Is an Adult-Child Syndrome a Life Sentence?

Next Generation: SUD

September 27, 2024

By Tom O’Connor and Lauren Grawert, MD, FASAM, Co-Authors

#adultchildsyndrome #substanceusedisorder #discoveryouradultchild

Topic

Is there a recovery from Adult-Child Syndrome? Is there partial recovery? Is it a life sentence?

Adult-child syndrome (ACS) was initially referred to the experience and symptoms of children aged 18 and up who grew up in a home where one or more parents suffered from Substance Use Disorder (SUD).

It is now used to describe adult children who grew up in any type of dysfunctional or abusive home. Rather than being a substance abuse parent, the parent may have a mental health condition such as:

● Substance Use Disorder (SUD)

● Major Depressive Disorder (MDD)

● Post-Traumatic Stress Disorder (PTSD)

● Obsessive-Compulsive Disorder (OCD)

● Narcissistic Personality Disorder (NPD)

● Histrionic Personality Disorder (HPD)

● Borderline Personality Disorder (BPD)

Please also read our last Vital Voyage Newsletter Issue: Substance Use and Co-Occurring Mental Disorders.

Additional Information For You

Co-author Lauren Grawert, MD, FASM, is an Addiction Psychiatrist, Chief Medical Officer at AwareRecovery Care, and a published Medical Writer.

Aware Recovery Care specializes in comprehensive in-home addiction treatment with a family recovery component for loved ones. Aware Recovery Care provides compassionate and effective therapy to individuals and families through 11 states: Connecticut, Florida, Georgia, Indiana, Kentucky, Maine, Massachusetts, New Hampshire, Ohio, Rhode Island, and Virginia. Its treatment program has helped thousands of people achieve and maintain long-term recovery from addiction. Their program has received national recognition for its innovative approach to addiction treatment, and its success rate is among the highest in the industry. You can visit them at www.awarerecoverycare.com 

What Causes Adult-Child Syndrome

According to the CDC-Kaiser Permanente, the adverse childhood experiences (ACE) study is one of the most extensive investigations of childhood abuse and neglect, household challenges, and adult-life health and well-being. This study revealed that having a parent with an addiction, namely alcohol or drugs, or a mental illness is the primary cause of childhood trauma.

A parent's substance use issues or mental health illnesses can lead to physical or emotional abuse and neglect of their children. Children who grow up in these circumstances are at risk for ACS.

Common Characteristics of Adult Children

According to research, mental health experts have identified a set of emotional traits and behaviors that are typical of adult children of alcoholics (ACOA) or parents with other mental health illnesses.

Common signs of ACS include:

● Feeling like a child

● Constantly seeking praise and approval

● Having a hard time identifying and expressing their emotions

● Fear of abandonment

● Difficulty having fun or being spontaneous

● Low self-esteem

● Impulsive behavior

● Self-doubt and self-blame

● Sense of inferiority

● Poor judgment and poor boundaries

● Problems with authority figures

● High sensitivity to criticism and rejection

● Finds it hard to say no to others

● Either intense perfectionism and a sense of responsibility or the other extreme, which is risky and irresponsible behavior.

The term Adult Child Syndrome was first introduced by Janet G. Woititz, Ed.D., in 1983 in her book “Adult Children of Alcoholics.”

According to Dr. Woititz:

“These characteristics are caused by the fact that you never knew when, or if, your parents would be emotionally available to you. You only knew unpredictability and inconsistency. Once the drinking or the trouble began, you simply did not exist. From experience, you knew your needs would not be met until the drinking episode and any accompanying crisis were over.”

According to a study by the National Association of Children of Alcoholics (NACOA), there are over 1 million children in the United States under the age of 18 living with families with at least one alcoholic parent.

The chaotic environment created by parental addiction can shape a young adult’s belief system and coping mechanisms, contributing to the manifestations of ACS.

Since that time, it has been recognized that not only children of alcoholics may experience this syndrome, but children exposed to any family dysfunction. Growing up in a home with any addiction, abuse, neglect, or dysfunction can lead to ACS.

How ACS Impacts Mental Health

Research reveals that adult children of alcoholics (ACOA) have significantly higher rates of anxiety, depression, panic disorder, and substance use disorders (SUD).

