Get practical tips to help you support your child with bipolar disorder on The Bipolar Parent!
Show me some love!
Parenting a child with bipolar disorder is a unique challenge. There are medications to manage, mood swings to endure, and the many times your child will surprise you with their capacity for rage–or empathy.
National Children’s Mental Health Awareness Day is observed annual on the first Thursday of May. Thursday, May 7th, 2020, is National Children’s Mental Health Awareness Day in the United States.
The Substance Abuse and Mental Health Services Administration (SAMHSA) created the day over a decade ago to better support families who struggle with mental health challenges in their children. The purpose of the awareness day is to shine a spotlight on the needs of children with serious mental illness and to encourage communities to get these children the help they need.
If your child suffers from bipolar disorder, don’t lose hope. You can rise to the challenge of parenting a child with mental illness.
Here are 5 ways to support a child with bipolar disorder.
1. Accept Your Child’s Limits
People with bipolar disorder often have mood swings that they cannot control. Your child will sometimes have terrible depression or manic energy that they won’t be able to rein in. They might laugh inappropriately, get into trouble at school, or be completely incapable of taking care of themselves, especially while depressed.
Accept your child’s limits. Be patient with your kid, letting them know that you will always be there for them and that your house is a no-judgment zone.
That doesn’t mean to not hold them accountable for putting in the effort to do chores or homework, but it does mean to give them a little leeway when they’re dealing with depression especially. If they are making inappropriate jokes due to a manic episode, call them on it, and ask them if they really feel those things are appropriate.
2. Validate Your Child’s Feelings
Validate your child’s feelings. Let them know that whatever they’re feeling, be it euphoria, frustration, rage, or the deepest pit of despair, is real. Tell them that you’re not judging them for having these feelings, and guide your child in ways that are appropriate to express their emotions.
Above all, don’t tell them to “stop acting crazy” if they get riled up. If they’re manic, they might be excessively goofy or silly, or have delusions of grandeur (including claims of superpowers). They can’t help themselves.
3. Communicate Honestly and Openly with Your Child
Communication is key to supporting your child with bipolar disorder. When your child approaches you, turn off your electronic devices and really listen. Even if you don’t understand how they feel, take in all that they say.
When your kid is struggling with their mood swings, or guilt, or other strong feelings, offer your child emotional support. Be patient, and validate what they feel (tip #2).
If you, too, have bipolar disorder, tell your child that you suffer the same kinds of mood swings that they do. Be honest with your children in an age-appropriate way.
(For a post on the differences between bipolar disorder in children and bipolar disorder in adults, click here.)
4. Set up a Routine
Children thrive on routine. You want to plan out your child’s days and weeks, and be consistent from day to day and week to week. Make sure your kid takes their medication at the same time everyday.
If necessary, talk to the guidance counselors and principal at your child’s school to set up an Individualized Education Plan, or IEP. This plan will enable accommodations to be made for your kid, including breaks from homework during difficult times, time outs during the school day, and longer times to take tests.
Parenting a child with a mental illness is a difficult, but doable challenge. If your child has bipolar disorder, there will be times when they feel utterly depressed or riled up with delusions of grandeur.
You can rise to this challenge. Use these five practical tips to help you.
This is true always, but is especially true as a parent stuck at home during self-quarantine for the coronavirus pandemic.
But what is self-care? A lot of people think self-care ideas are limited to bubble baths and painting their nails. But that’s just not true.
Self-care is taking responsibility for your physical and mental well-being. That’s it.
There are 7 types of self-care: physical, emotional, relational, social, intellectual, spiritual, and safety and security self-care.
Read on for self-care ideas you can do while stuck at home that cover all 7 of these areas.
Make notes of the ideas that apply to your life or that you want to try, and see which ones you can incorporate your children into. Put a C by those ideas. Next, put an I by those ideas that you need independent me-time for. We’ll come back to this later.
Some of these ideas are taken from a sheet given to me by the teachers at Lake Washington Toddler Group.
Physical Self-Care Ideas
Physical needs are usually the most insistent. When we’re hungry, we feel it in our bellies and throats. Here are some ideas on how to meet our physical needs. Some of these are done alone, and some are best done with others:
Go on a long walk outside with your child in the stroller or sling.
Drink plenty of water.
If you do get sick, call your medical providers and let them know, to see if you need to come in to their offices.
Emotional Self-Care Ideas
Emotional self-care is ensuring that you are emotionally and mentally healthy. You need to express a range of feelings in order to take care of yourself emotionally. Here are some ideas to meet your emotional needs:
Prioritize the activities that make you happy.
Spend time alone each day.
Check in with your therapist if they offer virtual visits.
