INTRODUCTION

Siblings share a unique bond that weaves through the fabric of family life. Amid the complexities of growing up together, one sibling's mental health, such as feelings of depression, can cast a shadow spillover, affecting not only the individual but also reverberating through their sibling's lives. In this manuscript we delved into the experiences of siblings who grew up with a brother or sister with depression in the cultural context of Israel, exploring their coping strategies, challenges, and lessons learned during the transformative phase of emerging adulthood.

Depression among adolescents and emerging adults

Depression is a multifaceted construct that encompasses a range of mood-related experiences and challenges (American Psychiatric Association, 2013). Specifically, the depression spectrum consists of a mood state that falls within the realm of normative mood fluctuations, as well as more severe forms of depressive and mood disorders. Depression among adolescents and emerging adults is an increasing global burden (Zhao et al., 2024). Meta-analytic results from studies around the world indicated that 34% of adolescents studied between 2001 and 2020 self-reported elevated depressive symptoms; rates were greater in the 2011–2020 decade relative to the 2001–2010 decade (24% and 37%, respectively, and youth in the Middle East, North Africa, and Southeast Asia having the highest prevalence; Shorey et al., 2022). Furthermore, empirical investigations have demonstrated that depression exerts a significant impact not solely on children and adolescents, but also extends its influence to their siblings and the family as a whole (Buist et al., 2019; Finan et al., 2018; Panaite et al., 2019).

Siblings' influence on depression

The intricate dynamics of sibling relationships come into play during childhood and adolescence. Siblings can influence each other's emotional well-being, including depressive symptoms, through two primary mechanisms (Buist et al., 2019). First, the quality of the sibling relationship itself plays a significant role in shaping the depressive symptoms experienced by children and adolescents. Namely, the nature of their bond can determine the extent to which one sibling's depressive symptoms affect the other. Second, siblings can influence each other through a process of sibling identification, whereby they learn from each other through observation and interaction (Finan et al., 2018). Given the inherent organic similarity between siblings, they serve as highly influential models for each other, potentially mirroring emotional states, including depressive behaviors. This influence is particularly pertinent to the experiences of emerging adults who grew up with a sibling coping with depression, as close and frequent interactions between siblings, as well as the significant amount of time spent together, could intensify these dynamics (Buist et al., 2019).

A life-course perspective to understand depression

The experience of siblings and families managing depression can be better understood through a life-course perspective, as it offers a valuable framework for comprehending the impact of disability (such as depression) on each of the family members (Avieli et al., 2019; Cook et al., 1997). Depression, like other mental illnesses, can be seen as a life circumstance that disrupts not only the expected social norms but also the personal trajectories of individuals and their family members. Indeed, it becomes an integral part of family life, shaping the experiences of all members over time (Farrell & Krahn, 2014) in terms of emotional distress, disrupted daily routines, and social damage caused by negative stigmas (Levkovich & Labes, 2023). The relationships within the family change, not only between siblings but also between parents and children. For example, we found in our recent study that parents' lack of availability due to the depression of one of their children had a negative impact on the other children in the home as they experienced deep feelings of neglect, disappointment, loss, and pain (Levkovich & Labes, 2023). By adopting a life-course perspective, researchers have highlighted the ongoing interdependence among family members during adulthood and have emphasized the importance of studying how the effects of a loved one's mental illness extend to other family members (George, 2013).

Siblings' relationships in the shadow of depression

As a result of living with a sibling with depression, researchers have identified a spectrum of coping strategies, ranging from active and engaged coping, where siblings consistently offer assistance and support to their ailing brother or sister, to passive coping mechanisms characterized by detachment and a lack of acknowledgment regarding the sibling's health condition. These coping strategies play a pivotal role in shaping the overall dynamics of siblings' relationships in the shadow of depression as they include avoidance coping patterns marked by evasion and escape (Levkovich & Labes, 2023).

