Hello, hello! Welcome to the Bipolar Parent’s Saturday Morning Mental Health Check in: The Future Edition! Thanks for stopping by.
How are you doing this week? What parenting challenges have you been facing? Are you getting enough sleep? Are you practicing self-care? How has the coronavirus affected your life lately? I hope you don’t have it! Let me know in the comments; I genuinely want to know about you and your struggles.
My (Two) Weeks — And the Future of The Bipolar Parent
I didn’t update last week, and for that I apologize. I was waiting on some news that was time-sensitive.
But now I can share it: I have a job! My friend and frequent commenter, author and mental health blogger Dyane Harwood, was approached by an editor at Verywell. Part of Dotdash (previously About.com), Verywell is a website focused on health and medicine that boasts 17 million unique visitors per month.
Dyane was told by the editor that Verywell needed a contributing writer for their articles re: bipolar disorder. Dyane, bless her, said she was overextended, and passed my contact information and blog onto the editor.
The editor contacted me, and asked if I would be willing to blog for them on a regular basis. After discussing the challenges of being a working parent with my husband, I agreed to take the job.
I am so excited! This is a wonderful opportunity to expand my writing resume and add feathers to my cap. A million thank yous to Dyane!
All of this means there will be some changes to The Bipolar Parent, my personal blog. I will be writing four articles per month for Verywell, and I don’t know if I will be able to continue blogging here as frequently.
My children will be out of school for the summer, and my husband is not comfortable with drop-in daycare for either of them. Rather than writing blog posts while they are in school, I will be writing in my very limited free time after the kids go to bed.
That being said, I need to discontinue the Saturday Morning Mental Health Check ins. I apologize in advance, but I already know that I won’t be able to keep posting on Saturday on The Bipolar Parent while writing for Verywell.
I hope to continue posting on Fridays, but I am uncertain if I will be able to keep up the quantity of quality posts while blogging four times a month for the other site.
I will check in with myself in April (next month) and make an honest decision. After that, whatever I decide, I will check in again in August, three months later, and see if I need to reevaluate my ability to post to both sites.
Whatever happens to The Bipolar Parent, I plan to continue blogging for the International Bipolar Foundation, so you can see me both there and at Verywell. If I’m not producing original content here, I will be linking to both my Verywell posts and my IBPF posts.
I appreciate that you’ve all supported me in my writing. The journey from beginning blogger to contributing writer at IBPF and Verywell has been long, but you all have been there for me. Thank you so much.
I’ve been burned out with family responsibilities and dealing with some intense conversations in therapy, and my blog has suffered for it. You may have noticed a dip in quality, for which I apologize for. I’ve only written a single post in the past six weeks. In short, while I have the motivation to blog, as I don’t want to disappoint you guys, my readership, I have lost the inspiration. I don’t want to churn out low-quality posts just to have something up on Fridays, so it is with a heavy heart that I’m announcing a hiatus until the first Friday in September, 2019. I promise to start blogging again then, and to give you the level of detail and quality you expect from The Bipolar Parent.
Thanks so much for being here with me. Until September.
As a parent with bipolar disorder, you might worry about the effects of your unchecked mental illness on your loved ones, especially your children. The devastating mood swings of bipolar disorder–ranging from manic “highs” to depressive “lows” and everything in between–can cause instability for your kids. One example, a 2014 study, showed teenaged children of parents with bipolar disorder are more susceptible to risky sexual behavior and emotional problems than young adults who do not have parents with bipolar disorder. As has been seen in many other cases, dysfunction in the home causes dysfunction in the child. This is equally true in cases of children with parents who suffer from mental illness, like bipolar disorder.
But there is good news. You can learn how to shield your children from the effects of your psychiatric condition. How? Let’s dig in.
Treat Your Disorder Properly
One of the most effective ways to shield your children from your bipolar disorder is to treat the disease properly. Try to eat a healthy diet and work exercise into your life. Adequate sleep is another requirement to keep you healthy and keep things from spiraling out of control. Make sure you get your forty winks, and if you have trouble, talk to your doctor. Taking medication regularly and working through emotional problems through therapy will help you manage your disorder and aid you in positively impacting your kids.
If your disorder is treatment-resistant, don’t give up hope. Dyane Harwood, author of Birth of a New Brain: Healing From Postpartum Bipolar Disorder, thought she’d exhausted all of her options to treat her bipolar depression, including electroconvulsive therapy. Then her doctor prescribed a monoamine oxidase inhibitor (MAOI). The drug worked, and Harwood is now engaged with her children and husband, living life the way she wants to.
Bipolar in the family needs a whole family solution. The entire household needs to learn coping skills to handle a parent’s disorder. Ask your therapist for ways to teach your partner and children to deal with the ups and downs of your bipolar disorder. If your children start showing symptoms of emotional problems, such as anxiety, phobias, or intolerance to frustration, find a child behavioral psychologist or a therapist willing to see children. Make a list of the symptoms you’ve seen in your kids, and be sure to include your family history as well.
