How Your Family's Mental Health and Substance Use Affected You as a Child—and How It Shows Up in Your Adult Relationships Today

parents walking their toddler

You may have heard the phrase: “What you don’t heal, you repeat.” For many of us raised in homes affected by mental health struggles or substance use, this becomes all too real in our adult relationships. You might be wondering why you feel like you're “walking on eggshells” with your partner, why you over-function or shut down during conflict, or why emotional intimacy feels both deeply desired and terrifying. As a trauma-informed couples therapist, I see this every day—and I want to tell you: you're not broken. You're patterned.

The Invisible Blueprint: How Childhood Shapes Love

Our first blueprint for love, safety, and emotional regulation is our family. If we weren’t with our biological family members, our caregivers who took care of us. When that environment is distorted by untreated mental illness or substance misuse, our developing brains adapt to survive—often at the expense of our future selves. These issues do not go without consequence, there is a world of extreme codependency in these wounds. This can be hard to tease apart for many individuals so let’s break it down together below in the main six ways we are impacted as adults, depending on the severity of our childhood interactions.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 1 in 5 adults lives with a mental illness, and millions of children live with caregivers struggling with mental health or addiction issues. These early dynamics often shape attachment styles, trust, emotional regulation, and how we handle vulnerability in adulthood. This is huge! I see so many individuals impacted by these issues and the impact they have on the children residing on them are the real consequences, often rooted in attachment.

"Children in homes with substance misuse are more likely to develop insecure attachment styles, emotional dysregulation, and difficulties in forming healthy relationships."
— National Institutes of Health, 2020

Let’s look at exactly how these early environments with these types of caregivers impacted and primed you for your adult love.

Attachment Wounds and Emotional Safety

What You Lived Through:

Children raised by caregivers with depression, anxiety, bipolar disorder, or addiction often experienced emotional inconsistency—sometimes being cared for, other times ignored, criticized, or even harmed. This can cause a child to minimally - not know what to expect often, which can show up differently for everyone but a theme: reactionary in order to feel safe is common.

"Parental unavailability due to depression or substance use predicts higher rates of disorganized and avoidant attachment in children."
— Attachment & Human Development, 2018

How It Shows Up in our Adult Relationships:

• Anxious Attachment: You may fear abandonment, crave reassurance, and feel hypersensitive to changes in your partner’s mood.

• Avoidant Attachment: You may keep your partner at a distance, shut down during emotional moments, or fear losing independence.

• Disorganized Attachment: You may experience a push-pull dynamic—desiring intimacy but fearing it will hurt you.

These aren’t flaws; they’re protective adaptations from a time when love felt unsafe. This is the first six years for someone, if it was inconsistent, neglectful, or harmful - an individual will need to do a lot of work to self-soothe and regulate their environment as an adult.

Hypervigilance and the “Emotion Radar”

When you grew up in an unpredictable household—maybe never knowing whether a parent would be sober, depressed, manic, or emotionally present—your nervous system likely became hypervigilant to protect yourself and care for yourself. You learned to scan for cues to stay safe. This survival skill can persist into adulthood without appropriate attunement or interventions.

How It Shows Up:

• You overanalyze your partner’s tone, silence, or body language.

• You struggle to relax, always waiting for “the other shoe to drop.”

• You take on the emotional temperature of the room, even if it's not yours to carry.

"Children exposed to high-stress family environments develop heightened amygdala activity and cortisol dysregulation, increasing adult reactivity."
— Harvard Center on the Developing Child

Hypervigilance often masquerades as people-pleasing, perfectionism, or control—especially in intimate relationships where vulnerability is highest.

Parentification and Overfunctioning

If your caregiver was mentally or physically ill, preoccupied, or addicted, you may have become the emotional or physical caretaker in the home for yourself, siblings, and or parents. This is called parentification, and it’s more common than people think and often is disguised with caregiving, so often children will be reinforced, rewarded, and receive positive attention when they overfunction.

“Parentified children often grow into adults who overfunction in relationships and struggle to identify their own needs.”
— Journal of Emotional Abuse, 2001

Signs in Your Relationship:

• You’re always “doing the work” in the relationship—emotionally or logistically.

• You struggle to receive help or rest without guilt.

• You feel responsible for your partner’s mood, stress, or happiness.

This often leads to burnout, resentment, or choosing partners who underfunction—recreating old dynamics that feel “normal.”

Emotional Suppression and Communication Struggles

Homes affected by untreated mental illness or addiction are often emotionally chaotic, unsafe, or invalidating. Many children learn to suppress their feelings as a survival tool.