Although the family system, including siblings, may be impacted by a child's experience of depression, very little research has been conducted to investigate the specific experiences of siblings when their brother or sister grapples with depression (Buist et al., 2019; Finan et al., 2018; Levkovich & Labes, 2023; Panaite et al., 2019). This gap in the literature is surprising given that the well-being of siblings who have brothers or sisters with medical, physical, or developmental challenges has been explored in numerous studies (Lamsal & Ungar, 2021; Lummer-Aikey & Goldstein, 2021; Shivers et al., 2023). The bulk of the evidence suggests that these siblings are at higher risk of experiencing psychological problems than those without such siblings (Sommantico et al., 2020). The unique experiences and challenges faced by siblings growing up with a depressed brother or sister, and the potential impact on their own development, remain relatively uncharted territory in psychological research.

The topic of siblings' relationships and depression has been addressed in only a few studies (Buist et al., 2019; Finan et al., 2018; Levkovich & Labes, 2023; Panaite et al., 2019). For example, in a study conducted among 412 sibling pairs, it was found that adolescent depressive symptoms were more strongly influenced by sibling depressive symptoms than by sibling relationship quality (Buist et al., 2019). The results of another study conducted among 372 adolescents suggested that relationships with siblings predicted depressive symptom trajectories for both girls and boys (Finan et al., 2018). Although important, these previous studies (Buist et al., 2019; Finan et al., 2018) were based on quantitative research methods, and thus the valuable insights that qualitative approaches can offer were not provided. Nevertheless, our recent qualitative study focused on the experiences of adolescents who grew up with a sibling suffering from depression (Levkovich & Labes, 2023). Although this research is significant (Levkovich & Labes, 2023), it overlooks the perspective of emerging adults who have had the experience of growing up alongside a sibling with depression. In the current study, we bridged this gap in the literature by concentrating on the experiences of siblings in emerging adulthood who grew up with a sibling coping with depression.

Emerging adulthood

Emerging adulthood is a developmental stage generally spanning from 18 to 29 years of age, although its demarcations may vary depending on cultural, societal, and individual contexts (Arnett et al., 2014). Its salient features include active exploration, formation of identity, and a pervasive sense of instability and transition. During this period, individuals generally undergo life transitions such as pursuing tertiary education, embarking upon vocational trajectories, engaging in romantic relationships, and gradually assuming greater levels of independence from parental figures (Arnett & Mitra, 2020).

Current study

In this study we examined the impact of growing up with a sibling with depression through the life-course framework to understand how this experience shapes the psychological and emotional well-being of emerging adults, their family dynamics, and their overall development. Focusing on this topic is highly relevant for several reasons. First, the emerging adulthood life stage is marked by critical developmental tasks (Arnett et al., 2014), making this period particularly susceptible to the profound impact of a depressed sibling on psychological well-being and overall development. This significance is amplified by the fact that most individuals grow up with a sibling (Dunifon et al., 2017), and sibling relationship often endures as one of the longest-lasting connections an individual may experience (McHale et al., 2012). Understanding how this enduring sibling bond interacts with depression during this pivotal life stage is of paramount importance.

Second, this study holds the potential to yield valuable insights into the complex interplay between sibling relationships and mental health outcomes during emerging adulthood. This knowledge becomes even more pertinent in light of the increasing prevalence of depression diagnoses, especially among young individuals. By addressing the research gap in sibling studies of depression, we can inform the development of targeted interventions and support systems. These practical solutions are vital for individuals navigating the challenges of growing up with a depressed sibling. Furthermore, understanding the experiences of these siblings has direct and practical implications for clinical practice, enabling mental health professionals to provide effective support and raise awareness among parents, educators, and practitioners about the significant influence of sibling dynamics on mental health outcomes. By delving into the specific impact of having a sibling with depression during emerging adulthood—that is, exploring the nuanced emotional, social, and personal growth aspects that may be affected—we can gain a deeper understanding of how these experiences shape individual development in this critical life stage. This approach extends beyond the scope of adolescence, which was the focus of our previous study (Levkovich & Labes, 2023).

Accordingly, the aim of the current study was to explore the experience of growing up with a sibling with depression from the point of view of siblings in the emerging adulthood stage of life. To reach this goal, our main research question was framed as follows: “How does growing up with a sibling with depression influence the experiences, coping strategies, and overall development of emerging adults?” Our inquiry delved into the lives of siblings who grew up with a brother or sister with depression, seeking to gain insights into their coping strategies, the challenges they face, and the valuable lessons they acquired along the way.

