Parenting Children with Bipolar Disorder

A reader asks, “My 18 year old was diagnosed with Bi-Polar Disorder last year. He is adopted and has always been my “Orchid” child. Our divorce was almost more than he could handle emotionally and I think he got to a point that he could no longer stuff the pain.

My son’s heart and spirit is broken. As a mother I want to put it all back together for him. I know I can’t do that but I want to be able to give him what he needs.  I’ve read books… many books but they tell me, instead of talk to me.

I was hoping you could point me in the direction of a book or article that will talk to me as a parent.  Help me when it comes to giving my child what he needs from his mom.  Truth be told, I want magical words, light bulb moments where I realize exactly what I need to do.

I know that isn’t going to happen so, a bit of guidance I will be happy with. Any suggestions?”

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I wanted to address the anguish and wounded love of this request here in this post in the hopes that other parents with similar struggles might both benefit, and also send spirit into the ether in support of each other—not to mention comments on what has actually helped other “children” with Bi-Polar, whether fifteen-years-old or fifty.  I would also ask readers to consider these ideas even if your specific child does not, mercifully, struggle with Bipolar disorder—to read in support of this mom, and all the kids who do have Bipolar.  By taking an interest in each other, we heal ourselves and empower ourselves to get things right with our own kids.

For those fortunate enough to know little or nothing about Bipolar because they haven’t needed to, it is an illness that typically onsets in adolescence or early twenties (although it can occur in younger children); the hallmarks of Bipolar are cycles of extreme agitation, including possibly psychotic process and a highly pressured sense of extreme energy that feels to the Bipolar like super-human invincibility, but feels to the rest of us like scary, crazy, dangerous and exhausting behaviors (i.e. maxing credit cards, running naked through the streets, thinking one has had a break-through that will change the world, fearing that everyone is tying to get them, gripped by paranoia).  These cycles can be days of manic up followed by weeks of depressed down, or they can be rapid cycles, more like Taz.  In literary terms, Robert Louis Stevenson’s Strange Case of Dr. Jeckyll and Mr. Hyde, is a classic example of the archetype of what is today called Bipolar.

For those who would like to learn more about Bipolar Disorder, such as diagnostic criteria and additional resources for help, a good place to start might be the National Institute of Mental Health’s website on the topic:   http://tiny.cc/0msA4 .

As far as what I can say to the mom who wrote in, and to other parents in her position, firstly, I would like to suggest that no one is Bipolar.  By this I mean that many of us have the diagnosis—a cluster of symptoms that we call “Bipolar” (and once called “Manic-Depressive”), but no one is his or her diagnosis.  We are human beings, sacred spirits, and we must keep this in mind as we deal with our children, siblings and even parents when they struggle with challenges like Bipolar. 

Next, if we are really going to “talk,” (rather than “tell” advice) even in this virtual context, we must compassionately recognize the anguish that you, the mother who wrote to me, are asked to hold and metabolize in bearing witness to your son’s pain.  We must start where Martin Buber ends—striving for the “essential deed” of relating to each other, all who stumble across these words.  Buber’s “I-thou” relating means seeing to the sacred in the other, where we transcend relationships of “use” (even the trying to help the other) and instead just see.  This creates a foundation from which to re-think helping and healing.

I must qualify my remarks by saying that they cannot possibly serve as treatment advice, and are meant only as support and encouragement to you, as a parent, as I think your calm, insight, trust and endurance can only help.  Given that your son has been diagnosed, I will presume that he is in treatment with professionals, and with conditions like Bipolar, this is essential; the scope of this blog is to support parents to be their best Selves in the face of whatever the world brings, in this case Bipolar.

Illness, pain, and injury happen in the context of relationships and they also heal in the context of relationships; the tenor of our relatedness creates the potential magic that facilitates organic healing.  For some thoughts on why depression is so draining to parent see my prior post:  http://tiny.cc/5bMMV on this.  

