and acting odd - is this schizophrenia? Could it be something else?

Depending on your parent's age, odd, paranoid, or even psychotic behavior could be a sign of a type of dementia. According to Geriatric Consultant Resources, psychotic or behavioral disturbances in the elderly population is most often associated with dementia, with Alzheimer's disease accounting for more than 60% of psychotic symptoms in the elderly. Normally, schizophrenia is diagnosed when the patient is in their late teens or twenties. Late-onset schizophrenia (diagnosis after age 40 or so) is more uncommon, and seems to be slightly more predominant in females of this age group. Research indicates that out of all patients hospitalized for schizophrenia, 13% have onset of symptoms in their 50s, 7% in their 60s, and 3% in their 70s or later.

For specific information on late-onset schizophrenia and other forms of dementia/psychosis, see the following online audio/video presentations:

1. Schizophrenia and Aging (NPR)
2. Schizophrenia in Late Life: What is New and What is Old? (UCLA grand rounds)
3. Schizophrenia and Aging: Myths and Reality (U. Chicago grand rounds)

See the General FAQ guide - symptoms and diagosis section for more information on how schizophrenia is recognized and diagnosed. However, regardless of the cause, symptoms that are debilitating to the person should be evaluated. Talk to a doctor, explain the situation and the symptoms ahead of time, and encourage your parent to make an appointment. If your parent doesn't want to see a doctor (a common problem for family members of the mentally ill) and you are still concerned about their behavior, see 'What if my family member refuses to see a doctor' for ideas.

If you do eventually receive a diagnosis of schizophrenia, see 'What to do after receiving a diagnosis - how you can help' for ideas and support.

What are my chances of inheriting schizophrenia from my parent? What are the chances that I could pass it on to my own children? What are my risks of getting schizophrenia if a family member or relative has schizophrenia?

As author Victoria Secunda points out by quoting the following "High-Risk" study in her book When Madness Comes Home, " individual's chances of succumbing to psychopathology or maladjustment are influenced by the patterns of the individual's life...The fact that someone has a schizophrenic parent implies nothing necessarily about that individual beyond the fact that he or she has a schizophrenic parent." (p. 209). While this may be true, it is also true that Population statistics on the heredity of schizophrenia estimate that a child with one diagnosed parent has about a 10% genetic risk of developing the disease themselves (this is compared to a 1% risk in the general population). The risk goes up significantly if a grandparent (or other close relatives) also has schizophrenia. (E.F. Torry, 1996).

(Image Source: Debby Tsuang, M.D., M.Sc., University of Washington/VAPSHCS, Special thanks to Dr. Kristin Cadenhead, UCSD)


Genetic inheritance is only one of the many factors (both biological and environmental) that contribute to the cause of schizophrenia. Moreover, research indicates that the inheritance of such a complex disorder likely involves a number of genes, some of which we may not know about yet. You may have inherited an increased predisposition to schizophrenia (or a related disorder) from your parent; however, not everyone who carries such a predisposition will develop the symptoms. In many cases, living in what is considered a "low-risk" environment for developing mental health problems is protective for those with either high orlow genetic risk.

For more information on the genetics of schizophrenia, as well as the environmental factors involved with schizophrenia and the steps you can take to lower your own and your children's risk of developing schizophrenia or another psychiatric disorder, see Causes of schizophrenia and Schizophrenia Prevention Strategies.


Do children of parents with schizophrenia have a higher incidence of other, related psychiatric conditions?

Since schizophrenia seems to involve multiple genes, it's certainly possible to inherit only some of them and be affected in a different way. Other conditions such as depression, panic disorder, Asperger's or Autism, or even extraordinarily low self esteem seem to be common among children of parents with schizophrenia. This could be related to genetic inheritance, the general stress of being a primary caregiver to a mentally ill parent, or a combination of factors.

Some children also exhibit symptoms of Post Traumatic Stress Disorder (PTSD), the result of, as one member put it, "growing up in a war zone with no training, no army behind us, [and] no rules."

It's very important for children of mentally ill parents, whether they are formally diagnosed with a disorder or not, to get support for their own difficult situations. Many children of schizophrenic parents on our boards have indicated that support groups or individual therapy has been extremely important in their own lives. Learn more about Schizophrenia Prevention Strategies.