METHOD

Participants

The study comprised 25 Israeli emerging adults between the ages of 18 and 29 who had lived during their adolescence with a sibling with depression. The mean age of the participants at the time of the interviews (May–September 2022) was 22.39 years, with a standard deviation of 3.47, and 57.14% (n = 14) of the participants were women. All participants were Jewish; most were unmarried (n = 23; 90.47%) and had no children. Five participants (20%) were actively serving in the military during the interviews, seven (28%) had completed their graduate studies and were pursuing careers, and the remaining 13 (52%) were students who held various part-time jobs.

Participants were geographically dispersed across Israel, encompassing various regions including rural areas and cities. All participants indicated that their siblings continued to experience depression, albeit at varying levels. The inclusion criteria were having lived in the same home during adolescence with a biological sibling with a medical record of depression, being currently aged 18–29 years, and the siblings shared the same mother and father. Potential participants who met the inclusion criteria were excluded if they reported having depression, expressed suicidal ideation, or their sibling had a history of psychosis. These criteria were implemented to safeguard the emotional well-being of participants, especially given the sensitive topics discussed during the interviews about growing up with a sibling with depression. Our primary concern was to prioritize the mental health and safety of all participants throughout the research process. Additionally, participants were required to provide a medical record documenting their sibling's history of depression during their (the participants') adolescence.

Research tools

As our group has done elsewhere (Levkovich & Labes, 2023), we employed a qualitative-phenomenological approach to identify and understand phenomena by exploring individuals' perceptions and actions within a given situation. This approach involves examining people's lived experiences and distilling these experiences into a description of the essential characteristics shared across individuals (Creswell & Poth, 2018).

We conducted in-depth, semistructured interviews using a flexible interview guide that covered key areas while allowing for meaningful self-expression and dialogue (Table 1). This approach enabled us to gather a comprehensive and authentic understanding of the participants' experiences and the meanings they attributed to them (Creswell & Poth, 2018).

The questions in the interview guide included inquiries about participants' experiences and views on the impact (on them) of having a sibling with depression. The interviews were recorded and transcribed verbatim, allowing the researchers to refer to the original narratives and ensure accuracy. Data collection continued until theoretical saturation was achieved, meaning that no new material was found in further interviews.

Research procedure

The study's protocol was approved by the university's institutional review board (approval no. 117/2022). Purposive sampling was employed to ensure a diverse group of participants, considering factors such as gender and age within the specified criteria. Additionally, we aimed for broad geographic representation to encompass all regions in Israel. The interviewees were recruited via social media platforms, primarily Facebook and Instagram, with a focus on individuals in the age range of emerging adulthood (18–29 years old) who had grown up with a sibling with depression. We specifically utilized relevant Facebook groups and Instagram pages dedicated to mental health support to reach potential participants. Recruitment was conducted via a letter posted on social media, and interested individuals sent an email with their details. Participants were given a comprehensive explanation of the research aims, and informed consent was obtained. Before to the interview, participants were required to provide signed informed consent and furnish a medical record delineating their sibling's depressive history. The participants voluntarily provided these medical documents, and the research team did not keep the documents. The primary objective was to verify that participants met the criteria of having a sibling diagnosed with depression, and the documents were not kept by the research team. We did not gather specific details about the sibling's diagnosis, treatment, or medication, as we emphasized capturing the participants' experiences and perspectives.

Three participants who were unable to produce medical documentation attesting to their sibling's experience with depression were excluded from the study. The interviews, conducted in Hebrew via Zoom by two experienced female interviewers, were transcribed verbatim. Subsequently, the transcriptions were translated into English for analysis. To ensure accuracy and quality control, both the transcription and translation processes were subjected to rigorous checks, involving cross-verification by bilingual experts. Each interview lasted 1 hour, and participants were guaranteed confidentiality and anonymity. No compensation was provided for participation.