The volatility and stress associated with growing up in a dysfunctional environment leave adult children with a sense of shame and a lack of trust in themselves and others. Because their needs were unmet during childhood, they may struggle with recognizing and filling their emotional needs as adults. Overall, adult children have difficulty functioning in the adult world.

Healing from ACS

Mental health treatment can effectively treat the root causes of ACS while giving individuals new skills for coping and emotional regulation when they feel triggers. Effective adult-child syndrome treatment can support recovery from anxiety, depression, substance use disorder, and other mental health conditions arising from childhood trauma.

Can Mental Health Illnesses Be Cured?

“Cure” may be one of medicine's most important yet easily misunderstood words. A cure is a remedy that eliminates a health problem and prevents it from returning. While many people hope for a cure, most diseases and conditions are not curable. Sometimes, treatment is available to helpmanage the problem when no medical cure exists.

According to the National Center for Biotechnology Information (NCBI) in the National Library of Medicine (NLM) under the United States government’s National Institute of Health (NIH) research they held the following findings:

● A mental illness can be defined as a health condition that changes a person’s thinking, feelings, and behavior and that causes the person distress and difficulty in functioning.

● Mental illnesses include general anxiety, clinical depression, obsessive-compulsive behavior, attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), autism, and schizophrenia.

● Treating mental illnesses can involve both medications and psychotherapy, depending on the disease and its severity.

● Most mental illnesses cannot be cured, but they usually can be treated effectively to minimize the symptoms and allow the individual to function in work, school, and social environments.

Can Substance Use Disorder Be Cured?

Substance Use Disorder (SUD) can be treated, but there is no cure only recovery. Remaining free from substance dependence requires permanent abstinence. Recovery is facilitated through medical treatment, including prescription medications and rehab, but it is ultimately maintained by staying away from alcohol and drugs.

According to research, 36% of alcoholics recover within the first year.

According to the National Institute on Drug Abuse (NIDA), there is no cure for drug addiction. Treatment options can help you overcome an addiction and remain drug-free. Your treatment depends on the drug used and any related medical or mental health disorders. Long-term follow-up is essential to prevent relapse.

According to the Mayo Clinic, substance use disorder (SUD) treatment depends on the drug used and any related mental health disorders you may have.Treatment programs for SUDs usually offer individual, group, or family sessions. The treatment focus is on understanding the nature of the disorder, becoming drug-free, and preventing relapse. Levels of care and settings can be outpatient, residential, and inpatient programs.

Can ACS Be Cured?

There is no medical cure for ACS in the sense of completely erasing the effects of growing up in an substance use household.

Research indicates that therapeutic interventions can help individuals develop coping mechanisms, address underlying trauma, and build healthy relationships.

Therapy, along with support groups and self-care practices, individuals can significantly manage and heal from the psychological trauma of their childhood experiences, effectively improving their quality of life and mitigating the symptoms associated with the ACS.

Your Call to Action

Specific Actions For Parents of Children Who Are Addicts 

According to our co-author, Lauren Grawert, an Addiction Psychiatrist and Chief Medical Officer at Aware

Recovery Care, people often ask, “How do I talk to a loved one about their alcohol or drug use?” Dr. Grawert states there are eight essentials to help these conversations go as smoothly as possible.

Simply click on the following link produced by the Substance Abuse and Mental Health Services Administration (SAMHSA) for “Screening and Treatment for Co-Occurring Mental Health and Substance Use Disorders.” Dr. Grawert and other medical professionals throughout the United States are featured in this

YouTube video.

https://www.youtube.com/channel/UCAkmVsd_pi2eLifaPJOiSCA/videos The following eight essential tips, according to Dr. Grawert, are:

One-on-One Only a Few People Work Best

Despite what is often portrayed in the media, more is needed regarding intervention conversations. Ideally, these discussions should take place on one. Initial conversations with more than 2-3 people often leave folks feeling more alone, ostracized, and distrustful of their support system.

Accept Your Anxiety

Intervention discussions can be challenging. Thinking and planning for them often arouses anticipatory anxiety, anger, frustration, fear, and general discomfort. This anticipatory feeling is normal.