What common issues/concerns do children of parents with schizophrenia deal with, and how do they cope?

All of these children, whether young or old, naturally have strong feelings surrounding their parent, their childhood, and the disease, that affect them in a variety of ways throughout their own lives. Many will choose (or have chosen) various defense mechanisms to help them cope with their unique situations, including self-involvment (i.e. self blame), dispacing anger or grief, denial, and defensive exclusion (emotional detachment or distancing). These protective efforts can eventually lead to long-term emotional patterns such as "anxious and ambivalent" attachments, "compulsive caregiving," or avoidance of all "affectional ties." (paraphrased from When Madness Comes Home by Victoria Secunda, p. 52).

Some of the common issues raised by offspring on our discussion boards include:

1. Boundaries: When you grow up with a parent who invades every aspect of your life in unpredictable and sometimes dangerous ways, you can't learn when to say no, when to back off of other people, etc.

2. Loyalty issues: Often times, especially when the parent is paranoid, the kid is repeatedly put in a situation where they need to "prove" that they aren't part of the "bad guys." This is part of the boundary issue - It's a tricky thing, trying to keep your sanity while trying to placate an insane person when you're a kid.

3. Social skills: A lot of us on this board have some difficulty once we hit adulthood with knowing who and how to open up to people, or how to trust our instincts about situations, and in general, how to negotiate around "normal" people. [We] were shut off from the rest of the world because of our parents, both physically and psychologically.

4. Life skills: If kids are still living with their ill parent, they often won't learn basic skills such as how to clean a house, cook, or pay bills..

5. Anger/Depression/Stress management: We offspring are often very depressed well into adulthood. Many have personal counselors/therapists, are involved in a peer counseling support group, or take medication for depressive, anxiety/mood disorders.

6. Guilt management: [Offspring] are especially prone to feeling a lot of guilt about everything. Many go through a phase of blaming themselves for the parent's illness. Almost all feel guilty for not doing enough (or doing too much) for the parent, other siblings, or the rest of the family.

7. Fear: Fear of becoming like the ill parent, or fear of becoming ill themselves has actually changed the trajectory of many children's lives. They delay having children for fear of "passing it on." They delay marriage because of not wanting kids, or not wanting to hurt a loved one by becoming mentally ill in the future. Often these children deal with a huge amount of self-criticism.

8. Attachment issues: may avoid attachments, or may become involved in overly-needy or abusive attachments.

9. Forgiveness: is often confused with acceptance. Acceptance of a parent's mental illness is an important step for self-healing and recovery; however, it is not required that you forgive your parent to reach that acceptance.

According to author Victoria Secunda, the offspring of mentally ill parents fare the best when they have several sources of support: supportive relationships with a well parent, relative, or friend, support from mental health care systems and professionals, and support from the legal system. "The hope...rests on the ability of well members of the family, in partnership with outside resources, to both contain the damage of a sever brain disturbance and to prevent the conditions that might evoke it in the next generation." (Secunda, When Madness Comes Home, p. 62).

Depending on your personal situation and/or feelings, you may or may not want to stay in contact with your parent after you become independent. That decision must be made by you and for your own best interests; however, counseling or support groups may help you deal with some inevitable guilt, frustration, or uncertainty about the decision. Author Victoria Secunda indicates that 79% percent of offspring and 74% of siblings of mentally ill patients out of those she interviewed for her book were or had been been in therapy. "Virtually all of them say that it has transformed them. Through therapy, they have restored their faith in themselves and in others, and have regained a sense of control over their lives." (Secunda, When Madness Comes Home, p. 282). has many excellent books, both reference and memoirs, for family members of schizophrenia patients. These books come recommended by others who have firsthand experience in dealing with mental illness. We also have links to over a 100 different internet -based videos and audio files - some of which deal with these issues.

I am a student/I have a full-time job/I live far away. How can I make sure my parent is taking care of themselves?

This is a concern that many adult offspring face as they start lives and families of their own, and their ill parent is still unable to be completely independent. The situation - and the solution - will be different depending on if your parent is in treatment, is medication-compliant, is living independently or in a group home/treatment center, is financially independent, etc. The following are some solutions used by members of to deal with their own situations - they may be helpful to you, or you may find a resource for advice/information.