Data analysis

The researchers employed thematic content analysis following data collection and transcription of interview recordings. The first phase involved open coding of each interview transcript to identify recurring themes and motifs. In the second phase, axial coding was performed to compare themes across interviews and reduce the number of categories. The two researchers analyzed separately and then discussed their selected categories to ensure accuracy. The third phase, selective coding, involved omitting categories that did not pertain to the central themes to obtain a clear and coherent picture of the main themes and their interrelationships. This reduction allowed for data refinement, targeting, and organization, ultimately leading to the final findings (Brinkman & Kvale, 2015). The researchers employed credibility criteria, which involved presenting the data in a dense and detailed manner, incorporating multiple realities grounded in specific contexts (Anney, 2014). By adhering to these criteria, the researchers bolstered the study's trustworthiness, enhancing the findings' reliability and authenticity.

RESULTS

In this study, we aimed to investigate the lived experience of emerging adults who, during their formative years, had lived in the same household with a sibling with depression. We sought to explore the various ramifications of their sibling's illness on their lives during emerging adulthood. Through in-depth analysis of the interview data, three overarching themes surfaced, shedding light on the multifaceted implications associated with growing up alongside a sibling with depression during their formative years. The first theme, “I'm often frustrated with their behavior and attitude toward me,” pertained to the relationship between emerging adults and their parents during the formative period of emerging adulthood and concerned the current relationship of the research participants with their parents in the shadow of their sibling's depression. The second theme, “I made a lot of effort to be there for her/him,” pertained to the implications of the sibling's depression for the current mental state and lives of the young adult research participants. The classification of the main categories and subcategories is illustrated in Table 2.

Theme 1: “I'm often frustrated with their behavior and attitude toward me” (the relationship between emerging adults and their parents during the formative period of emerging adulthood)

Assumed parental roles and responsibility

The study participants described their relationship with their parents considering their sibling's depression. Twenty-one emerging adults felt a sense of responsibility and commitment to the ongoing situation in the household even after leaving it. When visiting, they took on parental roles such as completing household tasks and looking after the sibling. The emotions expressed by these participants reflected a mix of injustice, reluctance, and guilt. They wrestled with a feeling of unfairness as they juggled their lives with these added responsibilities, yearning for their parents to take a more active role in managing the household and supporting their sibling.

This weekend, I had to return from an intensive course in the army, go home and spend a lot of time there with my sister so my mom could have some free time and do some things. That means cleaning the house, taking the dog out, doing some laundry, basically doing everything my mom can't do because she's busy with my sister 24/7. My sister needs 24/7 supervision so she doesn't harm herself. Sometimes I feel like I don't have parents at all. But even as an adult, I still need my parents. I wanted them to take responsibility, to take matters into their own hands and take responsibility for their marriage, their children, and be parents. To be the stable figure in this whole story. (20-year-old male participant)

Emotional disconnect and lack of support

The study participants reported challenges in the parent–child relationship. Specifically, 22 of them perceived parental unavailability, leading them not to express themselves emotionally or even have conversations with their parents. In their view, the parents' focus on the sibling's illness resulted in a lack of parental resources and emotional energy, hindering the establishment of meaningful connections. Participants described feelings of loneliness, frustration, suffocation, and disappointment due to the perceived lack of parental involvement in their lives; this perception stopped them from sharing experiences and emotions with their parents.

At least once a week, there's a moment of frustration where I feel like nobody cares about me, and I wonder why this is happening to me. I feel like I'm always sacrificing and my parents don't care, don't give back, and don't give me anything. I'm often frustrated with their behavior and attitude toward me. Sometimes I talk to them about it, and then the tone rises and tears come. They promise it won't happen again, and then it happens again … they promise it won't happen again and then it happens again and again, it happens all the time. (19-year-old female participant)

Witnessing parental difficulties

Another aspect that characterized the parent–participant relationship pertained to the consequences of their sibling's depression. All the study participants articulated how their parents' emotional well-being, occupational pursuits, and marital dynamics were profoundly influenced by their sibling's condition. Some parents ended up divorcing—in the participants' views, an indirect result of the conflicts arising from navigating their son's or daughter's depression. This familial dissolution presented a formidable hurdle for all family members and compounded the distress experienced by the study participants. In certain instances, the participants directed their anger toward their siblings, holding them responsible for their parents' divorce. Furthermore, some parents curtailed their work commitments (sometimes even leaving their jobs entirely) to assume a caregiving role for the child with depression, thereby exacerbating financial hardships. The primary challenge for the study participants lay in witnessing their parents' suffering. They conveyed that their parents' plight weighed heavily upon them, occasionally surpassing the difficulties associated with managing their sibling's condition.

