What Are the Mental Health Effects of Being Adopted?

Attachment starts in the womb, so even for children relinquished at birth, this represents a significant trauma and attachment wound. Adoption can play a role in attachment issues, trauma, and behavioral issues that affect people from childhood into adulthood.

There are about seven million adoptees living in the United States, and approximately 140,000 are adopted each year. While many people look at adoption as something beautiful—and it can be—the truth is that adoptees may deal with significant mental health effects after being adopted.

Adoption is often forgotten when speaking about trauma, leading to a form of disenfranchised grief, which is grief that is not typically acknowledged or validated by society. Both the trauma and the unrecognized grief may contribute to significant mental health issues. Here are some ways this affects adoptees.

Adoptees at Higher Risk for Mental Health Issues

Adoptees are statistically known to be more at risk for mental health problems, both due to the initial trauma and genetics. Mental health issues may also be prevalent in biological parents, who have suffered their own traumas, which are then genetically passed on to the child.

A meta-analysis (review of studies) about adoptees’ mental health found higher levels of depression and anxiety than in non-adoptees, with bipolar disorder and major depressive disorder as the two disorders most associated with adoption. Additionally, adoptees are more likely to attempt suicide.

Why Adoptees are at Risk

Adoption is a trauma that is often overlooked. "It’s not natural for a baby anything to be separated immediately from its mother," says Lesli Johnson, LMFT, a therapist who works with adoptees.

Attachment is the state of emotional connectedness with another human being, primarily parents. Research shows that children who have been adopted face higher levels of attachment insecurity than non-adoptees—and adoptees who enter their parents’ lives later than at one year old have deeper attachment issues than those adopted at birth or soon after.

Some of this may be due to intergenerational transmission of attachment issues—that is, the changes in one’s body/brain due to poor attachment being genetically passed on.

Additionally, Johnson says that some of the issues come from the messaging that adoptees receive—both societally and at home. "If they are told 'your parent loved you so much, she wanted you to have a better life,' kids might conflate love with loss. It’s not a great way for adoptive parents to explain it to kids."

Mental Health Effects of Being Adopted

Adoptees are more likely to have a psychiatric diagnosis than non-adoptees, both due to the effects of trauma as well as the increased chance of heritability. Some common diagnoses among adoptees:

• Depression
• Anxiety
• Bipolar disorder
• Attention-deficit/hyperactivity disorder (ADHD)
• Post-traumatic stress disorder (PTSD)
• Oppositional defiant disorder (ODD)
  

Common Issues Among Adoptees

While there are certain mental health conditions and diagnoses that adoptees are vulnerable to, there are also issues that arise that do not represent a clinical diagnosis, but nonetheless, affect adoptees' lives.

Disenfranchised Grief

While things like death and divorce are typically recognized as grief, adoption is not often recognized. This is called disenfranchised grief—a type of grief that people feel uncomfortable acknowledging publicly. 

Johnson says that this type of grief is common among adoptees because of the societal messaging suggesting "you should be grateful" or "you were adopted into a good family."

Hypervigilance

Often associated with PTSD, hypervigilance is a feeling of being constantly on guard for danger. In adoptees, Johnson says this is due to "the initial separation between mom and baby creating high levels of [the stress hormone] cortisol and a tendency for reactivity. That sense of danger for the baby is embedded in the nervous system."

Trust

Often adults and young adults will experience difficulty with relationships, according to Johnson. "They wonder, 'Who can I trust?'" Their major experiences with "love" have included loss, so they wonder who will stick around. 

Forming a Sense of Self

While most people will struggle at some point to figure out who they are in the world, adoptees have it even harder. If you don’t even know anything about the people responsible for your genetics, it can be hard to know who you are.

Issues in Children

Johnson says that younger kids, between ages three to five, often have a very literal understanding of adoption. "Adoption [to a kid] simply means 'I was given to this family.'

"But as kids get older, they start putting things together. They might see a classmate's pregnant mother and have questions their adoptive family may not be able to answer about their mother’s pregnancy." 

Grief looks different in children, she says. Rather than tearfulness or sadness, it often looks like acting out or not behaving.

Suicide in Adoptees

Adoptees are at a four times higher rate of risk for suicide, according to one study. It is believed that some of the reasons for this may be early trauma, attachment issues, and a history of institutional care, such as in an orphanage.

Other reasons may include the possible inheritance of susceptibility to mental illness, substance use, or suicidal behavior.

How to Find Help

If you are an adoptee and these or any other issues have been impacting your life, there is support for you out there, from adoption-focused therapists to support groups. You don't have to face this alone.

Therapy

The good news is that adoptees go to therapy at a higher rate than non-adoptees; they are represented twice as much as non-adoptees in therapy.

When looking for a therapist who specializes in adoption, Johnson suggests asking these three questions:

• Do you think separating a child from biological parents is trauma?
• What has your training been in working with adoption and foster care?
• What is your training in attachment?

You can also search therapy directories for therapists who have experience working with adoptees, or search lists specifically of therapists who have been touched by adoption themselves. 

Support Groups

Adoption can feel like a very unique and isolating experience that few understand. A support group of other adoptees may help you feel less alone. Such groups, whether in-person or online, help you connect with others who have had similar experiences. This can be a great source of encouragement, understanding, and valuable information.

Keep in Mind

You may be close to your adopted family and grateful for the life you have, but that doesn't mean that you aren't affected by your adoption. If you are an adoptee who is feeling the mental health effects of being adopted, you’re not alone, and there are therapists who can and want to help you process your trauma.