1) If your parent is living independently and you are concerned for them, look into hiring a part-time home aid. Such a person can come to your parent's house for a few hours every day to check in, make sure medications are taken, help with errands and around the house, and just generally visit. Your parent's insurance may cover home help.

2) If you have other siblings or your parent has close family still living, try and share the responsibility with a larger group of people. Everyone pitching in a little goes a long ways, and someone might live closer or be better equipped to give care than you are right now.

3) Explore ways to simplify your parent's treatment regimen, such as using compartamentalized pill containers, automated pill-notification systems, or switching to long-acting injectable medications. Many schizophrenia patients are far more able to care for themselves and live independently if they consistently take their medication. If you're concerned that your parent is refusing to take their medication or cooperate with their treatment, see the General FAQ section on treatment issues for ideas.

4) Appoint a lawyer or another conservator to handle finances and make sure the bills are paid.

5) Contact a local support group or mental health center, and ask what resources are available in your parent's area.

What if my parent wants to come live with me?

Even though many children feel obligated to help their ill parent or guilty about not taking on the responsibility, most are neither prepared nor equipped to accept a mentally ill parent into their homes, particularly if they have a job and a family of their own. It's most important that the patient stay in treatment, and if you cannot ensure that in your house, then taking them in helps no one. Your first obligation must be to yourself (your own mental and physical health and well-being) and to your children, if you have any.

In many situations, the best thing for everyone involved is to find the ill parent another place to live. Research treatment centers, halfway houses, group homes, or a live-in home/nursing aide. Below are some resources to get you started:

1) National Mental Health Association's list of Federal programs providing housing aid for people with disabilities to live independently in the community.
2) The Fountain House is the original Clubhouse for the mentally ill, founded in New York and now with 250 centers in 43 states. Fountain House has programs for housing, education, outreach, advocacy, and social/recreational activities.
3) International directory of clubhouses.
4) Your local NAMI chapter or support group may have some useful resources in your area. Look also to see if there is an Assertive Community Treatment program in your area
5)Contact local Public Housing Authorities (you can find them listed under county/city offices in the gov pages of the phone book - may not be under exactly that name) - they are responsible for allocating Federal funds for low-cost and subsidized housing. They will know what is available in your area.

See General FAQ - housing concerns for a further description of what options are available. members who have gone through the experience of finding appropriate housing for an ill loved one recommend finding a support group or a counselor to talk over your options and your own emotions about the situation. It's a terribly draining experience, and speaking to others who have had to deal with similar situations can be an excellent support.

Deciding to obtain guardianship or power of attorney:

If the illness is severely debilitating, some children consider obtaining guardianship, conservatorship, or power of attorney over their mother or father. Depending on what kind of legal standing you obtain, it can assign you the right to manage your parent's financial affairs and assets, and/or make treatment decisions on their behalf. Below are descriptions of the different types of legal guardianship one can have over a disabled adult:

Guardianship: May be considered in situations where an individual becomes incapacitated due to their mental or physical condition. In situations where an individual has become so incapacitated and unable to make sound decisions that they are facing either a prolonged or serious risk, it may be necessary to consider seeking guardianship. Persons must prove that they cannot care for themselves and need someone to look after their best interest. The process is extensive and requires the approval of a court. Guardianship is an involuntary protection imposed by the probate court only when necessary to protect a vulnerable person from harm, and only when other options such as a power of attorney or representative payeeship are not possible.

Durable Power of Attorney for Health Care: Allows the older adult to direct whether or not life sustaining treatment should be given; also allows the older adult to name a trusted person (agent) to make medical decisions.

Financial Power of Attorney: Allows an adult to appoint someone they trust to pay bills; cash or deposit checks; deal with insurance; take care of other financial matters as needed. It is highly recommended that people see an attorney for this process. State law requires specific language in order for the power of attorney to be legally effective.

Representative Payeeship: A representative payee can be assigned to manage social security benefits on behalf of an individual if he/she is unable to manage the monthly check. A payee can be an identified family member or caregiver. A document must be filed with the Social Security Administration that states why the person needs a representative payee. This is an involuntary process imposed by Social Security when necessary to protect the recipient. Social Security will decide based on medical information whether payeeship is necessary.