Indulge in a good, cleansing cry.
Listen to a comedy show.
Watch a movie that you love.
Say no to extra responsibilities.
Relational Self-Care Ideas
Relational self-care is ensuring your relationships with your family members are strong. Familial relationships are critical for good mental health, as without them you may feel alone and unsupported. And with all the time you’re spending with your family during the coronavirus crisis, you can deepen your relationships with them. Relational self-care ideas include:
Cuddle, kiss, and hug your children.
Make love to your partner, if you have one and you have a sexual relationship.
Play a game with your family.
Play a game specifically with your partner, after your kids have gone to bed.
Establish healthy boundaries around alone time for everyone, and respect those boundaries.
Social self-care is strengthening relationships with those outside your immediate family. Socialization is so important to your mental health, even if you’re an introvert. It’s part of the Maslow’s hierarchy of needs pyramid. Ideas for social self-care include:
Check in with family and friends via Facetime, Skype, phone calls, or texts.
Ask friends and family to remind you that things will be okay, and that what you’re feeling is temporary.
Cuddle with your immediate family or a pet.
Schedule time each day to talk to another adult.
Intentionally reconnect with someone you’ve lost touch with or have unresolved conflict with.
Leave a funny voicemail for someone you care about.
Intellectual self-care is looking after your intellectual pursuits and critical thinking skills. One of the best ways to develop your intellectual self-care repitoire is to engage in creative pursuits. Here are some intellectual self-care ideas while you’re stuck at home:
Check your library’s website for their online catalog, and check out some books to read on your phone or ereader.
Read books slightly above your child’s grade level to them.
Listen to podcasts or audio books while you work.
If your child is doing an art project, sit down with them and create your own art.
Write something, be it a blog, stories, or a personal journal.
Watch documentaries on TV, from the library, or on a streaming service.
Identify a project that would be challenging and rewarding, and then plan to do it.
Return to old hobbies that you may not have pursued since the birth of your children.
Spiritual Self-Care Ideas
Spiritual self-care is not synonymous with religion, though it can take the form of attending church services and praying to a higher power. It’s a search for purpose and understanding in the universe, and expressing values that are important to us. Spiritual self-care ideas include:
Pray or meditate, especially in front of your children.
Volunteer to pick up groceries for an elderly friend or neighbor.
Write in a journal to reflect upon your new life.
Be open to inspiration and awe.
Contribute to causes you believe in.
Spend time outside in your front yard or on your balcony.
Attend religious services online.
Safety and Security Self-Care Ideas
Safety and security self-care involves having health insurance and being smart about your personal safety. Understanding the financial sphere falls under this type of self-care. Many people wait to evaluate their safety or finances until they’re in trouble. Don’t do that. Make sure you have contingency plans. Here are some ideas for safety and security self-care that you can do while stuck at home:
Check out an ebook from the library on investing, and read it.
Read backlogs of articles on personal finance sites.
Double-check your locks. Change them if someone might have a key that you don’t want to.
Order a locking mailbox on Amazon and install it when it arrives.
Change your internet passwords.
Call your insurance company and find out if they cover virtual medical appointments.
Go through your credit card statements line by line and see if there are any charges that you don’t recognize.
Examine your bills (utilities, cell phone, internet, streaming services). Find out if there are any fees you don’t want, and call the companies to see if those fees can be waived.
Self-care isn’t complex. But it can be difficult to think of ideas to do, especially while you’re stuck at home with your kids due to the coronavirus pandemic.
Review your list to see which ideas you can incorporate your children into and which ideas you need me-time for.
If you’ve placed a C next to the ones you can do with your children and an I for ones you need independent time for, then pick out one or two that you can do tomorrow.
Start with the C ideas. Once you’ve performed some self-care alongside your children, find some time to work on the I ideas.
(For a post on how to find time for self-care as a parent stuck at home, click here.)
Self-care, especially independent self-care, can make you feel better. You may soon see the rewards–for yourself and for your family–of a little bit of me-time.
I also shared a daily schedule my toddler and I try to follow, which had room for eating, sleeping, outside time, and work, but not much else.
So how do you find the time to do self-care when you’re stuck at home with small children–and you need to work?
Here are some practical tips that you might want to try while in self-quarantine.
Tip #1: Fill Your Child’s “Tanks”
Sometimes, your kids whine and glom onto you like limpets. That’s usually when they have a physical or emotional need.
Often, before you separate from your children to perform self-care for yourself, you need to fill their physical or emotional “tanks.”
Spend a little time with your children before jetting off, and you’re less likely to be interrupted when you do go take that bubble bath.