Cultivate a Support Network
One aspect of getting help is relying on a support system of healthy adults. They can spot you when you’re feeling too up or too down. They can offer your children a more stable environment during manic or depressive episodes by taking the children to a different place, like your friends’ homes, or coming over to yours. Your kids need adults they can consistently rely on, even if you can’t provide that reliability sometimes. Try to develop that support if you don’t have it. When you are well, cultivate reciprocal friendships with other adults you can trust with your children. Easier said than done, of course, but try to be a reliable source of childcare for your parent friends, so they will pitch in when you need them.
Prepare Your Kids
Shielding your kids from bipolar disorder doesn’t mean hiding the illness from them. Preparing your children to accept what’s happening around them can be difficult, but it is worthwhile. Communication with your children is crucial when managing their understanding of bipolar disorder. You might think explaining your disease to them is wrong. There’s an instinct to hide uncomfortable situations from your children, but kids are intuitive. They will know if someone in the family is suffering, even if they can’t put their finger on why. If the problem isn’t explained to them, they may assume the worst, even to the point where they think it’s their fault. Letting your children know up front what to expect if you’re suffering from a mood episode will help your kids roll with the punches. Keep the explanation simple, and be ready to revisit the conversation anytime your children have questions.
When explaining your bipolar disorder to your children, stress that this disease is not your kids’ fault. Also stress that taking care of a parent suffering from mental illness is not their job. They will probably appreciate your candor and feel more secure in their relationship with you and their place in the world. If things don’t go well, talk to your therapist for ways to help your children understand bipolar disorder and their relationship with you as a parent with a mental illness.
If your older children are concerned about developing bipolar disorder themselves, tell your preteens honestly that they are not destined to have the disease. Studies put the inheritance rate at about 30% with a single parent affected by bipolar disorder, and around 60% for both. You don’t need to quote the statistics to a younger child, but a teen might be interested. Because of the instinct to hide uncomfortable situations from your children, you might want to keep this from your children. But knowing even uncomfortable statistics, like the 30%, is better than the unknown.
When you suffer from mental illness, taking care of yourself is a tall order. Taking care of a child as a parent with bipolar disorder adds additional complications, but it’s worth it. You can shield your children from bipolar disorder in several ways. Make sure that you treat your disease with professional help. Cultivate a support system. And it’s paramount that you communicate with your children about your disorder, so they know what to expect and what their place is.
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.
“Mom, are you crazy?” my eight-year-old son, Ryan, asked after reading over my shoulder while I worked on my book. My memoir, Committed, is about my stay in a mental hospital one week after Nolan’s birth, and the page he read demonstrated a particularly erratic behavior from me.
“No, honey,” I said. My heart sank. I was not ready to have this conversation yet, but Ryan’s question made me think otherwise. “I do have bipolar disorder, which is a mental illness.”
“What’s bipolar disorder?” he said.
“Bipolar disorder is when I sometimes feel depressed–like nothing in the world matters anymore,” I said, patting him on the arm. “But it also means I feel super energetic sometimes, and can’t control myself very well.”
“Will I get it?” he said, his eyes widening.
“I don’t know,” I said. “You might. It comes when you’re a teenager or young adult. But there are medications available to help manage it, so don’t worry.”
“Oh,” he said, giving me a hug. “I’m sorry you have bipolar disorder, Mama.”
And that was that. The dreaded conversation–the start of many–was over.
Arming your kids with age-appropriate information about your mental illness can help them feel secure. If you talk to them about your disorder, they will know what to expect when you have a down–or up–day. They’ll also learn to separate you from your illness, and from any negative feelings that might occur. If you don’t talk to then, they’ll invariably draw their own conclusions, which can make them feel unsure about you and their position in the world.
Here are some tips for talking about mental illness with your kids.
1. Keep it Simple
Children only need to know the basics of mental illness: it’s not contagious, they are not destined to have a disorder, there are treatments available, etc. Another important factor that goes into talking about mental disorders with your kids is stressing that it’s not their fault. They can’t make their parent better, nor should they try. They can only support their mother 0r father by checking in on them, watching movies with them, and generally being their awesome selves.
2. Reassure Them
Explain to your children if they ask that they might get your disorder, but reassure them that there are treatments available and that you’re getting help yourself, if you are. Tell your kids that you still love them, and no amount of mental illness will change that.
3. Know Your Child’s Maturity Level
All kids are different, and mature at different rates. Preschoolers will only want very basic information about why you’re sad. Preteens will want more information, so give them as much as you think they can handle. Teenagers will often turn to their friends when seeking information about things that bother them, so make sure they’re well-informed.
4. Address Their Fears
Ask your children if they have any worries now that you’ve brought up the topic. Reassure them that their needs will be met and that you’re not going anywhere. Repeat information if they appear confused. It may be helpful to bring their fears up with a mental health professional, so you can make a plan to address them.
5. Make Yourself Available
Make sure you don’t end the conversation there. Children will have questions as they grow, and it’s important that you be available to answer them. Explain to your kids that they are always welcome to ask questions of you about this topic.
Talking with your kids about mental illness can be tough. But if you’re open to it, they’ll appreciate your candor and feel more secure knowing what’s going on with their parent.