Mental Health Challenges In Adoptive Families: Strength And Awareness

Adopting a child often accompanies unique challenges during the adoption process and the process of welcoming and assisting the child as they transition into a new home. Families may also face long-term challenges that can be difficult to predict. 

Challenges in adoptive families can result in a wide range of intense and often stressful emotions for all members of the household. When unaddressed, these emotions can lead to more serious mental health conditions like anxiety and depression. 

To understand the unique variables present in adoption dynamics, it may be helpful to examine the types of adoption and explore the mental health problems often associated with them. You may also utilize tips for how families can cope with those challenges to build stronger bonds and nurture mental health for everyone. 

Types of adoption

Within the context of parenting, adoption is the legal process by which an adult permanently assumes a parental role for a child. According to the Administration for Children and Families (ACF), roughly 53,700 children were adopted from foster care in 2022. Several types of adoption are available, including the following types. 

Domestic adoption

Domestic adoption occurs when a family adopts a child born in the same country as the adoptive parents. A family might choose infant adoption, where a birth mother voluntarily places their child for adoption, or foster care adoption, where a child in the foster care system becomes legally available for adoption.

International adoption

International adoption involves the adoption of a child from a country other than the adoptive parent’s country of residence. Parents often address and navigate strict legal requirements, immigration laws, and cultural considerations when choosing international adoption. International adoption may involve children from orphanages, agencies, or other care facilities. 

Open adoption

In an open adoption, there is some level of communication and contact between the birth parents, adoptive parents, and the child. The form of contact may vary widely depending on what the families have agreed to, but it may include staying in touch through letters, photos, and occasional visits. 

Semi-open or mediated adoption

This popular type of adoption involves using an adoption professional to facilitate communication between adoptive and birth families, or the adoptive and birth families may communicate directly. In either case, both parties have the option of keeping their identifying information sealed. 

Closed adoption

Kinship adoption

Kinship adoption, sometimes called relative or family adoption, refers to a process where the adoptee is placed permanently with a relative, whether a close family member or someone in their extended family. 

Stepparent adoption

Stepparent adoption is the process in which a stepparent legally adopts their spouse’s child. This type of adoption can help unify the family and provide the stepparent with legal rights and responsibilities. Some LGBTQ+ families go through this process if their spouse is not considered a “legal” parent or cannot be added to the child’s birth certificate.

Mental health challenges faced by adopted children and adults

Research suggests that adopted children have a higher risk of mental and behavioral difficulties, making support and nurturing from adoptive families, healthcare providers, and other influential adults critical to the child’s well-being. Various factors can influence an adopted child’s mental health, self-esteem, and overall well-being, including but not limited to the following. 

Attachment and intimacy

Some adopted children who have experienced problems in early caregiving relationships, have had multiple placements, or have grown up in an institution might have difficulty with attachment that manifests in disordered behaviors. Some people may refer to these behaviors as “adopted child syndrome,” although the term isn’t an officially recognized mental health condition and may be considered offensive. Children might have trouble bonding with their new family because they fear abandonment or struggle to regulate emotions. Attachment issues can also be due to trauma in general, even if it is not related directly to the adoption. 

Identity and belonging

Children and adolescents may face challenges in coming to terms with who they are and where they belong in the world, but these challenges are often amplified for adopted children. These questions of identity and belonging can severely affect a child’s self-esteem and lead to confusion and insecurity.

Grief and loss

Adoption may involve a significant amount of loss for children, particularly for adolescents adopted later in life. This loss can include separation from their birth parents, siblings, familiar environments, and culture. An adoptee can struggle with feelings of grief, sadness, or longing for their birth family even if they have a positive relationship with their adoptive family.

Rejection 

Adoptees can experience a sense of rejection or fear of rejection. A sense of rejection can stem from their experiences with their birth parents or family members, and placement for adoption can leave a child believing they have been abandoned. Additionally, fear of rejection is common when a child considers contacting or reaching out to their biological parents.  

Guilt and shame

People who have been adopted may struggle with feelings of guilt or if they want to contact or find out more about their birth families. They may think doing so would be selfish or somehow disloyal to their adopted families. In some cases, children may feel guilty if they believe they must have done something to drive their biological family away. 

Some adopted children internalize their experience, believing their family put them up for adoption or didn’t want them because there’s something “wrong” with them. This thought process is often experienced as shame. 

Lack of control

In some cases, adoptees may believe they are powerless because they had no control over their environment when they were put up for adoption and, in some cases, may have been relocated to multiple homes before they were placed in their adoptive home. This lack of autonomy can create severe issues with security and self-esteem.

Behavioral challenges

The above factors can contribute to a child’s behavior, particularly when multiple issues exist together, and the child has been exposed to trauma. Every child is unique and, thus, may experience and respond to their emotions differently. Examples include:

• Aggression
• “Acting out”
• Withdrawal
• Detachment
• “Clinginess”
• Testing rules and pushing boundaries
• Defiance
• Depression
• Low tolerance for stress
• Sensory self-stimulation (“stimming”), such as repetitive body movements when excited or stressed 
• Difficulty regulating emotions

Trauma and psychiatric disorders in adoptees

Not every adopted child develops a mental illness or developmental issues later in life. How individuals grow and develop often depends on a combination of factors, including innate qualities and early life experiences. For example, adolescents adopted as infants may have significantly different experiences than those adopted later in life, which shape how they behave and their risk for mental health issues. 