Set them up with a snack, give them some kisses and cuddles, and play racecar driver with them. Listen to your tween’s ramblings about Minecraft for a while. You’ll be glad you did.
Generally, the happier your kids are when you leave them (provided they can be left; toddlers can’t, which I’ll cover in the next tip), the more time you’ll be able to take for yourself.
Tip #2: Preplan STEAM Projects
This follows my tip #5 from yesterday: to keep your child entertained and busy on their own with independent play, prepare STEM/Art, or STEAM projects. STEM stands for Science, Technology, Engineering. and Math. With Art, that’s STEAM.
Yesterday, I listed several activities my 3-year-old has done and the supplies we have on our crafting shelf. I won’t list them all again here, but if you’re looking for ideas for a toddler, check them out.
As I write this, she was sorting through buttons with a clothespin, placing them into a cup. She worked on fine motor skills and shape recognition, both parts of STEAM for a toddler. She also worked on counting, as she counted the buttons, and pattern recognition as she sorted them by color.
STEAM activities are as simple as that. The last time she did this activity, she entertained herself for an hour with minimal input from me.
This time, she lasted about 20 minutes, and then we made purple playdough. She’s currently kneading and rolling out the homemade dough, then cutting it into shapes with cookie cutters. So far, she’s been entertained for 45 minutes by the playdough alone, enabling me to write.
In preplanning activities, I printed a calendar for March, and spent a couple of hours listing one activity per day. We do this project at 1pm every afternoon. The calendar has taken a lot of the pressure off of me to think of something every day.
Take a couple of hours to preplan activities and write them down on a calendar for April. You can pick up supplies at any grocery store or order them on Amazon.
Preparing STEAM projects takes a little up front work, but the payoff of more time for work–or, preferably, self-care–is worth it.
Tip #3: Prepare Meals on the Weekends
This tip is similar to tip #2: prepare meals on the weekends, also known as meal prepping. If you do as much upfront work on your meals as possible, you don’t have to make dinner during the week.
This saves a huge amount of time, some of which can be used for self-care.
Slow cooker “dump meals” are meals where you place all the ingredients in a Ziploc bag and then dump them in the slow cooker on the morning you want to cook it. The food cooks all day and smells wonderful, tastes great at night, and takes minimal prep on the weekend.
Brown all your ground beef on Saturdays. Chop all your vegetables. Bake and shred that chicken. Soak and cook those beans.
Make cooking a family activity. All hands on deck means less work for you, and the kids get to learn something, too.
There are many websites on the internet devoted to meal prepping. Type that term into your preferred browser’s search bar, and you will find sites that list recipes, meal plans, and shopping lists for a week’s meals or more.
Tip #4: Get Support from Your Partner
If you’re lucky to have a partner isolating himself or herself with you, count your blessings.
If you’re burned out and need a little bit of me-time, ask your partner for some support. Ask them to watch the kids for an hour while you take a nap.
Most partners are supportive if you ask, but sometimes we don’t know how to ask or even what we need. Figure that out before you approach your partner.
Take some time after the kids are in bed to make a list of self-care ideas that appeal to you, and the time each will take. Then figure out what is reasonable to ask of your partner.
Don’t be afraid to ask; the worst thing they can say is no, and that opens up a chance for you two to have a conversation.
Be sure to reciprocate as well. If your partner offers you an hour to yourself, offer them the same in return.
These times are stressful for everyone, especially parents with bipolar disorder who also have to work at home. You’re wearing many hats: homeschooler, partner, parent, employee, and mental illness manager.
Self-care is critical for your survival. You have to eat, sleep, and spend time by yourself so you have a chance to breathe.
Take care of yourself. Stay healthy.
I wish you well in your journey.
Tune in next week for types of self-care, as well as several self-care ideas for parents with bipolar disorder isolated at home with their kids.
Stuck at home due to coronavirus quarantining? Read on for practical tips on how to manage working at home as a parent with bipolar disorder, from this post by The Bipolar Parent!
Show me some love!
Panic about coronavirus has infected all of our lives. As of this writing, one in three Americans are under shelter-in-place orders. Our kids’ schools are canceled, and if you can work from home, that’s a great blessing in disguise–as well as being distracting as all get out.
So how do you survive being stuck at home as a bipolar parent, especially of young children? Read on for some practical tips from me, a woman with bipolar disorder in the trenches with an 11-year-old and a 3-year-old.
Tip #1: Understand Your Kids’ Limits
Unfortunately for everyone, most children, especially toddlers, are not self-sufficient. As a parent, and especially as a parent with bipolar disorder, you need to understand their limits–and yours.
