There is a dark secret lurking in the shadows of the adoption community. No one wants to talk about it for a variety of reasons. It’s difficult to articulate, it’s embarrassing, it can feel ungrateful or unloving. However, the fact remains that many adoptive families suffer from poor mental health. It is no one’s fault in particular. It is borne out of a “pull yourself up by your bootstraps” mentality and a desire to represent adoption in a positive way. Hiding the mental health issues that can come along with adoption is toxic and can be dangerous. Suffering in silence is not necessary, but sometimes it can feel like it is. Sometimes it can feel like the only option you have is to scream into a pillow, cry in a closet, binge eat a tub of chocolate ice cream, and isolate yourself from the people around you who don’t seem to understand. 

Children who are adopted may often feel a sense of disloyalty to their biological parents if they attach too strongly to their adoptive parents. They also may feel disloyal if they want to pursue their biological parents when they are older, not understanding that their feelings are natural and perfectly acceptable. As adults, these children who may claim they lead idyllic childhoods may struggle to form adult relationships, wrestle with chronic depression, and feel anxiety over things that seem irrational. These things are all manifest of an underlying, unaddressed issue. 

Adoption, though a beautiful way to form a family, leaves a child feeling unwanted at the center of their being. Being adopted can feel like a loss to all parties involved. Even the adoptive parents, who receive a fulfillment of a long asked for prayer, can feel loss as their child struggles to accept them as the parent. Scientists had long thought that infants do not retain memories and have no real feelings before they can communicate. Doctors didn’t even provide painkillers for children during surgery. An article from Boston Globe even explained that “for years, even as life-saving surgeries became more invasive, longer, and more intense, the majority of newborns still underwent them without anesthetic. Often, they were given nothing more than a muscle relaxant to keep them from thrashing around during the operation. It was the best practice at the time, following the best available science” (MCROBBIE, 2017). Can you even imagine the terror of being cut into with a sharp blade while unable to scream out, unable to move at all? Can you imagine what trauma that would wreck on the brain of a baby who is already suffering? 

With that in mind, it is no stretch to follow that logic into the adoption world. If a baby cannot feel or remember physical pain, they won’t remember gestation or bonding with their biological mother. They won’t remember the sensation of being removed from her, not smelling her familiar scent, being held against her skin, hearing her voice. They won’t remember, and therefore it should present no problem.

Unfortunately, those assumptions were horrifically wrong. The fallout from those decisions is still felt today as adults suffer from PTSD from extreme terror and pain they have no actual memory of. Their bodies remember. Their brains remember the terror, the loss, the grief. They just don’t have words to say what is wrong. When CPS removes children from their homes for the child’s best interest, say in the case of extreme abuse, it is not uncommon for a child to still cry themselves to sleep because they miss their mama. It is an instinct to crave the person who is supposed to be your caretaker, even if that caretaker is mentally ill, cruel, or simply unable to be a satisfactory caretaker. 

So, How Do We Address Mental Health?

The first thing is seeking help from people who understand childhood trauma. Even the adoptive parents need to seek help from people who understand childhood trauma because it is so different from other types of issues families may have. I remember a discussion with a potential therapist where I described one of my daughter’s hour-long tantrums. She stared at me in awe and fear and readily admitted she had no advice to give me. She had no suggestions and no idea how to proceed. I’m glad she was honest and saved us both some time. It is also for your safety you’ll need someone intimate with childhood trauma. If you describe a tantrum of a child who has been with you since birth, most people assume that you as the parent have done something horrifically wrong. There are people that know better, but you need to seek them out. The last thing you need is another adult piling on to your already difficult situation. 

The children are the true victims in these situations. They don’t understand why they feel the way they feel. They just feel it. It is important to get them into therapy and to work on attachment. Even very small children can learn a lot from play therapy and benefit from baby massage, baby wearing, etc. They need adults around them that will help them work through their big feelings. It is so important that the adults do not take it personally. It is not your fault that the child ended up needing to be adopted. It is not (necessarily) the birth mother’s fault that the child is struggling. It just is what it is, and we need to work through it. 

Birth parents, too, need therapy. There is a gap where there wasn’t before, even if the pregnancy was unexpected and unwanted. Groups that support birth mothers are so important in keeping birth parents mentally healthy. Adoption agencies need to prioritize this important need. 

A frustrating part of mental health in adoption is very little work can be done beforehand. You have to live in it to understand the grief on all sides. I didn’t understand how much loss I would feel over not having a biological connection to my daughters until a stranger questioned me about where they got their beautiful hair. It hit me like a gut punch that I didn’t actually know. My girls will sometimes ask a question that I cannot answer, that I did not anticipate in any reality, and I am caught flat-footed and unable to speak. 

