One in five adult Americans lived with an alcoholic while growing up. Child and adolescent psychiatrists know these children are at greater risk for having emotional problems than children whose parents are not alcoholics. Alcoholism runs in families, and children of alcoholics are four times more likely than other children to become alcoholics. Most children of alcoholics have experienced some form of neglect or abuse.

A child in such a family may have a variety of problems:
Guilt The child may see himself or herself as the main cause of the mother's or father's drinking.
Anxiety The child may worry constantly about the situation at home. He or she may fear the alcoholic parent will become sick or injured, and may also fear fights and violence between the parents.
Embarrassment Parents may give the child the message that there is a terrible secret at home. The ashamed child does not invite friends home and is afraid to ask anyone for help.
Inability to have close relationships Because the child has been disappointed by the drinking parent many times, he or she often does not trust others.
Confusion The alcoholic parent will change suddenly from being loving to angry, regardless of the child's behavior. A regular daily schedule, which is very important for a child, does not exist because bedtimes and mealtimes are constantly changing.
Anger The child feels anger at the alcoholic parent for drinking, and may be angry at the non-alcoholic parent for lack of support and protection.
Depression The child feels lonely and helpless to change the situation.

Although the child tries to keep the alcoholism a secret, teachers, relatives, other adults, or friends may sense that something is wrong. Child and adolescent psychiatrists advise that the following behaviors may signal a drinking or other problem at home:

Failure in school; truancy
Lack of friends; withdrawal from classmates
Delinquent behavior, such as stealing or violence
Frequent physical complaints, such as headaches or stomachaches
Abuse of drugs or alcohol; or
Aggression towards other children
Risk taking behaviors
Depression or suicidal thoughts or behavior

Some children of alcoholics may act like responsible "parents" within the family and among friends. They may cope with the alcoholism by becoming controlled, successful "overachievers" throughout school, and at the same time be emotionally isolated from other children and teachers. Their emotional problems may show only when they become adults.

Whether or not their parents are receiving treatment for alcoholism, these children and adolescents can benefit from educational programs and mutual-help groups such as programs for children of alcoholics, Al-Anon, and Alateen. Early professional help is also important in preventing more serious problems for the child, including alcoholism. Child and adolescent psychiatrists help these children with the child's own problems, and also help the child to understand they are not responsible for the drinking problems of their parents.

The treatment program may include group therapy with other youngsters, which reduces the isolation of being a child of an alcoholic. The child and adolescent psychiatrist will often work with the entire family, particularly when the alcoholic parent has stopped drinking, to help them develop healthier ways of relating to one another.

© Copyright © 1997 by the American Academy of Child and Adolescent Psychiatry.American Academy of Child and Adolescent Psychiatry (AACAP).