Witnessing the impact of my brother's situation on our parents has been challenging. The harmony that once existed between them seems to have dissipated, giving way to frequent arguments. Often, I find myself playing the mediator, attempting to discern who is right and who is wrong, while dreading the tense atmosphere awaiting me at home. Personally, I believe a separation would have been more conducive; the present circumstances only exacerbate the already strained relations. (21-year-old female participant)

Summary of Theme 1: The study participants expressed challenges in their relationships with their parents stemming from their sibling's condition. They encountered parental unavailability, difficulties communicating with the parents, and a profound sense of loneliness. These feelings created a distance, stopping them from sharing experiences and emotions. Additionally, the participants noted that they witnessed disputes between their parents and perceived that the parents' strained relationship further aggravated their relationships with them.

Theme 2: “I sacrificed a lot to be there for my sibling” (the implications of the sibling's depression for the personal lives of the emerging adults)

Sacrificed personal goals and dreams

Twenty participants described how their sibling's illness had affected their ability to build their future as emerging adults and shape it following their desires. For these emerging adults, the shadow of their sibling's illness loomed large over their aspirations. The weight of their sibling's depression affected their ability to forge their own futures in alignment with their desires. They recounted how their choices and decisions at various life stages were intrinsically linked to their sibling's condition and often came at the expense of their own dreams and ambitions.

When I was in the army, I went through a very difficult period because of my sister's condition. Even though I had left home, I received phone calls from her ten times a day. This situation made it difficult for me to integrate and continue with my tasks, and it did not give me any peace of mind. When I came back home, I remember seeing her sitting on the couch staring at me with those empty eyes of depression, and I remember feeling pressured, thinking to myself, “What do we do?! I can't remember what to do!” I also entered a state of distress, both physically and mentally, but I continued to function and be there for her. (24-year-old female participant)

I think my sister's illness made me grow up too quickly. I was exposed to the world of mental health at a relatively young age. Dealing with mental illness, self-harm, and keeping an eye on my sister so she wouldn't harm herself was very challenging for me. It made me feel a great responsibility for my parents, my sisters, and the household. This feeling is still with me … I thought something would change, but the responsibility continues to weigh unfairly on me … I want to be responsible, good, and serious. I thought when I left home, I would be able to free myself from this burden, but I can't seem to escape this role and it has implications for my personal desires. (28-year-old female participant)

Balancing independence and guilt

On the other hand, five participants described choosing to distance themselves from their sibling, adopting an avoidance coping strategy to prioritize personal development and independence while grappling with feelings of guilt, conflict, and concern for their sibling. These emerging adults shared their hope that this distance would bring them relief and allow them to focus on personal development. However, their desire to spread their wings and lead independent lives conflicted with their sibling's situation, causing them to feel heavy guilt and deep concern for the sibling. In this subtheme, their complex emotional struggles and the strategies they employed to balance pursuing their own lives and fulfilling their responsibilities as siblings were elaborated upon.

I have no relationship with my brother today. He for some reason thinks there is a connection, but I've been filtering his calls for months now. I realized that it was too big for me; I can't handle it. Being with him is emotional turmoil for me; either he insults me or describes how he'll hurt himself. I can't bear it. I just wanted to succeed in my studies, to progress, but to see him stuck makes it totally impossible. It takes me back and fills me with this overwhelming sense of guilt and conflict. (19-year-old male participant)

Emotional toll and mental health impact

According to participants' testimonies, a central desire that they had to suppress (due to their sibling's depression) was the wish for lives that were independent and separate from their immediate family. They described great difficulty in disconnecting emotionally and physically from their family. They couldn't ignore their sibling's distress and felt obligated to help in the sibling's treatment. Therefore, they struggled to leave home, try new things, fulfill their aspirations, or make choices that might limit their ability to help their sibling and parents. They had to give up roles in the army or jobs far from home, as well as leisure time with friends; they suffered from the impact of their sibling's condition on their romantic relationships. Participants described experiencing feelings of guilt, confusion, hurt, and pain.