Be aware that guardianship, depending on your state and situation, may or may not give you the what you're looking for; in other words, it may make your situation harder instead of easier. It gives you legal and financial power, but does not really give you any more control over your parent than you ever had. As one member put it, "I have never found a way to force an adult to do anything they don't want to do, even with rational adults, And schizophrenics are not rational." You might be setting yourself up for a long haul of frustration and burden. See Assisted treatment options for ideas on what to do if your parent is not treatment compliant - there are other things to try before obtaining the lifelong post of legal guardian.

An Advanced Psychiatric Directive is also an option to discuss during times when the ill person is in control and in a reasonable frame of mind. This legal document allows the person with the illness to dictate what actions should be taken on their behalf (including appointing another person to make treatment decisions) if they should become unable to make decisions for their own well-being. Bear in mind that Advance Directives are not appropriate for all, or maybe even the majority, of people with schizophrenia. In order for a Directive to be an empowering rather than a coercive tool, the person who prepares the document for themselves must have the skills and the social support to make beneficial decisions. For more information, and for downloadable documents to help prepare an AD, see the Advanced Psychiatric Directives section of the Bazelon Mental Health Law Website.

If you decide that obtaining legal power over your parent is the best course of action, check with the psychiatrist and/or social workers at the hospital to find out what the procedure in your area is, or look up individual state laws online.

Is my parent eligible for disability aid or health insurance?

See General FAQ - Practical Matters for a description of available federal funding, aid, and health insurance programs for the disabled, the low-income, or the elderly. (Source: Mental Health, Mental Illness, Healthy Aging, a guidebook from the New Hampshire chapter of NAMI)

How can I help a parent (or older family member) who's depressed?

Depression is not uncommon in the elderly, particularly those who have outlived many of their family and friends, or who have moved away from their homes or familiar places. Schizophrenia patients may be especially likely to suffer from depression. Many take antidepressants along with antipsychotic medication, or attend additional counseling/support groups, to help manage these symptoms.

NAMI recommends the following steps to help the elderly with depression. You can help your family member:

  • Maintain spiritual customs, social customs, old relationships, and family connections
  • Develop new relationships (through clubs, church functions, nursing home, senior day centers, etc)
  • Tend to grandchildren or other young children in the family
  • Explore civic and community activities (clubs, community centers, day programs, churches, etc)
  • Volunteer in the community (this is especially helpful for a lot of schizophrenia patients; it is a good use of special skills or talents, and keeps them feeling active and productive).

See Managing Depression on the website for more information on recognizing and coping with depression.

Living with a mentally ill parent is affecting my own thoughts - I have to remind myself who's delusional! Is this common?

Many children living with schizophrenic parents do find themselves "questioning their own sanity", largely because the paranoia and hallucinations of the parent are so integrated into their normal daily life. This does NOT necessarily mean that you have schizophrenia (see 'How Can I Tell If Someone Has Schizophrenia'), especially if you are able to distinguish between the real thoughts and the delusional ones.

Talking to a therapist, counselor, or peer support group can give you a good reality check, and relieve some of your daily stress burden. It's important for someone to care for the caregiver.

How do I explain to my children about Grandma/Grandpa's illness? Should I keep them from visiting?

Your individual decision will depend on whether you still have contact with your parent, and if you do, how severe their symptoms are. If you decide to tell your child, base the amount you share on his/her maturity, stability, and ability to understand. Answer any questions they have as honestly as you can.

There are a few books about mental illness that are written specifically for children. View these books and their reviews at

Making a decision about visiting is something that most every adult who has a relative with schizophrenia must face, and it's a hard one for all of them. Many on the discussion boards have made the decision that their own children and family comes first, and have cut off communication with the ill relative to protect the children from unnecessary emotional or physical harm. Some families bring their children for very short, very supervised visits once they are older and can understand why the illness makes people act the way they do.

Here are some sentences to open a discussion with your children. They are based off of things that children of schizophrenic parents on our discussion boards wish someone had told them.

"Your [grandmother/grandfather] has an illness called schizophrenia. It makes it hard for her/him to think straight, and so they act very oddly sometimes [examples of times the child has experienced or heard about]."

"Remember that what you're seeing is symptoms of an illness. We're all doing our best to help her/him get well, but this is a very serious illness and hard to treat.

"Right now there is no cure for this illness. We really really really hope there will be a cure someday, but right now there is none."





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