Christopher *, 32, immediately notices on his grandfather's birthday that something is wrong with his brother. They had not seen each other for a few months. Turned up and without point and comma, his brother talks about sleepless weeks and numerous projects he is currently studying. He also does not stop babbling as he sits at a table without a direct interlocutor and listen to all the other guests a solemn speech of the uncle.
"I immediately realized something was wrong," recalls Christopher. At the end of the family celebration, he addresses his brother and cautiously explains his concern. It's not always so positive, but the brother takes his concerns and goes to a clinic after a few days on his own.
There Christophers suspicion is confirmed: his brother is in the middle of a mania, the counterpart to the depression. He urgently needs professional help. Christopher may have saved him from worse.
Parents, children and siblings are suffering
A mental illness almost always affects the family. The parents, the children, as well as the brothers and sisters. In the lives of those affected they often play a major role, are sometimes the main contact or - like Christopher - first responders in crises.
There are millions of siblings in Germany, but as helpers and supporters they are often overlooked. Hospitals and therapy facilities are almost exclusively geared to their mothers and fathers with offers of help and counseling, and rarely do they see those with affected siblings. But they definitely need support.
"Outside before and yet in the middle" is the name of one of the first studies describing the situation of siblings of mentally ill patients in Germany. The psychologist Rita Schmid from the University of Regensburg and her colleagues even describe siblings as "forgotten relatives" in the 2004 study: "Therapeutic decisions are usually made without their own opinions and opinions, although they often know the patient and his illness the longest ", write the study authors. Last but not least, such decisions often have an influence on the life of the healthy sibling.
Disregarded by practitioners
An investigation from Austria with the title "Unjustly neglected" confirms the findings. While eight out of ten parents of patients with schizophrenia were invited to groups of relatives in a psychiatric hospital, only four in ten siblings received this invitation. Here, the siblings are a "subjectively heavily burdened group", which should be respected more, stressed the study authors.
Also Reinhard Peukert, emeritus professor and still researchers in the field of community psychiatry, wants to strengthen the role of siblings. He knows the problem from his own experience: As a young adult his brother fell ill with schizophrenia. For years, Peukert stood by his side and accompanied him. "There were many sad and depressing experiences, yet it was a huge win for me to be his brother," says Peukert. The illness had greatly influenced his interests and even his career choice.
The brother took his life years later. To this day, Peukert does not let the topic go. For decades he has been involved in research projects dealing with the subject. In his research, he reports on siblings who sometimes not only overlook each other, but feel completely disregarded by clinicians in clinics.
Even Christopher has never spoken to a doctor of his brother, although this has been several times in clinics. He would be quite ready for it. Although he often acts only as a silent observer, but for the sick brother, he is an important support.
A healthy voice more in the room
"Having siblings in treatment talks with them is a win-win for everyone involved," says psychologist Thomas Bock from the University Medical Center Hamburg-Eppendorf. The conversations would not be more complicated than might be supposed, but easier. "Siblings catalyze," says Bock. "It gives them a healthy voice in the room that makes clear what the family's usual conflicts are and what the disease adds."
In addition, valuable valuable solidarity and understanding between the siblings can often be seen in such family discussions. For the most part, Bock only invites the patient and his siblings to a further discussion: "These conversations are often constructive and relieving - for both sides."
The health scientist Jacqueline Sin from the University of London therefore goes one step further. She is convinced that an organized support of the siblings also helps those affected and therefore calls for a kind of psychological training for siblings.
Exhausted or depressed by illness of the other
Above all, Reinhard Peukert wants siblings to be supported. For this purpose, he has founded a sibling network that also offers an online self-help forum. "We want to bring the experiences of siblings more to the public and into the social consciousness," he explains. Also, more self-help groups should emerge from the network, because so far there are only a handful nationwide.
Many affected siblings desperately need discussion and exchange, because the illness of the other also shakes one's own emotional state, as another study by the Regensburg psychologist Rita Schmid reveals: Two out of three people suffer from emotional problems if their brother or sister mentally ill. Many suffered from sleep disorders, were exhausted or depressed.
DISPLAY
Jana Hauschild:
Overlooked siblings
Life as a brother or sister mentally ill
Beltz; 231 pages; 17.95 euros
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The reasons are manifold: Depending on how intense the relationship is, siblings sometimes lose an important partner. They are afraid for each other, sometimes ashamed or angry. For many, the shock is deep.
Three out of four mental illnesses start before the age of 25, ie in childhood, adolescence or young adulthood. The siblings are often in a similar age, in which the consequences of the disease are usually strong. Especially young siblings need explanations about what happens to their brother or sister. Especially young children seek the blame even with them. Was I too frantic playing with my brother? Did I annoy the sister too much?
Older siblings, on the other hand, often feel guilty for another reason: because they are healthy. Researchers speak of the so-called "survival guilt", because sometimes this feeling occurs when people survive accidents or disasters in which others have died. You ask: why my sister, why my brother, why not me?
Christopher was well informed when his brother fell ill, he had studied psychology himself. Therefore, he was able to immediately recognize his brother's mental distress - and act right.
* Name changed by the editor