Your children need to be fed, cared for, and entertained. You don’t have to entertain them all the time–independent play is a beautiful thing–but you do need to set them up with projects or toys so you can get some work done.
Give your children–and yourself–some grace during this stressful period. The panic about coronavirus is temporary. As soon as the virus is under control, your life will largely go back to normal.
If your back is against the wall and you’re about to start snapping at your kids, it’s okay to relax your guidelines on screen time, for example, just so you can get a breather (and get some work done). This is an extraordinary time, and extraordinary times call for extraordinary measures–of patience, as well as other things.
My toddler is currently in the bath, pouring water into and out of cups and singing to herself, while I’m writing this. I’m sitting on the toilet with my laptop on my crossed legs. Do whatever you have to do to keep sane and get some time for yourself.
Tip #2: Don’t Neglect Your Mental Health
If you have medications, take them. I can’t say it any clearer than that.
This is the worst time to have a mood episode. Your children need a sane parent. You need stability to get through this. Forgetting to take your medication is not an option. Set an alarm on your phone if you have to.
I take my morning meds before I sit down for breakfast and my evening meds immediately after dinner. Find a time (or two times, if you have morning and evening meds) that you can stick to every day.
And call upon your coping skills. You need them to survive. Depression can strike at any time, especially in a time where most people are isolated from their supportive social networks.
Which leads to my next tip.
Tip #3: Practice Self-care
We all know the airplane oxygen mask metaphor. Before you help your little ones, you need to put on your own oxygen mask.
This means that self-care is crucial for you to function as a parent with bipolar disorder. Don’t neglect to take care of yourself; if you’re run down, you won’t be able to parent effectively, and you may even end up getting sick.
A lot of people think self-care ideas are limited to bubble baths and painting their nails. But that’s just not true.
Self-care is taking responsibility for your physical and mental well-being. That’s it.
There are six big statutes of self-care which need to be practiced daily:
socializing with other people. Tap into your social network via FaceTime or Skype and ask for support during a time when you might be feeling vulnerable.
Tip #4: Create a Schedule
Kids (and adults) thrive on routine. I know creating a schedule and sticking to it are some of the most difficult suggestions to follow for parents with bipolar disorder, but if you want to remain sane while staying at home with your kids, you must. Creating a schedule is imperative.
You don’t have to plan down to the minute. In fact, it’s better if you don’t. Plan in thirty-minute or hour-long blocks. Try to have the same wake times and sleep times every day. If you can, wake up thirty minutes before your children, to get some time to center yourself (or work).
My toddler’s schedule looks like this:
8:30am – Toddler gets dressed, brushes teeth, brushes hair, comes down for breakfast
9:00am – Breakfast
10:00am – Chores
11:00am – Playing outside on the trampoline or in the kiddy pool while Mom watches (and gets some work done on her laptop or phone)
1pm – STEAM project at the kitchen table while Mom gets work done
2pm – 30 minutes of reading
2:30pm – more outside time
4:30pm – screen time while Mom makes dinner
5:30pm – dinner
6pm – Playing with toys or more STEAM projects while Mom gets work done
7pm – bath and bedtime routine
8:30pm – bed for Toddler
9:00pm – Mom gets more work done
10:30pm – Mom goes to bed
We don’t follow this schedule to a T every day–my toddler took a bath at 3:30pm today, and will take another at 7pm tonight, for example–but it’s a good basic outline.
We do a lot of STEM/Art projects, which leads me to the next tip.
Tip #5: Prepare STEM/Art Projects
STEM/Art, also known as STEAM, stands for Science, Technology, Engineering, Art, and Math. For a toddler, these are as simple as practicing cutting a straight line. Fine motor skills, pattern recognition, and counting are all a part of STEAM.
When the cancellation of my 3-year-old’s preschool was looming, I knew I had to take action. So I looked up toddler-friendly STEAM activities on the internet (Busy Toddler and Little Bins for Little Hands are great resources) and printed a calendar off for March. I wrote one activity per day, and have been following that calendar religiously. Every day at 1pm, we do the scheduled activity on the calendar.
In doing STEAM projects, we have:
glued different-sized buttons to paper
dug blueberries out of a Tupperware-shaped ice cube with a butter knife
threaded pipe cleaners through a colander
painted landscapes and faces on construction paper with watercolors
picked up different-sized buttons with a clothespin from a bag and placed them into a cup
baked bread together.
Some of these projects, like the blueberry-ice excavation, entertained her for up to two hours. Some, like the colander threading, lasted all of one minute (that’s a rare case). Gluing and playdough lasted an hour each. These activities have been hit or miss, mostly hit.
