When Your Family Blames Your Mental Health for the Estrangement

Client: David, 45-year-old male. Tampa, FL

Presenting Concern: Estranged from his family because of repeated boundary violations, disapproval of his partner, and conflict over religious differences. The family is engaging in a smear campaign.

Current treatment focus: Learning to tolerate being misunderstood, accepting his family members, building self-esteem, and grieving the loss of a family unit.

David sat in my office, his phone buzzing in his lap. Another text from an old family friend—“David, your mother is worried about you. Can’t you just talk to them?”

He exhaled sharply and locked the screen without responding. It was the same story over and over. It wasn't an impulsive decision when he chose to step away from his family a year ago. It came after years of exhausting fights, broken boundaries, and the crushing weight of their disapproval—of his partner, his beliefs, and his choices.

David started therapy with me after initiating some boundaries with his parents. He wasn’t fully estranged from the family. He was trying to identify how he could be in a relationship with his partner and engage with religion in a way that made sense for him while maintaining a relationship with his parents.

He tried to explain and make them see that he wasn’t rejecting them. He just wanted to live his life on his terms. But they couldn’t hear him. Instead, they had to turn him into a villain.

Now, they told anyone who would listen that he was unstable, that he was lost. They painted him as someone who had been “led astray,” someone who was mentally unwell, not someone who had simply set limits. The smear campaign stung, not because it was true, but because it erased the years of pain he had endured.

In therapy, we’re working on living with being misunderstood and accepting that his family’s version of the story might never match his reality. Some days, that knowledge crushed him. Other days, it felt like freedom.

He was learning to grieve the family he wished he had rather than trying to force them to become something they weren’t. He was learning that self-worth couldn’t come from the approval of people who refused to see him. And he was slowly learning that it was okay to build a new kind of family—with people who allowed him to be who he was.

In this article, you will learn:

• Why families use “mental illness” as a way to avoid accountability
• How to respond to a smear campaign about your mental health
• How to reflect on your behavior and mental health in these moments

Why Some Families Use “Mental Illness” As A Way To Avoid Accountability

Estrangement is already painful, but when your family blames it on your mental health, it can add another layer of hurt, frustration, and self-doubt. Many people who choose distance from their family do so because of longstanding patterns of mistreatment, boundary violations, or emotional harm. But instead of acknowledging these issues, some families shift the blame entirely onto the estranged person—calling them "crazy," "too sensitive," or "mentally unstable."

David’s family continues to tell anyone who will listen that David has simply “drifted away from God” and isn’t well. They blame therapists and social media. In their opinion, there is no way David made this decision based on their behavior. They do this so they can avoid any reflection or accountability. If they see David as the problem, they can be the victims who are protecting themselves from his behavior. By involving their community in these discussions, they’re clearly trying to craft a narrative that makes David the villain and them the victim. This may also be done to elicit sympathy, maintain control over the narrative, and ensure their story is dominant when people wonder why they don’t have a relationship with their son.

When someone doesn’t want to take responsibility for their behavior, they often shift the focus onto the other person. If your family says you’re estranged because you’re “unstable” rather than acknowledging patterns of emotional neglect, manipulation, or abuse, they’re avoiding accountability. In their version of the story, you become the problem, and they don’t have to reflect on their actions. Even if you have struggled with anxiety, depression, PTSD, or any other mental health condition, that doesn’t mean you’re wrong for setting boundaries. Having mental health challenges doesn’t obligate you to tolerate mistreatment.

Abusive relationships and dysfunctional environments can also be the source of some mental health symptoms. It’s possible that leaving these relationships can help resolve symptoms for some people. Sometimes, estrangement is the healthiest decision for your well-being. If being around certain family members exacerbates your anxiety, triggers your trauma, or makes you feel unsafe, stepping away is an act of self-care, not instability.

How To Respond To A Smear Campaign About Your Mental Health

When a family member tells others that their child is “crazy” for cutting contact, they’re often trying to control the narrative. They may not want others to see their behavior clearly, so they discredit you first.

This can be incredibly frustrating, especially if mutual friends or extended family believe their version of events. But remember: you don’t have to convince everyone of the truth. People who are willing to listen may see through the smear campaign over time, or they will remain committed to this false narrative for their own reasons. You don’t need to provide medical records, therapist notes, or detailed explanations to justify why you stepped away. Your boundaries are valid even if no one else understands them. If someone refuses to believe your perspective, they likely weren’t open to it in the first place. Instead, focus on the relationships that honor and respect your well-being.

Many estranged people long for their family and their community to finally “get it.” But some people will never acknowledge their role in the estrangement. That doesn’t mean your decision was wrong. Your healing is not dependent on their recognition. You don’t need their agreement to move forward.

How To Reflect On Your Behavior And Mental Health In These Moments

If your family blames your estrangement on your mental health, it says more about them than it does about you. Healthy families want to understand, repair, and respect boundaries—not dismiss someone as “crazy” for needing space. And it’s possible that your mental health diagnosis or symptoms have influenced your behavior. Someone can struggle with their mental health and become estranged. That does not mean that your mental health is a reason for the estrangement, and you want to be aware of how your symptoms are showing up and influencing you.

It’s important to reflect on how you’ve been feeling and communicate with others. You may want to check in with a trusted person like your therapist, friend, or partner. This is extremely important when your family members are trying to convince you that you’re crazy or unwell for leaving the relationship.

Sometimes, untreated mental health issues or a substance use disorder can get in the way of you having healthy relationships. Many diagnoses have symptoms that disrupt relationships and make it difficult to interact. Your family can set boundaries around those behaviors and encourage you to seek help. But there is a big difference between telling a family member, “I think you’re insane, and that’s why you won’t have a relationship with us,” and, “I can see that you’re struggling. I want to help you and have a relationship. I can’t stay on the phone when you call and yell at me. I am going to hang up now.” It comes down to the way a family speaks about their family member who is struggling with their mental health. A healthy, compassionate family system will understand that someone’s emotional and mental health struggles can disrupt a relationship, and they still need to be accountable for the ways they show up in that relationship. The moment your estranged family members begin using your mental health issues as a weapon to shame you and vilify you in the community and within the family, it’s a manipulation tactic to avoid accountability.