Glass children is a recent designation for children like Nick, Alice, and Monica. They aren’t called that because of their fragility; rather, because their parents look right through their needs to the demands of their siblings. According to the Sibling Leadership Network, an organization supporting siblings, “Glass children are healthy children who have brothers or sisters with special needs. They are typically emotionally neglected, experience severe pressure to be problem-free and perfect, take on parental responsibilities within the family at a young age, and have an overwhelming need to make others happy. All this while receiving little nurturing and support in their development years.

When Monica was six, she always remembers being told by others to be a good girl because her parents have enough challenges dealing with her brother, Mike, with Autism. As Mike got older, his aggression increased, and Monica often became a target. She was hit, and frequently her treasured possessions were destroyed. As a senior in high school, she labored all night, perfecting an essay that would assure her “A” grade in English. The paper was never turned in; Mike got to it the morning it was due. Monica’s parents never knew; Monica didn’t tell them because they had “enough challenges.” She got a “B” and a lecture from her parents that she should have tried harder.

As we gather historical information from patients, ask if they have a sibling with a chronic condition. If so, and the condition placed high demands on the parents, there is a high probability you may be seeing a glass child

Ascertain the expectations imposed on them and the source. Many expectations may have been self-imposed.

Autism has been gentrified. This is a dynamic I now cannot stop seeing: once a human attribute like autism or mental illness becomes seen as an identity marker that is useful for social positioning among the chattering class, the conversation about that attribute inevitably becomes fixated on those among that chattering class. It becomes impossible to escape their immense social gravity. The culture of that attribute becomes distorted and bent towards the interests and biases of those who enjoy the privilege of holding society’s microphone.

Today we have the usual demand to have it both ways, to be seen as one’s disorder when convenient for differentiating ourselves from the pack and then setting aside that definition when uncomfortable. Again, the truly disabled can’t do this. They do not deftly craft facades from their disorders, lacking the self-control and capacity for social scheming required to do so. They aren’t afforded the possibility of ignoring their condition when convenient. Yet the voice of the ambitious and shameless patient seeking validation and coin for being sick is becoming the voice of mental illness, those unprincipled enough to treat it all as marketing. Mental illness should not be fodder for building your personal brand.

there is something disordered, and untoward, about a society in which legions of successful people have suddenly discovered their diagnoses and, despite those conditions never having impeded their relentless marches up the ladder of American meritocracy, making the mental illness conversation all about them.

how do you proceed with your quest to turn mental illness into a positive thing, an honored thing, a “valid” thing, without inevitably privileging the narratives and interests of those whose mental illness is least malign? How do you tell generations of young strivers that having a mental illness is cool and unique, without alienating those who feel neither cool nor unique, but only afflicted?

How do you keep the schizophrenic and the schizoaffective and the bipolar and the borderline and the violent and the self-harming and the catatonic and the permanently deluded at the forefront of the culture? Because the way things are going, contemporary mental illness discourse threatens to do to the truly incapacitated the very thing it claims to oppose - leaving them voiceless, ignored, unheard, alone.