And since we’re at the kitchen table, the mess is largely contained. I now have a crafting shelf on a bookshelf right next to the table stocked with:
watercolors and brushes
pom poms of various sizes
Today we peeled stickers off of a sticker book and stuck them to purple construction paper. Toddler activities are as simple as that, and she was entertained for 30 minutes while I cleaned the kitchen.
Take a couple of hours after the kids have gone to bed to prepare a calendar full of activities. Even one STEAM activity a day is great for their budding brains. You can purchase supplies at any grocery store or Target. (I purchased mine on Amazon before delivery slowed down.)
Tip #6: Remember Your Priorities
Hopefully, your kids are your highest priority (after self-care, but often times for a busy parent, the kids come first). Sometimes the schedule all goes to pot and your kids are whiny, needy, and generally require a lot of attention.
That’s okay. Show your kids that you love them that day. Tomorrow will be better.
Ask your boss to give you leniency in this stressful time. Any boss worth their salt will understand the new crunch you’re under, and that this is temporary. If you can’t get work done while the kids are awake, then plan to work like a demon after they’re in bed.
But don’t pull an all-nighter, as tempting as that sounds. You need your sleep to fend off a manic or hypomanic episode. You need to keep your mental health in balance and stay stable. Prioritizing your sleep does prioritize your work and your kids, because you’re prioritizing yourself.
Without taking care of your mental health, you can’t be present as a parent or an employee. So take care of yourself (tips #2 and #3) so you can take care of your kids–and everything else on your plate.
Prioritize self-care. Prioritize your kids. Try to get your work done as much as possible, but ask for grace–and give some to yourself.
What About Older Kids?
You may have noticed that I mentioned I had a 3-year-old and an 11-year-old, but that I’ve mostly talked about working from home with a toddler. That is because my 11-year-old is mostly self-sufficient, thank goodness.
He wakes up, brushes his own teeth, pours his own cereal, calls his friends, does his homework, and puts himself to bed at night. I make him lunch and dinner.
I made a calendar of STEAM activities for him, too, but he wasn’t interested in any of them. So I ordered workbooks one grade level higher than his current grade, and told him to do 2 1/2 hours of work everyday. He likes baking, so he bakes bread and pizza–with homemade sauce, cheese, and pepperoni and olives–for himself whenever we have the yeast (the store has been out lately).
But what if your child is not that self-motivated? Well, then most of the toddler tips still apply. Create a schedule together, and scale up the STEAM activities to their age level. STEM Activities for Kids is a great resource for older kids.
Fortunately, independent play is much easier to set up for an 8- or 9-year-old, as they can generally be trusted with a bottle of glue without spilling it. And even if they do, they can clean the mess up themselves.
This tip applies only to older kids: If you are fortunate enough to have a home office or even your own bedroom, communicate with your kids that Mom or Dad has “office hours” for 1-2 hours at a time every day, or however long you feel comfortable leaving them to unsupervised play. Then set them up with a STEAM activity and let them have at it.
Tell your kids not to interrupt you unless someone’s hurt or have set something on fire. Set your office hours to the times when you’ll have conference calls, and hopefully you’ll be able to attend that virtual meeting without kiddos joining in.
Also, kids, especially older ones, are allowed to be bored. It’s a good time to let them find (safe) ways to amuse themselves. Reading is always a good idea; my son’s school requires 30 minutes of reading a day, and I extend that to the weekends to give me 30 minutes of peace on Saturdays and Sundays.
I’m not saying my schedule will work for everyone. You don’t even have to do multiple STEAM activities in a day like we do. But do try to make a schedule, and try to let your children loose with glue and paints once in a while. Let the kids be kids.
If this sounds like a lot of extra work, well, it is. Parenting is hard work; always has been, always will be. And working from home when you have children with you is the pinnacle of parenting.
But you can handle this. You are self-quarantining only temporarily. This, too, will pass.
Understand your kids’ limits (and your own), don’t neglect your mental health, practice self-care, create a schedule, prepare STEM/Art projects, and remember your priorities.
Communicating with your children about your bipolar disorder is crucial for managing their relationship with your and your mental illness. In part I, we looked at common pitfalls, including your kids being too young and disrespecting your children’s boundaries. Read on for one more common pitfall of communicating about your psychiatric condition.
Waiting Too Long
On the flipside of your kids being too young, you might have put off having this discussion until your kids are teens. Then your kids might be too old to listen to you properly. Some teens think they know everything, and refuse to hear out their parents or other authority figures, however well-meaning.
A friend of mine, a mother of four, related her experience of being rebuffed by her teenagers when she brought up serious subjects, and what she did to handle that. She said to them, “Just let me do the ‘mom thing’ for thirty seconds, and then I’ll let you go, okay?” She said they’d roll their eyes, but acquiesce to listen to whatever she had to tell them.