For parents, planning to discuss concerns around alcohol or substance use openly can also invoke feelings of shame, disappointment, self-blame, and guilt. All these feelings are understandable. Accept the discomfort. Give yourself grace.

Ask Permission to Have the Conversation (Skip for Teens/Children)

When you begin the discussion, asking your adult loved one’s permission to discuss the topic is helpful. We often skip this step in our efforts to help, but it is a powerful and frequently underrated step.

Asking permission shows respect and empathy. It demonstrates that you value the other person’s view on when and where to have the conversation so they don’t feel blindsided or taken off guard.

Avoid Conversations Late at Night or on an Empty Stomach

Being “hangry” might seem obvious, but initial intervention conversations are often lengthy and emotionally charged. Being tired or hungry can dramatically lower our natural defenses and make even the best of us snappy and quicker to anger.

Be Mindful of Your Language

Our word choices convey our attitude in subtle but powerful ways. “I would like to talk about your relationship with alcohol” is neutral and non-judgmental. Other good phrases include “My worry for you is…” or “My concern for you is…” Worry and concern convey love and empathy.

When It Comes to Outcomes, Set Realistic Expectations

We often hope that the initial conversation with our loved ones will end with them agreeing on everything and enthusiastically admitting to a 30-day inpatient rehab facility.

However, having high expectations for a first-time conversation can set you up for disappointment and frustration when or if your loved one is less ready and willing to change than you had hoped. Instead, view this as simply the first conversation of an ongoing dialogue. Having this perspective will also lower your anxiety around the conversation.

Ask Permission to Continue the Conversation

At the end of every intervention conversation, asking permission to continue later is essential. Asking permission sets the expectation that your concerns are serious issues you want to address.

Don’t Forget to Take Care of Yourself

Addiction is a family disease. It affects everyone around the person who is suffering. If you have a close friend or family member who has an addiction, it's crucial to take care of yourself.

Specific Actions For Parents of Children with ACS 

According to Optimum Performance Institute (OPI) is a residential treatment center for young adults (www.optimumperformanceinstitute.com), the best ways that parents can help their children with ACS include:

Practicing Self-Care

Self-care is an essential piece of managing the symptoms of ACS. Self-care is often difficult for these adults due to the negative patterns and behaviors in childhood. Self-care practices such as meditation, breathing exercises, yoga, or exercise can help reduce for young adults trying to overcome ACS.

Improving Self-Esteem

Low self-esteem can also be part of ACS. Being around supportive friends and family can help boost a young adult’s confidence. Parents can also participate in self-esteem-building activities that can help young adults learn to build their self-worth.

Improving Physical Health

Regular exercise, good eating habits, and healthy sleep hygiene can help manage symptoms associated with ACS and lower stress and anxiety. Engaging in physical activities improves physical health and releases feel-good chemicals in the brain, natural mood lifters that can help combat stress and depression in young adults.

Setting Boundaries

Learning to say no and creating boundaries with others are essential self-care practices. Saying no can help prevent burnout and reduce stress for young adults, helping them make good decisions and learn how to build healthy relationships later in life.

8

Seeking Professional Help

Mental health professionals and treatment programs can support young adults with ACS by teaching them coping skills, giving guidance on behavior modification methods, and overseeing medication management.

Adult-Child Syndrome Summary

ACS is currently used to describe adult children who grew up in any type of dysfunctional or abusive home. If can now be growing up in a household under the following dysfunctional environment with parents who suffer from:

● Substance Use Disorder (SUD)

● Major Depressive Disorder (MDD)

● Post-Traumatic Stress Disorder (PTSD)

● Obsessive-Compulsive Disorder (OCD)

● Narcissistic Personality Disorder (NPD)

● Histrionic Personality Disorder (HPD)

● Borderline Personality Disorder (BPD)

There is no cure for Adult-Child Syndrome or the other disorders listed above that affect ACS. Often, addressing ACS issues requires a multifaceted approach, including emotional support, practical skill development, addiction intervention, mental health intervention, and sometimes tough love to encourage responsibility.

Professional guidance from therapists, counselors, or life coaches can also be invaluable in supporting individuals with ACS.