You might’ve been told:

• “Don’t upset your father, he’s had a hard day.”

• “Don’t complain or disagree with us.”

• “We don’t talk about that.”

• “You’re being dramatic.”

How This Carries Forward:

• You struggle to express needs, set boundaries, or name feelings.

• You fear conflict because you associate it with emotional pain or danger.

• You feel shut down, numb, or dissociated during arguments.

In therapy, many clients say, “I don’t even know what I feel.” That’s not dysfunction—it’s adaptation.

Substance & Behavioral Misuse as a Learned Coping Strategy

Growing up in a household where substances or behaviors were used to escape, celebrate, or cope sets an internal precedent: this is how we deal with life. This role modeling and escapism can be detrimental to children, often resulting in them struggling with low self-esteem and insecurity. Even if you vowed to be different, the neural blueprint remains unless consciously rewritten.

According to the National Institute on Drug Abuse, children of parents with substance use disorders (SUDs) are more likely to develop their own SUDs, struggle with impulse control, or gravitate toward partners with addiction issues.

“Intergenerational transmission of substance use is driven by both genetic and environmental modeling influences.”
— NIDA, 2021

Reenacting the Past in Adult Love

This is the crux of what I see in couples therapy: unhealed family trauma unconsciously reenacted in intimate relationships. Nobody likes to hear or see this I have found, however it can be very unconscious the attachment wounds you enact in your adult relationships and understanding it through compassionate lens is the best way to approach it.

You may be:

• Trying to fix your partner like you wished someone fixed your parent.

• Staying in a toxic dynamic because chaos feels familiar.

• Sabotaging stable love because you don’t know what to do with peace.

This isn’t conscious. It's neurobiological.

The body remembers, and the brain seeks out the familiar—even if the familiar was unsafe.

“Unresolved childhood trauma often leads individuals to choose partners who replicate early relational injuries.”
— Bessel van der Kolk, The Body Keeps the Score

So What Do You Do With This Exactly Amy?

1. Call it out to Control It

Start identifying the specific patterns from your family of origin that shaped you. You are not in trouble and you are in control of your life. Ask yourself:

• What roles did I take on as a child?

• How did my family handle emotions, conflict, or stress?

• How am I repeating these dynamics today?

• What areas do I fall into more Caregiving verses Controlling, what areas can I let go of doing both?

Therapy, journaling, or trauma-informed couples sessions can help uncover this gently and safely for both parties if you get stuck!

2. Practice Secure Attachment Skills

Even if you didn’t grow up with secure attachment, you can learn it as an adult. These include:

• Expressing needs clearly

• Responding with empathy

• Repairing after rupture

• Setting and honoring individual & couple boundaries

A trained therapist using the Gottman Method, Internal Family Systems (IFS), or Emotionally Focused Therapy (EFT) can guide you if you get stuck with communication and emotional flooding.

3. Build Nervous System Regulation

Trauma isn't just in your thoughts; it's in your body. Healing requires a full biopsychosocial approach in my opinion, often including a lot of somatic work:

• Breathwork, grounding, and mindfulness

• EMDR or somatic experiencing

• Safe touch and co-regulation with your partner

Regulating your nervous system improves your relationship—even before the words catch up.

4. Get Curious, Not Critical

Instead of blaming yourself or your partner for repeating these dynamics, get curious:

• What old role are you reenacting?

• What wound are you protecting?

• What emotion or unmet need is under this behavior?

Shifting from criticism to curiosity builds safety—and from safety, love grows.

You’re Not Alone, and You’re Not Doomed

It’s easy to believe you're too damaged for healthy love when your childhood taught you otherwise. However, the good news is that you are here, you are consciously aware that you would like something better for yourself and your relationships. And your past doesn't disqualify you from connection. It just means your road might be more intentional—and that’s a strength as you will be able to heal yourself, which I know is possible as I have helped thousands of individuals and couples do it. You are not your trauma. You are the survivor of it. In my San Diego-based couples therapy practice, I see couples break these generational cycles every day. They learn to trust, repair, feel again, and create relationships that are rooted in safety, compassion, and choice—not just survival.

If this resonates with you, reach out. Healing is possible. And you don’t have to do it alone.

Ready to Start?

If you and your partner are noticing these patterns and want to explore how to rewrite them, I offer trauma-informed couples therapy in San Diego, CA, and throughout California and Pennsylvania via telehealth.

Let’s create a relationship you don’t need to recover from.

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