Tips For Communicating With Your Kids About Your Bipolar Disorder
You might not know where to start the conversation when speaking to your kids for the first time about mental illness. That’s okay. You can simply say something like, “you may have noticed that I have been erratic lately. I have a disease, bipolar disorder, which causes me to have different mood episodes, called mania and depression.” As long as you have their attention, be concrete and pragmatic.
If you’ve waited until your children are teenagers to talk to them about your bipolar disorder, there is a danger of their being angry, especially if the discussion arises from comments on your behavior, and not by your choice. If this is what happened, you haven’t ruined anything, but do expect to deal with your children’s anger. The best way to handle that is to prepare for it, by thinking about what they might say ahead of time, and making sure to listen to what they actually do say. Chances are, your kids already know about your bipolar disorder. You want to make sure that what they know is the truth, and not whatever desperate version they’ve decided on.
Some teens can benefit from statistics. For example, your kids are between 15-30% likely to develop bipolar disorder if one parent suffers from the disease, whereas they’re 45-60% likely if both parents do. You might be tempted to hide this information, so as not to freak them out. But knowing accurate facts about mental illness helps them to understand you better, and possibly themselves.
Knowledge, even uncomfortable knowledge, is better than the unknown. In addition, if they know common symptoms of bipolar disorder, they can be on the lookout for those symptoms in themselves and their friends, and understand you when you’re experiencing mood episodes.
Try not to hide information from your kids, especially teenagers. If you don’t inform them about your mental illness, they’ll probably turn to friends to ask why their mom or dad is acting strange. Or they might hide the dysfunction entirely, blaming themselves and growing up in a culture of shame. Reassure your kids that you will always love them, regardless of how your bipolar disorder makes you feel in the moment. And above all, be honest.
Trigger warning: This post contains discussions of suicide. If you or someone you know is at risk of suicide, please call the U.S. National Suicide Prevention Lifeline at 800-273-8255, text TALK to 741741 or go to SpeakingOfSuicide.com/resources for additional resources.
Communicating with your children about your bipolar disorder is one of the best ways to ensure that they can handle your ups and downs. You may have an instinct to hide uncomfortable situations from your kids, but kids are intuitive. They will know if someone in the family is suffering, even if they can’t put their fin0gers on why. If the problem isn’t explained to them, they can assume the worst, including but not limited to thinking that your mental illness is their fault. Preparing your kids properly is crucial to managing their relationship with you and your bipolar disorder.
Sometimes, things don’t go as well as you might expect. This happened to a friend of mine recently. Her son casually suggested that he wanted to die by suicide. “I wanted him to know I take that very seriously, and serious steps will be taken,” she said. “I wanted to scare him, just a little. But I scared the crap out of him.”
She explained to him that her 18-year-old cousin died by suicide, and then began to answer his questions. Her mistake was in answering too many of his questions, no matter how inappropriate for his age. “He was way too young for me to answer all those questions,” she said. “You have regrets in parenting… That’s on the list.”
When communicating with your kids about mental illness, having a plan or roadmap helps. Going astray from that plan is common, so here are some common pitfalls when talking with your kids about your mental illness, like bipolar disorder:
Your Children are Too Young
There is no “too young” for communication, but there are age-appropriate versions. My friend’s mistake was that her son was too young for the information and ideas that he received. He didn’t understand why casually suggesting that he wanted to die by suicide was so serious. So when she tried to explain that, she frightened him with knowledge beyond his ability to handle. Sometime our children are too young to understand issues surrounding mental illness. But even a two-year-old can understand that you need to take medication to stay healthy. Your toddler might not be able to quite get that your illness is in your head, but he or she can understand you saying, “Mom has an illness. Sometimes she needs to go see a doctor.”
With toddlers and the preschool set, keep your answers simple. Five to ten-year-olds require short, true answers, whereas preteens need more concrete, also true, information. Try to ask questions of your children to gauge what their maturity level is, so you know how much information to share.
Disrespecting Your Children’s Boundaries
Most parents don’t intentionally disrespect their children’s boundaries. But sometimes, we as parents can accidentally cross a line with our kids. We need to consider their comfort levels during conversations, especially ones about a parent’s mental illness. The topic is admittedly fraught with emotions, especially given how much our mental illnesses affect our kids. They are dependent on us for their physical and emotional health; thinking that their parent is fallible is scary.
The best way to avoid crossing boundaries with our kids is to ask questions, and check in with them regarding their comfort level. When discussing mental illness, try to be as pragmatic as possible. Offer explanations and reassurances in equal measure. Explain to your children that your moods are affected by your bipolar disorder, and that may affect them in turn. Tell them that you will always love them, regardless of how you’re feeling in the moment.