I sacrifice a lot to be there for my sister. I'm in a place in the army that I didn't want to be in, just to be closer to home, to be with her more, to help more. I gave up a role in the army that I had dreamed of just so I could be closer to home. Even my relationships with women are affected by this. I've already broken up with a girlfriend because I felt like I didn't have enough time for her and didn't have the energy to invest in the relationship. (20-year-old male participant)

Furthermore, the sibling's depression had an impact on the study participants' emotional state and mental health. The emotional distress, fear, and tension they experienced were not only emotionally taxing but also posed substantial challenges to their personal growth and self-discovery. Emerging adults typically explore their identities, dreams, and aspirations during this period. However, for these participants, the constant concern for their sibling's well-being and the responsibilities they assumed cast a shadow over their journeys. This internal conflict, navigating between personal aspirations and familial obligations, added a layer of complexity to their passage through emerging adulthood. This turbulent reality of life with a sick sibling caused 13 participants to experience fear and tension, which led to a psychological crisis. Six of the research participants described needing psychological treatment to cope with the emotional distress they felt as a result of their sibling's illness.

I felt at certain stages that it was so intense that I couldn't even help myself, and it weighed too heavily on me. Eventually, I realized that due to all of the struggles and the desire to succeed and overcome difficulties at home, I had lost a significant part of my childhood and basically forgot the point of living, which is not to protect someone else or to escape a difficult mental state. I lost some of the magic of things at a certain point and eventually started trying to regain it. This led to a lot of recklessness and a lot of irresponsible decisions, not-so-wise decisions, like certain drugs or things with women, all kinds of reckless decisions. (20-year-old male participant)

Resilience and personal growth

Despite the aforementioned, all of the study participants were able to indicate strengths they saw in themselves today because of growing up alongside a sibling with depression. They described the resilience they discovered in themselves, the abilities they acquired, and how their rapid maturation process shaped them into who they were today. They had developed resilience skills that helped them cope with crises, sensitivity and empathy toward those around them, a desire to assist others in similar situations, and a personal sense of understanding situations and circumstances maturely compared to their peers. These strengths instilled a sense of pride and self-satisfaction in the study participants.

I also pay much more attention to what's happening around me, to other people on the subject [of depression]. One of my coworkers uttered a certain sentence to me that I know is typical of a person who's depressed. At first, I wasn't comfortable confronting him about that sentence, but in the end, I did talk to him about it, in a way that I think was comfortable for someone who struggles with these things. I'm interested in this because it's something I probably wouldn't have done if I didn't have the knowledge, if I didn't have a past. (29-year-old male participant)

In addition, 10 participants reported experiencing personal growth, characterized by heightened emotional sensitivity and an enhanced capacity for empathy and support. This newfound empathy extended beyond their immediate familial context, allowing them to connect more deeply with the emotional needs of others. They emphasized the significance of fostering supportive communities, exemplified by creating WhatsApp groups where individuals sharing similar experiences could offer understanding and guidance. In doing so, they forged connections that transcended their difficulties, highlighting the remarkable strength and resilience that can emerge from the crucible of emerging adulthood in the context of sibling depression.

I've matured a lot and become more sensitive to my surroundings. I understand that I have strength in this area. We have now opened a WhatsApp group for “siblings of” and people share there, and I know how to respond, simply because I've been there. It's really something I gained from. There are ups and downs, both good and bad things. But mainly it is something very meaningful that was part of my life. It's part of my story. (19-year-old female participant)

Summary of Theme 2: Participants indicated that many decisions and choices were influenced by their sibling's situation. Despite moving out, most continued to care for and look after them, albeit with a sense of emotional distress. A small number who chose to disengage experienced feelings of guilt. Despite the challenges faced, all participants reported experiencing personal growth and the development of empathic ability.

DISCUSSION

The current study aimed to explore the experience of growing up with a sibling with depression from the point of view of siblings in the emerging adulthood phase of life. This study contributes to the existing body of literature by elucidating the distinct challenges for siblings during this developmental life stage, thereby enhancing our understanding of the enduring impact on their overall well-being and the intricate dynamics inherent in sibling relationships influenced by depression.

