20 Years of Caring for My Brother With Schizophrenia — and Finally Letting Go of Guilt

F or nearly 20 years, Mitul Desai lived what felt like a double life. To his colleagues, friends, and neighbors, he was a driven professional climbing the corporate ladder. But behind closed doors, Mitul was the primary caregiver for his younger brother, who had been diagnosed with schizophrenia.
“For a long time … no one knew about my brother’s diagnosis,” says Mitul. “I had my own shame and stigma around it, and that got in the way of me talking about it.”
Like many relatives of people with severe mental illness, Mitul initially carried the invisible weight of managing his brother’s care. For years, he struggled with the feeling that he didn’t deserve a full, happy life while his brother navigated the challenges of schizophrenia. This quietly dictated how he lived his own life.
Now, Mitul is breaking that silence, turning his decades-long private struggle into a journey of empowered public advocacy.
When At-Home Schizophrenia Care Isn't Enough
Mitul’s brother, whose name is kept private for confidentiality, received constant care from his parents, with whom he lived for many years. But after he stopped taking his medication consistently, the family could no longer manage the more severe episodes on their own.
“Given the unpredictability of [my brother’s] behavior, crises would pop up from time to time,” says Mitul.

Eventually, the Desai family recognized that they couldn’t give him the care he needed and made the decision to move him into a supportive housing facility. The facility has on-site staff that provide regular meals and room care, as well as routine medical visits from doctors and nurses.
“Because [my brother] is not in a position to live independently, he needs that infrastructure to ensure his room and daily needs are cared for,” says Mitul.
Although the transition wasn’t completely smooth, Mitul and his parents could take comfort in knowing their loved one was safe and being given the best care possible.
Brother First, Caregiver Second

Even after his brother moved to supportive housing, Mitul still took on the role of the primary caregiver. Over the years, their visits seemed to become more about his brother’s treatment and management and less about spending time as brothers.
Mitul realized he was viewing his brother exclusively through the lens of his diagnosis and potentially stripping him of his agency, choices, and fundamental dignity.
To protect their relationship, Mitul made a conscious decision to focus on shared experiences and joy, rather than having every conversation revolve around treatment. As a result, their relationship became stronger than ever.
From ‘Survivor’s Guilt’ to Accepting Joy

In addition to trying to sustain a strong bond with his brother, Mitul also struggled with maintaining outside relationships. The reason: “survivor’s guilt,” or the belief that he didn’t deserve happiness while his brother was managing a mental illness.
“In a way, you almost feel good about denying yourself happiness, because you feel like you’re doing it to maintain camaraderie with your loved one,” says Mitul. “You think, ‘He is living a difficult life, so I will do the same to show him respect and empathy’.”
Over time, Mitul realized that robbing himself of joy and happiness wasn’t improving his brother’s situation. It was compromising his ability to care for him. For Mitul to be truly happy, he needed to stop closing himself off from others and, instead, share his brother’s diagnosis and his role as a caregiver.
His Path to Mental Health Advocacy

Six years ago, Mitul decided to align his profession with his experience as a caregiver and advocate for his brother. He walked away from his corporate career and now works exclusively with mental health organizations and advocates. The first step, though, was telling his colleagues why he was leaving.
Mitul expected his coworkers to judge him. But he was met with overwhelming support and stories of other people’s experiences with mental health issues. “In that moment, I knew I was on the right path,” he says.
Mitul cofounded The Care Hack, an organization that provides support for caregivers of people with mental illness or dementia. While Mitul made the decision to completely dedicate his professional life to mental health advocacy and support, he believes even small acts of advocacy can make a difference.
Advocacy doesn’t require a podium in Washington, DC, he says. Rather, it begins the moment you choose to be transparent with a trusted friend, a partner, or a close colleague.
“You don’t have to scream it from the mountaintops or post about it every day on social media,” he says. “Just take one small step.”

Eric R. Williams, MD
Medical Reviewer
Eric Williams is the associate dean of student affairs and career advising and associate professor of neuropsychiatry and behavioral science at the University of South Carolina Sch...