Try to gauge how uncomfortable your children are by reading their body language. If they turn away from you or fold their arms or generally look non-receptive, then back off and try the conversation again later, when they’re more ready.
Communicating with your children about your bipolar disorder is crucial for managing their relationship with you and your mental i0llness. You will make mistakes, like my friend. That’s okay. Just keep trying and do your best. Look for the last common pitfall and more tips to talk to your kids about your bipolar disorder in part II.
In the past five to ten years, bipolar disorder has been identified in more and more children. Up to 5% of American children suffer from bipolar disorder.
Bipolar disorder is a mood disorder that affects 2.6% of American adults–about 5.7 million people–according to the National Institute of Mental Health. The disease is characterized by mood episodes: “highs” called mania and “lows” known as depression.
Symptoms of Mania and Depression in Children and Adults: A Side-by-side Comparison
Check out the following chart to see a side-by-side comparison of symptoms of bipolar disorder in children and adults:
Sad, empty, or hopeless feelings
Anhedonia – Loss of interest in pleasurable activities
Insomnia or sleeping too much
Fatigue, loss of energy
Weight gain or loss
Feelings of worthlessness
Inability to concentrate
Thinking about, planning, or attempting suicide
Sad, empty, or hopeless feelings
Anhedonia – Loss of interest in pleasurable activities
Insomnia or sleeping too much
Failure to gain weight
Change in grades, getting into trouble at school, or refusing to go to school
Withdrawing from friends
Acting out suicide in play
Excitement, or abnormal cheerfulness
Decreased need for sleep
Euphoria, exaggerated self-confidence
Spending sprees and other poor decisions
Decreased need for sleep
Silliness or excessive goofiness
Grandiosity, including statements about superpowers
These symptoms are similar, but the way they manifest is different for children than adults. For example, during both manic and depressive phases, children are much more likely to be irritable and aggressive.
Let’s take a detailed look.
Childhood-onset usually refers to children who develop bipolar disorder at age 12 or younger. The first signs of bipolar disorder in adults are usually manic or hypomanic episodes. But in children, depression is often the first indication that anything is wrong. Studies show that up to 30% of children who suffer from clinical depression will develop manic symptoms later in life, which can lead to a diagnosis of bipolar disorder. For a more detailed overview of what depression looks like in children, even toddlers, click here.
Pattern of the Disorder
The most striking difference between childhood-onset and adult-onset bipolar disorder is the patterns of the illness. Adults generally vacillate between defined episodes of mania and depression that last weeks or months. They can also have periods of wellness that last from months to years in between.
Kids are the opposite: they experience prolonged periods of rapid cycling, which means they bounce between mania and depression daily, if not multiple times per day. And there are no periods of respite in children with bipolar disorder; they are always suffering from a mood episode.
One study of pediatric bipolar patients examined children with bipolar disorder who suffered more than one hundred mood episodes over a short period of time. The manic periods were called “mini-manias.” According to the study, none of the patients under 9 years old endured a single mood episode lasting two weeks or more. Short, frequent episodes was the way the illness presented in the children.
Kids who end up with bipolar disorder were usually genetically predisposed to develop the disease. One of the many causes of bipolar disorder can be family history of the illness, though sometimes the disease can occur without any history present. But, in the case of children who develop the disorder, there are typically more family members with bipolar in their lives than those children without the disorder. The kids are also much more likely to have relatives–such as parents, aunts and uncles, and grandparents–on both sides with the disorder.
Adults who develop bipolar disorder may or may not be genetically predisposed. Genetic loading is less common in adults than children. If the adults are predisposed, the disease may or may not be more severe. It’s a lottery.
Difficult Time Adjusting
Pediatric bipolar disorder presents unique difficulties compared to the adult-onset form of the disease. Kids are still developing mentally and physically, so when they suffer from the rapid cycling moods of bipolar disorder, life can become very difficult. These children are establishing their identities, and enduring vacillating episodes of bipolar disorder makes that very hard.
Adults usually have their identities established, or at the very least, are set in their ways, so figuring themselves out is not as much of a struggle. Adults are also more emotionally mature than children, and can better handle shifts in mood.
Chronic Irritability and Mixed States
Instead of the euphoric highs of mania typically experienced by adults, kids are much more likely to suffer chronic irritability, a state where they are grouchy all of the time. This is because children tend to suffer from mixed states, where they endure extreme episodes of mania and depression at the same time. Treating mixed states can be very difficult. Even lithium, the gold standard medication that is used to treat bipolar disorder, is often ineffective at handling mixed states. Lithium is able to treat both depression and mania in bipolar patients, but it’s totally ineffective at handling mixed states.
