Kiesel’s story is one of what psychologists refer to as destructive parentification—a form of emotional abuse or neglect where a child becomes the caregiver to their parent or sibling. Researchers are increasingly finding that in addition to upending a child’s development, this role reversal can leave deep emotional scars well into adulthood. Many, like Kiesel, experience severe anxiety, depression, and psychological distress. Others report succumbing to eating disorders and substance abuse.

“The symptoms look similar to some extent, from cradle to grave,” said Lisa M. Hooper, a professor at the University of Louisville and prominent parentification researcher. Some of these behaviors start out in childhood, and become exacerbated in adulthood, she explains.