Some adopted children had adverse childhood experiences (ACEs) in their early life, such as neglect, abuse, severe dysfunction in the household, or loss of caregivers. Such experiences can lead to the development of severe mental disorders early or later in life, requiring specialized support and intervention. These conditions may include but are not limited to: 

• Post-traumatic stress disorder (PTSD)
• Anxiety disorders
• Major depressive disorder (MDD)
• Attention-deficit hyperactivity disorder (ADHD)
• Oppositional defiant disorder (ODD)

If you think your adopted child may be showing symptoms of a psychiatric illness, reach out to receive a psychiatric diagnosis and treatment plan from a qualified mental health professional experienced in child behavior.

Challenges faced by adoptive parents

From navigating the adoption process to managing the relationship with the biological family (when applicable) to supporting their child’s growth and well-being, parents may have their own challenges to face when raising an adopted child. Aside from the logistics and legalities, adoptive parents may experience the following post-placement mental health challenges. 

Attachment issues

Like adoptees, adoptive parents may encounter attachment issues. However, the parent is responsible for taking every step possible to ensure their child is connected, safe, and loved in their new home. Building a robust and secure attachment with an adopted child can be challenging, especially if they’ve experienced trauma or disruptions in prior caregiving relationships. Building trust may take time, but with nurturing and patience, it can be possible.

Trauma and behavioral challenges

Neglect, abuse, or loss of caregivers are common sources of trauma for adopted children that can manifest in behavioral challenges like defiance, aggression, withdrawal, or emotional dysregulation. Learning to cope with and manage such behaviors can be essential in supporting an adopted child’s mental health and well-being. This ability may often be developed alongside the intervention and guidance of a mental health professional.

Guilt, loss, and grief 

Guilt, loss, and grief can impact an adoptive parent’s mental health. For example, they might experience a sense of loss over missing developmental milestones. Guilt might emerge when they feel so much joy at becoming a parent “at the expense” of another’s loss and grief— even when placing the child up for adoption was the biological parent’s decision. Parents might also experience guilt if they don’t feel the joy and excitement they think they should have once the child is home.

Identity

In some cases, adoptive parents have a conflict of Identity when they don’t “feel” like the child’s biological parent or don’t believe it’s their place to act like the child’s parent. This conflict can be further complicated in cases where the adoptive parents must determine their roles with biological parents involved. 

Rejection 

If the adopted child has difficulty bonding with their new family, it may cause a sense of rejection when the child attempts to push their adoptive parents away, doesn’t want a relationship, or would prefer to return to their biological family. 

Post-adoption depression (PAD)

Although it isn’t officially recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), adoptive parents may experience post-adoption depression when the realities of parenthood, such as increased stress, responsibilities, and everyday challenges conflict with the excitement and expectations of welcoming the child into the home. PAD can be challenging if the adoptee has behavioral and mental health issues that cause distress in daily life for all parties. 

Supporting mental health in the family together

Supporting the mental health of adoptive families may ensure the well-being of all parties in adoptive households. Below are steps adoptive families can take to cultivate mental health in the household:

• Educate oneself: Take advantage of education and training for adoptive parents on topics like attachment, grief, trauma, and loss, as well as parenting strategies focused on adopted children. When equipped with knowledge and skills, parents may better support their child’s mental health and well-being.
• Find mental health resources: Seek out mental health resources focused on working with adopted children and their families. Therapy, counseling, and support groups may help families address challenges and provide strategies for coping and healing. 
• Find support groups: Connect with support groups or peer networks to share experiences, seek advice, and receive emotional support. Peer support from individuals who understand the unique challenges of adoption can be invaluable in reducing isolation and building a sense of connection and community. Support and peer groups may also be highly beneficial for cross-cultural adoptive families in celebrating and honoring the heritage and background of their adoptive child. 
• Ask for support: Caring for a child with complex needs can be emotionally and physically demanding. Ask for support from family and loved ones when to help you rest, recharge, and prevent burnout. 
• Practice self-care: Promote self-care and stress management for everyone in the family by engaging in activities they enjoy and finding ways to relax. Mindfulness and relaxation techniques, nutritious foods, quality sleep, and regular exercise may boost mental health and well-being. 

Explore coping strategies for adoption trauma with a professional

Talk to a compassionate therapist

Support options 

Although adoptive families may face challenges, patience, empathy, understanding, support, and therapy can be helpful in working through them. Therapy can be a valuable resource for individuals struggling with adoption-related challenges, including adult adoptees. However, some people may avoid in-person appointments due to a busy schedule or other barriers. 

In these cases, online therapy platforms like BetterHelp offer flexible, convenient, and affordable treatment options for individuals and families struggling with the challenges they may face in an adoption situation. Virtual therapy allows flexibility in scheduling, allowing clients to schedule appointments when convenient for them, including outside of typical office hours. Online therapy platforms eliminate geographical barriers to therapy and provide access to a broader, more diverse selection of mental health professionals experienced in helping individuals with adoptive challenges. 

Studies show that online therapy is effective. In one study, researchers found that internet-based interventions were effective in reducing symptoms of severe mental illnesses in families, as well as the impacts of mental illness on family members.