Four mental health tips to combat the stress of living with extended family

July 28, 2020 in Family Caregiving  •  By Miles Varn, MD
mental health issues

Because of the COVID-19 pandemic, the structure of many people’s households has changed dramatically. Campuses closed and young adults returned home and many will still be at home this fall as colleges and universities continue to limit on-campus classes. Some people moved in with family after a job loss. And some families temporarily moved older relatives out of independent and assisted living communities to limit their risk of being exposed to the virus.

These changes can make the already stressful situation created by the pandemic even more stressful. That ongoing, heightened level of stress can negatively impact both physical and mental health issues, causing a range of problems that can have a long-term effect on your wellbeing.

Manage stress and protect your mental health

There are a number of steps you can take to manage stress and lower your risk of mental health issues including depression, anxiety, and alcohol and substance misuse while living with your extended family.

  1. Communicate honestly and often. When you don’t communicate, negative feelings can snowball. Family members may think their concerns should be obvious or may be hesitant to express themselves frankly for fear of hurting someone’s feelings or starting an argument. Arrange formal and informal opportunities for communication to help family members better understand each other’s concerns and provide an opportunity for conversation. You can hold a regular family meeting where everyone has the opportunity to say what’s on their mind without judgement from the rest of the group. Informal check-ins are also important, especially if you notice that a family member seems upset, withdrawn, or angrier than usual. Simply ask if there’s anything they would like to talk about. The goal is not for you to solve the problem, but to provide the chance for the person to be heard and for you to work together on a possible solution and ways you can provide support.
  2. Set boundaries and respect them. Lack of privacy can markedly increase stress. Whether it’s your young adult children or your parents or in laws, everyone should have the chance to set boundaries, which, when respected, will help reduce friction and stress. Each family has its own flashpoints, but common issues can include how to handle child rearing and discipline, work routines and the need for a quiet workspace, fairly sharing household chores, bedtime, screen time limits, financial contributions to the family budget, and what’s expected at mealtime, for example is everyone expected to eat the same food and take part in routines like family dinner.
  3. Develop and stick with a routine. Lack of structure can increase feelings of depression and anxiety for some people, especially young children, teens, and older family members living with cognitive problems like dementia. As much as possible, create and maintain a consistent daily routine—get up and go to bed around the same time, have meals at generally the same time, take part in regular physical activity like going for a walk or playing in the yard, get dressed rather than staying in pajamas or sweats all day. It’s also helpful to differentiate weekday and weekend routines to help keep every day from feeling the same.
  4. Don’t be afraid to seek help. If you or other family members are experiencing significant, ongoing symptoms of depression or anxiety, if pre-existing mental health issues are being made worse by stress, or if someone is misusing alcohol or substances, talk with your doctor and ask for a referral to a mental health specialist. Many mental health providers offer phone or video appointments, which can make it easier to access the care you need. You can also connect with mental health providers through your health insurance or by contacting the SAMHSA (Substance Abuse and Mental Health Services Administration) helpline at 1-800-985-5990 or on the web.


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