There’s a version of the sibling experience that doesn’t get talked about enough.
Not the general “it was complicated growing up” version. The one where your sibling had significant behavioral challenges — meltdowns, aggression, self-injury — or serious medical needs that meant hospitalizations, crisis calls, and a household that was always one bad day away from falling apart.
If that’s the family you grew up in, this one is for you.
The research on siblings of individuals with high needs is not ambiguous. A 2019 population-level study found that siblings of children with developmental disabilities have significantly higher odds of being diagnosed with depression or another mental health condition compared to siblings in families without a disability. A large 2022 systematic review that looked at 81 studies found consistent evidence of more anxiety, more depression, lower self-worth, poorer social adjustment — and in some cases even higher mortality rates — in siblings compared to their peers.
Let that sink in for a second. This is not anecdotal. This is not us being dramatic. The data has been there for years.
I’ve written before about what I call unintentional neglect — the idea that siblings of kids with disabilities can develop the same symptoms as children who experienced neglect, even though no one meant for it to happen and no one is at fault. Parents weren’t withholding. They were overwhelmed. The needs in the room were just louder than anyone realized.
That chronic low-grade stress — the kind that comes from living in a home where things can escalate quickly, where a good day can turn without warning, where you learned to read the room before you learned to read — leaves a mark. Even when you love your sibling deeply. Even when things are better now. Even when you’d never trade them.
The mark is still there.
Here’s what I hear most often from siblings who grew up in high-needs households:
“I didn’t realize I was anxious. I thought I was just prepared.”
“I’m exhausted in relationships because I’m always waiting for something to go wrong.”
“I feel guilty even being in therapy. Like, nothing happened to me. I wasn’t the one who was sick.”
That last one breaks my heart every time. Because something did happen to you. It happened slowly and quietly and without anyone meaning for it to, but it happened. And you are allowed — you are more than allowed — to get support for it.
Research backs up what so many of us felt but couldn’t name: guilt is one of the most commonly reported experiences in siblings of people with disabilities. More than 50% of siblings in one study reported high levels of depressive symptoms, a poor sibling relationship quality, and low overall wellbeing. You are not alone in this. You are not making it up. And you are not weak for struggling.
For siblings with medically complex brothers or sisters, there’s an additional layer that often goes unacknowledged: grief that doesn’t have a clear name.
You may have watched your sibling go through things no child should go through. You may have spent time in hospital waiting rooms learning how to disappear into the background. You may have had a parent whose attention and emotional bandwidth was consumed by medical needs, not because they didn’t love you, but because the situation demanded it.
Research on siblings of children with chronic illness confirms this too — they report higher emotional, behavioral, and social problems than siblings in families without chronic illness. And yet they are almost never the ones being asked how they’re doing.
You adapted. You became self-sufficient. You stopped asking.
And now you’re an adult who is very good at not asking.
For siblings whose brothers or sisters had significant behavioral challenges — aggression, self-injury, explosive meltdowns — there’s something else that needs to be said plainly:
Being hurt, frightened, or traumatized by a sibling’s behavior is not something to be ashamed of. It is not a betrayal of your sibling. It is not evidence that you don’t love them.
It is a thing that happened. And it deserves space to be processed — with a therapist, in a sibling support group, or both — without guilt, without minimizing, and without anyone telling you that your sibling didn’t mean it so it doesn’t count.
It counts.
Mental Health Awareness Month is a good time to ask yourself honestly: Have I actually dealt with this? Or have I just gotten very good at functioning around it?
Functioning is not the same as healed. Coping is not the same as being supported.
If the idea of unintentional neglect resonated with you when I first wrote about it — or if you’re reading it for the first time — I’d encourage you to sit with it. Not to assign blame. But to permit yourself to name what your childhood actually felt like, not just what you’ve always told yourself it was.
If you’ve been carrying this for a long time and you’ve never had a space that was just for you — not for your family, not to process your sibling’s needs, but genuinely just for you — please consider finding one.
Some places to start: a therapist who has experience with family systems or caregiving dynamics. A Sibshop or adult sibling support group. This community, which is full of people who will not need you to explain the backstory.
You spent years making room for everyone else’s needs. There is room for yours, too.
Cheryl Albright, OTR/L, C-IAYT
Cheryl Albright is an occupational therapist, yoga therapist, and founder of SpecialSib.com and Soul To Soul Yoga. She has spent over 20 years working with children, families, and the siblings who often get overlooked.
