Understanding the Relationship Between Adoption and Mental Health Issues

How to Help Your Loved One Find Support

In a lot of ways, adoption isn’t all that dissimilar to childbirth. After all, parenting in any form is one of the most difficult and rewarding adventures in life. And whether you have carried your baby in your belly for the greater part of a year or you’ve spent those months working with an adoption agency to complete your family, the moment you finally meet your child is preceded by great anticipation and followed by overwhelming joy, and sometimes, pain. Boy or girl, via birth or adoption… in the end, all any parent really wants is a happy, healthy child.

In many ways, however, adoptive parents must be prepared for things that birth parents do not typically worry about, specifically the psychological toll adoption can have on everyone involved. The truth is, while every child is going to need lullabies sung, boo-boos kissed, and homework checked, adopted children are more likely to struggle with emotional or behavioral disorders ranging from depression, anxiety, and ADHD to suicidal ideation and substance abuse.

So, what is an adoptive parent to do? Are there steps you can take to reduce the probability of your child experiencing mental health issues as a result of their adoption? What signs and symptoms should you look for as your child grows? And how do you help your child, your family, and yourself find support and treatment if you need it?


Adoption is a difficult process for everyone involved. The process of gaining a child by removing him or her from another family can trigger a range of emotions, positive and negative. As difficult as it is to fathom for those who haven’t experienced it firsthand, the joy, hope, and love that comes with welcoming a new family member is almost always accompanied by feelings of loss, grief, and guilt.

For a child, these emotions can be difficult to process. As young children, the advantages of a safe, stable home where physical and emotional needs are consistently met are many. Even so, adoptees are more likely to be diagnosed with mental health issues like oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), conduct disorder, major depressive disorder, and separation anxiety disorder in adolescence according to a study by the University of Minnesota. Additionally, there is research to suggest adoptees are more likely to abuse drugs and alcohol and attempt suicide than their non-adopted peers due to trauma in their early childhood years.

Children and adolescents with these disorders commonly experience attachment issues, where they are either unable to bond with their new caretaker or are unwilling to leave their side even for a moment. They may have emotional outbursts or exhibit age-inappropriate behavior such as tantrums. This can lead to behavioral challenges at home and at school, as well as academic underachievement. In some cases, adopted children can even exhibit borderline-psychotic behavior, including threats and acts of violence toward their adoptive family members or themselves.


When it comes to the relationship between adoption and mental health, knowledge is power. As an adoptive parent, simply being aware that your child may experience one or more of these issues is an important first step. Because children are commonly unable to vocalize or even identify what they are feeling, it is unlikely they will ask for help. By educating yourself about the emotions adoptees experience as a result of their adoption, you will be better able to provide the support your child needs.

Unfortunately, there has been very little research done on the prevention of adoption-related mental health issues specifically. That said, implementing practices identified as effective in preventing mental health disorders in general is a great place to begin. According to the World Health Organization, there are a variety of evidence-based programs that can reduce the risk of mental illness. Intervention strategies are aimed at both parents and children at every developmental stage and, while they vary based on the type of mental health issue, most focus on developing social skills, emotional resilience, and healthy coping mechanisms.

For adoptive parents, determining which type of programs may benefit your child, or simply what is available in your area, may be overwhelming. For this reason, it’s important to consult with a mental health professional. Members of your adoption team may be able to direct you to additional post-adoption resources.


Early identification of mental health issues can lead to more successful treatment, so it’s important for adoptive parents to be aware of what potential mental illness looks like in a child. According to one expert, you should address your concerns with your child’s doctor if he or she is:


Having more trouble at school


Avoiding friends and family


Lacking energy or motivation


Disinterested in his or her cleanliness and appearance


Attempting to harm him or herself


Experiencing mood swings frequently


Having difficulty focusing


Complaining of physical pain


Hitting or bullying peers


Experiencing intense emotions


Not sleeping well or is having bad dreams


Eating significantly more or less than usual

You should also trust your gut. Symptoms of mental illness in children can be difficult to identify. In many cases, signs of emotional or behavioral disorders, like outbursts and sleep issues, are common in children without these conditions at varying stages of development. As a parent, you should pay attention to age-inappropriate emotional responses, as well as symptoms that last longer than normal or don’t improve regardless of what you try.

Another factor of which adoptive parents should be aware is drug and alcohol use and abuse. In addition to being a threat to your child on its own, substance abuse commonly accompanies other mental health disorders, and can be an indicator that your child is struggling with other issues.


If you believe your child is suffering from any mental health condition, you should first schedule an appointment with your pediatrician or family doctor. Be sure to mention your concerns specifically, as many doctors require a special type of appointment and pre-screening for mental health visits. In many cases, your child will be referred to a mental health specialist for further assessment, but your medical doctor will continue to be responsible for monitoring your child’s physical wellness and prescribing medication.

A child struggling with any depressive, anxiety, conduct, or attention disorder will usually require a multifaceted treatment plan to address behavior and emotional stability at home, at school, and in social settings. Depending on factors like the age of the child and the severity of the illness, treatment may include interactive therapy (like art, music, or play) to help communicate their feelings and learn positive behaviors, and/or medication to help manage the physiological effects of the illness. Many schools also offer academic accommodations for children with special emotional or behavioral needs in the form of an Individualized Education Program (IEP) or a 504 Plan, allowing children extra time to complete assignments, providing for separate testing, or permitting the use of assistive technology to help them learn and cope.

As you pursue treatment for your child, don’t neglect the rest of the family. Mental illness is a disease that affects every person in the home. In fact, post-adoptive depression syndrome is a known condition in parents who have recently adopted a child. Symptoms are similar to postpartum depression in birth parents, and include loss of interest in activities you used to enjoy, difficulty concentrating, fatigue, difficulty sleeping, and feelings of excessive guilt, powerlessness, worthlessness, or hopelessness.

Additionally, other adopted and biological children in the home may need help if a sibling is struggling with mental health issues. No matter their age or how well they may or may not be able to comprehend what is happening with their brother or sister, even young children will pick up on stress and tension within the family. Therapy can help them learn healthy coping mechanisms and self care, as well as how they can best support their sibling.

As with any parenting challenge, you must remember that your job, above all, is to love your child. Strive to communicate with your child in a way he or she can understand. Encourage him or her to express emotions, ask questions, and share feelings. Stay connected via activities he or she enjoys. Focus on the positives, and remember: there is no better person than you to help your child.

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