The findings indicated that participants' lives during the emerging adulthood period were very much affected by their sibling's depression and the burden that accompanies the caregiving role (Arnett & Mitra, 2020; Arnett et al., 2014). Despite, for the most part, not living at home and perceiving themselves as outside the formal caregiving system, participants felt overwhelmed by the responsibility of caring for their siblings. This burden hindered their ability to lead independent lives and navigate the developmental tasks of emerging adulthood. This finding aligns with findings from studies conducted among siblings of individuals with mental illness, highlighting how the burden continues for these siblings (Barnett & Hunter, 2012; Finan et al., 2018; Guan & Fuligni, 2016). A previous study also found that higher levels of caregiving reported by these siblings were generally associated with their poorer psychosocial functioning, increased sense of burden, lack of engagement in self-care, and maladaptive coping strategies (Jansen et al., 2015).

The results of this study uncovered two primary coping strategies employed by emerging adults navigating the complex interplay between familial responsibilities and personal goals while supporting siblings with depression. The “active coping engagement” strategy (Cassidy & Shaver, 2002), favored by 80% (n = 20) of participants, showcased a deep commitment to their siblings, wherein they actively provided emotional support and care. However, this dedication often came at the expense of their aspirations. On the other hand, 20% of participants (n = 5) opted for an “avoidance coping strategy” (Shivers et al., 2023), prioritizing personal growth and independence. This strategy allowed them to establish boundaries but was accompanied by feelings of guilt and concern for their siblings. Each approach carries its own set of advantages and disadvantages, shedding light on the intricate dynamics within families coping with mental health challenges.

The findings of this study provide valuable insights into the complex dynamics and changes that take place within parent–child relationships during emerging adulthood (Oliveira et al., 2020), specifically in the context of managing the consequences of a sibling's depression. The findings suggest that children's assumption of adult roles and responsibilities, known as parentification, can occur as a response to familial needs and challenges, resulting in the alteration or removal of boundaries within family structures (Hooper et al., 2012). Indeed, participants demonstrated a strong sense of responsibility and commitment to their families, resulting in a shift toward assuming parental responsibilities. These findings align with family systems theories and socioecological theories, which emphasize the reciprocal relationship between family functioning and individual-level functioning and emotional status (Bronfenbrenner, 1979; Hoffman, 1981).

Participants described a range of negative emotions, including feelings of injustice, reluctance, and guilt, as they navigated their sibling's depression. They expressed a desire for their parents to take more responsibility for various aspects of family life, including their marriage, children, and overall stability. They also had challenges in the parent–child relationship, primarily due to a perceived lack of parental availability. They felt that their parents' focus on their sibling's illness consumed their emotional resources and hindered meaningful connections. It should be noted that family caregivers of individuals with mental illness often face difficulties related to juggling multiple responsibilities in the caregiving process (Tamizi et al., 2020). Finding a balance between fulfilling these caregiving responsibilities and attending to the needs of other children in the family can be particularly challenging for parents.

The study also revealed significant difficulties in parents' lives in the wake of their child's depression. Participants reported observing profound effects on parents' emotional well-being, career pursuits, and marital dynamics. This finding aligns with a previous systematic review, highlighting the impact of a child's health and mental well-being on their parents (Barreto et al., 2020). In the current study, participants found it challenging to witness their parents' suffering and struggled to empathize with their parents while at the same time grappling with their emotional burdens related to their sibling's condition. These findings underscore the significant impact of a child's mental health on the entire family system and the need for support and understanding for all family members (Giallo et al., 2012).

In comparison to our previous study (Levkovich & Labes, 2023), which focused on the experiences of adolescents adjusting their behavior and coping with feelings of confusion, helplessness, and loneliness due to a sibling's depression, our study uniquely highlights the long-term impact on the personal lives of young adult siblings. Specifically, our findings reveal how young adults' life choices and aspirations are significantly influenced by their caregiving responsibilities toward their depressed sibling. This ongoing commitment often leads to emotional and psychological burdens, as well as personal sacrifices, as these individuals prioritize their sibling's well-being over their own personal growth. This aspect of enduring emotional and psychological challenges in the quest for personal independence and development in young adulthood is a distinct contribution of our study, adding a deeper understanding of the long-lasting effects into the young adult phase, beyond the adolescent experiences explored in our previous study (Levkovich & Labes, 2023). These findings align with prior studies highlighting the burdens experienced by family members when one individual in the family is experiencing mental health issues (Lippi, 2016; Malhotra, 2016). A central desire frequently suppressed was the longing for an independent and separate life from their immediate family, as family life seemed to hinder their ability to establish a distinct sense of self (Bowen, 1978).

