Recognizing When a Family Relationship is Harming Your Mental Health

I was watching the show Long Bright River this weekend. The show is about a Philadelphia police officer who has a sister who struggles with addiction. She shares with a friend that 25% of her brain has always been focused on crisis. When her sister is using, she’s afraid she will die. When her sister isn’t using, she’s afraid she will relapse. She has no idea what it’s like not to be worried about the health of her sister or an impending crisis. This is what it’s like to love someone who has a serious, persistent mental illness or addiction. You can detach with love, set boundaries, and find a way to help within your limits, but that worry is always there, simmering under the surface.

In every one of our groups this month, someone has brought up the constant tension between empathy and accountability. They’ve wrestled with finding ways to help and identifying when that help has become too painful. It’s so challenging to recognize when a family relationship is harming your mental health. It’s even more complicated when that family member is sick or struggling. You may ask yourself, “Am I a bad person if I stop helping them?”

This article will help you:

• Identify when a family relationship is negatively impacting your mental health
• Understand the consequences of these relationships
• Decide what to do when the relationship is taking a toll on you
• Release the guilt of being unable to sustain a relationship that is harming you (even if it’s family)

Signs That a Family Relationship Is Hurting Your Mental Health

It’s hard to admit when a family relationship is hurting your mental health. Abusive or harmful family relationships can be even more detrimental to your health than a toxic friendship or romantic relationship. Here are some signs the family relationship is hurting your mental health:

• Feeling constantly anxious, guilty, or drained after interactions.
• Dreading phone calls, visits, or text messages.
• Feeling like you have to "walk on eggshells" around them.
• They minimize or dismiss your emotions and experiences.
• They react with anger or defensiveness when you set boundaries.
• You feel unseen, unheard, or emotionally neglected.
• Guilt-tripping, gaslighting, or emotional blackmail.
• Using financial, emotional, or social pressure to control you.
• Passive-aggressive comments or unpredictable mood swings.
• Constant criticism, belittling, or comparisons to others.
• You feel like you’re never "good enough" around them.
• They undermine your confidence in making your own decisions.
• Feeling responsible for their emotions and well-being.
• Being expected to prioritize their needs over your own, even at a personal cost.
• Difficulty making life choices without their approval or input.
• Repetitive, toxic arguments that never lead to resolution.
• Cycles of temporary peace followed by renewed conflict.
• Feeling drained and emotionally exhausted after every interaction.
• Increased stress, anxiety, and/or depression.
• Difficulty trusting others or maintaining healthy relationships.
• Physical symptoms such as fatigue, headaches, or digestive issues.
• Feeling emotionally stuck, unmotivated, or unable to focus.

What to Do if a Family Relationship Is Hurting You

Set Boundaries

You can only control what you allow into your environment. You have to create barriers to keep yourself safe, and you cannot expect someone else, especially someone who is not well, to maintain those barriers.

When you’re trying to set a boundary with another person, I want you to come back to these questions:

• Where do I experience difficulty in this relationship?
• Is there something about this relationship that makes it difficult for me to feel safe or understood?
• How can I keep myself safe if this person never changes and never does anything different?
• What boundary will be reasonable to enforce?
• What is my goal for this relationship?
• What limit do I want to set?
• What will happen if I don’t set this boundary?
• What issues might I face when setting this boundary?

When you decide to communicate your boundary, you want to share it clearly and with empathy. It is okay for the other person to ask questions and seek clarity respectfully - this is not always an example of disrespect or pushback.

• Determine where you need a boundary in the relationship.
• Clearly define the issue and how you will be responding if and when this issue comes up again.
• Give the other person the opportunity to seek clarification and adjust to the boundary.
• Be patient and remember that boundaries can be flexible and may need to be adjusted.

Limit or End Contact (If Necessary)

Unfortunately, distance or ending contact is sometimes the only way to adequately mitigate the damage this relationship is causing. This is especially true if the relationship has escalated to physical or emotional abuse and harm that is consistently damaging or if there are children or adults involved who cannot protect themselves. In these cases, you may have to limit contact or change how you engage with this person. This may include only using text messages or email, limiting in-person contact, or not allowing any contact while they are in a particularly dangerous state. You should communicate this in a direct, kind, and plain way. You may say something like, “I cannot speak to you when you are under the influence. You can call me back when you are sober and able to speak.” You may have to maintain that boundary by not answering the phone or ending the conversation when you know they are under the influence. If you are concerned about their safety, you can establish ways to check in that limit your exposure to any dangerous or violent behavior.

Prioritize Your Mental Health & Healing

I know it is hard to prioritize yourself when someone you love is struggling. It may even seem selfish or impossible. Loving someone with a persistent mental illness can be one of the most emotionally complicated things a person goes through. You might feel torn between deep compassion and overwhelming exhaustion. You might be grieving the relationship you wish you could have while still trying to show up for the one in front of you. And that doesn’t make you a bad person—it makes you human.

It’s okay to feel frustrated. It’s okay to feel sad. It’s okay to want space. Loving someone doesn’t mean you have to sacrifice your mental health in the process. You are allowed to have limits. You can say, “This is too much for me right now.” Boundaries are not a betrayal—they are a form of love for both you and them.

You are not responsible for fixing them. You can support someone. You can walk beside them. You can offer care, love, encouragement, and resources. But their healing—however that looks—is ultimately their journey. You’re not failing them because you can’t save them. That was never your job.

You deserve support, too. You deserve to be heard and understood. It’s okay to need help. It’s okay to feel like you’re running on empty. You can love someone else and take care of yourself at the same time. You’re doing the best you can in an impossibly complex situation. And that’s more than enough. You are not alone in this. You're not weak for struggling. You're not heartless for needing rest. You're brave for continuing to love in such an uncertain, messy reality.