Mental health in adoption needs to be discussed more at the forefront of the adoption process. Even if you can’t understand it, a fair warning could be useful. Many agencies require a psychological evaluation as part of the home study process. That is a good start. Continuing therapy about why a family is adopting, any infertility issues, and so forth could be a great step in advancing mental well-being in adoptive families. Lists of potential therapists who specialize in helping adoptive families would be crucial in helping a family. Not having to vet 100 people to make sure they understand your problem makes trying to face the problem that much less daunting. 

Unfortunately, while the children and biological mothers in the adoption are somewhat expected to have mental health difficulties, it is frowned upon for adoptive families to struggle this way. As an adoptive mom, I’m just supposed to feel thankful I have any children at all. I’m supposed to be grateful I get to parent children that other parents could not. I am supposed to paste on a smile and go into a battlefield every day, hoping today will be different than yesterday. Facing 100 tantrums over the wrong shoes, or shirt, or pants, or cereal is just supposed to be part of the package for getting to parent these kids. Don’t get me wrong. I love my kids, and I will take every tantrum if it means I get to be their mom. However, I need to be able to say when it is too much and not risk someone calling CPS on me for being a terrible person. I am only human, and I can only do so much. Thankfully I have an amazing physician who understands me and could see I was breaking under the strain. She recommended a psychiatrist to me, which got the ball rolling towards meds, a counselor, a psychological evaluation, and a great deal of self-reflection on how I had let things go so far I broke down in the doctor’s office when she asked how I was doing.

The truth is adoption and mental health need to be something that is talked about much, much more. It is unfortunate we have made mental health taboo and frightening. For years, “crazy” has been derogatory slang to describe someone simply disagreeing with personal opinions. “You need help” is a slam on someone’s ideas or actions. The reality is that to some degree, we all need help. We all need to evaluate our circumstances and see if we and the people around us are okay. Maybe you’re okay today, but in a few weeks, you won’t be. Something could knock you sideways completely out of the blue and make you need inpatient help. There is no shame in that. That is part and parcel of being human. We need to remove the stigma that getting help when you need it is weakness instead of strength. Mental healthcare needs to be more accessible, and there need to be more mental healthcare providers. It should not be a year-long waitlist to get my kids some mental health care, but that is the state of things at the moment. 

What Can You Do?

If you see a friend, especially an adoptive mom or dad (or foster mom or dad) struggling, offer to bring them a meal. Sometimes just taking one little thing off their plate can offer tremendous amounts of relief. Offer to take the kids to the park with yours so they can go to a counselor. Pick up their groceries for them, visit with them and let them know it is more than okay if the house is a mess. 

Do you know any birth parents? Especially around Mother’s Day or their child’s birthday, send them some love. They may not want to talk about it, but they will probably be having big feelings about it. Do they need a ride to therapy? Someone to pick up their meds? Someone to watch their kids? Someone to hold their hand while they cry? Be that person. Every little bit can help make the difference between okay and not okay. 

I don’t remember much about the first few months I was a foster parent. My world was a blur of appointments, late nights with the baby, school enrollment, and sleep deprivation. What I do remember is the people who loved us through those difficult, disorienting months. It wasn’t easy going from a couple to a family of five overnight. I loved those days, but I also remember crying because of how overwhelmed I was. There was nothing anyone could have said to me before that to make me understand how I would feel.

The biggest way you can help with adoption and mental health is by believing someone when they tell you things are hard. Believe the birth mom, who could in no way support a baby, who tells you she grieves not having her daughter with her. Believe the adoptive mom, who yearned for a baby for years, telling you her daughter is pushing her away. Believe the adoptee, who is trying to figure out who they are, saying, “I want to find my birth parents, but it isn’t because I hate my adoptive parents.” Sometimes just being heard can be the most healing salve on an injured or hurting person’s heart. 

Are you considering placing a child for adoption? Not sure what to do next? First, know that you are not alone. Visit or call 1-800-ADOPT-98 to speak to one of our Options Counselors to get compassionate, nonjudgmental support. We are here to assist you in any way we can.

Christina Gochnauer is a foster and adoptive mom of 5. She has a bachelor’s degree in Psychology from Letourneau University. She currently resides in Texas with her husband of 16 years, her children ages 3, 3.5, 4.5, 11, and 12, and her three dogs. She is passionate about using her voice to speak out for children from “hard places” in her church and community.