Nevertheless, these challenges also led participants to experience positive changes, sometimes called posttraumatic growth (Zhou et al., 2021). Previous research on siblings growing up with a disabled, chronically ill, or special-needs sibling has, indeed, consistently demonstrated the positive impacts of these experiences, including the development of tolerance, sensitivity, independent work skills, high self-confidence, and the discovery of leadership abilities (Panaite et al., 2019; Sanders & Szymanski, 2013). In the present study, participants exhibited resilience in navigating crises, gained increased sensitivity and empathy toward others, and cultivated a mature perspective on life compared to their peers. This transformative process allowed them to form a distinct sense of self (Bowen, 1978), shaped by their unique understanding of mental health struggles. They expressed pride and satisfaction in their personal growth and strongly desired to assist others facing similar challenges. It is important to acknowledge that the positive impacts observed in the participants, such as increased sensitivity and maturity, may also have had a downside. Although heightened sensitivity can lead to greater compassion, it can also negatively affect one's emotional well-being. Likewise, in line with our previous study, maturity is generally seen as a positive trait, but in emerging adulthood, it may conflict with expectations of increased personal freedom and decreased familial obligations when leaving the family home (Levkovich & Labes, 2023). It seems that many participants could not fully engage in the conventional experiences of emerging adulthood, which typically encompass personal growth, independence, and exploration. The unique challenges posed by their sibling's depression seem to have deprived them of these expected opportunities. Therefore, consistent with previous research, the findings of the current study emphasize the importance of acknowledging both the personal losses as well as the personal growth that adult siblings experience because of having a family member with mental illness (Leith & Stein, 2012; Sanders & Szymanski, 2013).

This study had several limitations that should be taken into consideration. The analysis did not incorporate demographic factors such as sibling sex, age gap between siblings, or birth order, which are known to influence sibling relationships and could significantly impact the experiences of emerging adults with a sibling suffering from depression. Incorporating these factors would be important for a more comprehensive understanding of how sibling dynamics and coping strategies are shaped in this context, especially recognizing that depression is more common in adolescent girls than boys (Shorey et al., 2022). In addition, no data were collected regarding participants' socioeconomic status or income. Future studies may benefit from investigating the role of these factors for a more holistic perspective on the subject. In addition, the use of social platforms to recruit participants may have influenced the data as individuals who are more active on social media and potentially more open to discussing their experiences with mental health challenges and sibling relationships were selected. Future studies may consider diversifying recruitment methods and collecting participant characteristics to mitigate potential biases from social media platforms. Last, the cross-sectional nature of the study design restricts our ability to examine the dynamic nature of the sibling relationship and its long-term impact on individuals' lives. Longitudinal studies would allow for a more comprehensive exploration of how these experiences evolve and change as individuals transition into adulthood.

In conclusion, this study sheds light on the profound implications of a sibling's depression for the personal lives of emerging adults. The findings highlight the significant sacrifices made by participants, as their choices were often influenced by their sibling's condition, which suppressed their desire for independent lives. Understanding the experiences of emerging adults who have siblings diagnosed with depression holds significant implications for professionals working in the field of mental health and clinical practice. By recognizing the unique challenges and emotional difficulties these individuals face during their emerging adulthood, mental health professionals can tailor interventions and support services to better address the specific needs of this population. Clinicals must provide resources and guidance that will help these individuals navigate their caregiving roles while also promoting their personal growth and well-being. Moreover, therapists and counselors can play a vital role in fostering open communication between emerging adults and their parents, assisting in reducing feelings of frustration, guilt, and emotional isolation. Additionally, interventions that focus on resilience-building and coping strategies can empower these emerging adults to manage their mental health effectively while caring for their depressed siblings. By recognizing and addressing these implications, professionals and families can better support and nurture the distinct self of emerging adults while simultaneously helping to provide care for their siblings with depression.