Adults can also suffer from mixed states, but children are much more likely to experience them.
Often, childhood-onset bipolar disorder is missed or inaccurately diagnosed until the kid becomes an adult. Children are also more prone than adults to conditions that occur at the same time, such as attention deficit hyperactivity disorder (ADHD), learning disabilities, or anxiety disorders, which can make accurately diagnosing bipolar disorder difficult. If you weren’t diagnosed with bipolar disorder until adulthood, but suspect you have had it since you were a child, this information may help you sort out your own childhood.
The Bottom Line
If your child suffers from two or more of bipolar disorder symptoms, call your pediatrician to get a referral to a pediatric psychologist. Refer to the symptom chart to present daily examples of bipolar disorder symptoms to the doctors. Anhedonia is especially important to note, as it’s not typical of most healthy children. If you have a family history of bipolar disorder, make sure to bring that up.
When children with bipolar disorder grow up, their diseases are worse than people who suffer from an adult-onset version of the illness. The mood episodes are more intense in childhood. But early therapy and other interventions can help your child deal with their condition. The earlier a treatment team can intervene, the better.
Researchers at Ohio State University are searching for a way to and quickly and accurately test for bipolar disorder in children. The scientists think they may have found it: a blood test which looks for a protein associated with vitamin D.
Finding a blood test could reduce the current average diagnosis time of ten years, said Ouliana Ziouzenkova, the study’s lead author and an associate professor of human nutrition at Ohio State.
In the study of 36 young people, levels of the vitamin D binding protein were 36 percent higher in those with bipolar disorder than in those without a mood disorder. The study appears online in the journal Translational Psychiatry.
Ziouzenkova said it made sense to look at vitamin D binding protein because it potentially plays a role in brain inflammation. The researchers also looked at inflammatory markers in the blood, but found no significant correlations. Looking for the nutrient vitamin D in the blood, as opposed to the binding protein, appears to have low diagnostic power, she said.
Confirming that the blood test works will take time, but Ziouzenkova and her colleagues are excited about the potential to help kids and their parents.
So you’ve discussed your child’s symptoms with a pediatric mental health specialist, and have a diagnosis of bipolar disorder. What now? Thankfully, there are some suggestions you can take, and taking care of your child with bipolar disorder is similar to taking care of an adult with the disorder.
1. Pay attention to medications and therapy appointments
As a parent, you are responsible for making sure your child follows their treatment plan. Use whatever reminders you can to remember to give him or her the medication that he or she needs. If your child must take their pills at school, then open a line of communication with his or her teachers and school nurse. Appointments with his or her therapist are also important. Make sure your child attends their appointments
2. Monitor side effects
Some side effects of atypical antipsychotics, like weight gain and blood sugar changes, are awful in adults–and children do seem to be more prone to them. These drugs were originally formulated for adults, and few have been tested on kids. Ask your child’s psychiatrist what side effects you need to keep an eye on.
3. Work out agreements with your child’s teachers
Some children with bipolar disorder need more help at school, such as more breaks during manic episodes, or less homework. During especially bad episodes, your child may need to be removed from school until he or she stabilizes. Talk to your child’s teachers. Keeping an open line of communication is the best way to ensure your child has success at school.
4. Keep a schedule
Try to be consistent with mealtimes and bedtimes, as well as waking your child up at the same time every day. This will help keep stress in the home to a minimum. Try to be patient with your child as they adjust to new routines.
5. Go to family therapy, if needed
Taking care of a child with bipolar disorder may put a lot of stress on the family as a whole. Your marriage might suffer, and the child’s siblings might be jealous of all the attention he or she gets. Attending therapy as a family may help you handle these issues.
6. Don’t ignore threats of suicide
Suicide threats are extremely serious, even in young children who may not understand what it means. Talk to your children, and if they do have suicidal ideation, give them a safe environment. Remove all the weapons or pills from the house. And talk with their mental health specialists. Crisis lines are always open.
7. Communicate with your teenager
Teenagers may become irritated or resentful if they feel that you’re compelling them to be treated. Talk to them about why you’re giving them medication and taking them to therapy appointments. Educate your kids about their mental illness. Also, it’s important that your teenager avoid substance abuse, as the risks of developing a problem are much higher in teens with bipolar disorder. Alcohol and drugs can interact with medications poorly and worsen mood episodes, so it’s important that your teenager be made aware of the risks.
All in all, taking care of your child with bipolar disorder requires an extra level of parenting. But you can do it. There are steps you can take to help you.