Also keep in mind, no matter what difficulties we may be parenting, the essential self of the child (or parent) is either like a bowl—if we have gotten enough accurate understanding to develop—or it remains more like a colander and everything we pour in seems to go right through.  Thus with Bipolar, accurate understanding can be healing to the self, and in turn make it easier to manage the tumultuous thoughts and feelings that come by virtue of neurochemicals, or perhaps by forces none of us truly understand.  For more on the bowl and how to build it see:  http://tiny.cc/jQflV .

While Bipolar is very serious, that doesn’t mean that it cannot be successfully managed.  Too often doctors lack bedside manner; they scare, but do not reassure; they label, but this does not heal.  My clinical experience leads me to suggest that proper medications, at least at this point in our Western understanding, is still critical—but it is still not a “cure.”  Those with Bipolar frequently resist or quit their meds, as the flattening effect is unpleasant, however, preventing manic episodes is crucial as each one seems to lead to a deeper depression in its aftermath and an overall worsening of the situation.

Although scary to discuss, suicide is a significant concern with Bipolar, (talk about scary, but this is why parents, partners and caregivers of those who struggle also need love, compassion and support to be that front-line responder and facilitator of healing relationships).  Keeping lines of communication open, and responding very seriously to any talk of self-harm, helps keep in mind that keeping those we love safe from harm, including their own harm, is a key priority. 

Those with Bipolar can be at particular risk of self-harm due to the impulsivity that can occur at different points in the cycle of the up and down.  Additionally, the bleakness of the depression must be understood as an agony far exceeding anything a typical person would call “sadness.”  Reading about depression (i.e. Darkness Visible by William Styron) can help deepen empathy if you are fortunate enough to have never suffered true depression.  So, safety first—any doubts, call your child’s doctor and/or 911.

Lest you think I speak only from a textbook, or even just from my clinical experiences with Bipolar (which are numerous), Bipolar is also an issue in my family.  A relative recently had an episode in the midst of holiday would-be-cheer where the monster rattled the cage pretty hard, murderous threats were hurled, children were threatened, police called and parents had to walk the heartbreaking line of protecting a grown child with a terrifying illness and at the same time protecting everyone else, including the very children of the one in crisis.  If we are truly inter-beings, we might take a bit of comfort in remembering that ultimately, we are not alone—when suffering is inescapable, I say let’s make it productive suffering, continually asking ourselves, “how can we learn and grow from this?”  It also helps for us all to realize that if any one of us suffers, at some level, no matter how subtle, we all suffer.

It may be useful to keep in mind the conceptual notion of mania as a defense against depression.  Thus as the depression begins to well up like an incipient earthquake, the frightened mind takes flight, off into the grandiose sky of big plans and no limits.  Yet the frightened psyche flies as high up as the true problem goes deep down.  And when the manic defense finally crumbles, and it always does, the poor soul is tossed into the belly of the beast—the very thing they’d hoped to elude with their flight.

Another interesting perspective on Bipolar is to be found between the lines of a book on cave art, The Mind in the Cave:  Consciousness and the origins of Art by David Lewis-Williams.  It seems that the genetic mutation for Bipolar appears in the genetic record just about the same time as cave art appears on cave walls.  This may suggest that the shift in human consciousness that brought us Shamans and their visions, and out of this spirituality, mythology and religion—the foundations of culture—relate to some of the same things that we modern humans call “madness.” 

After all, a culture decides who is a visionary and who is an outcast, who is to be medicated and who is to be listened to.  One shaman’s “magical flight” is another patient’s “manic episode.”  If your son is a gifted “orchid child,” perhaps it will help to provide as calm and stable of an environment as possible, helping him to value the way he’s hinged together. 

On the one hand you don’t serve your son by colluding with his wishes to indulge in mania, but on the other hand he must be understood as having something to say and contribute—to all of us.  You say the divorce triggered a worsening of his condition, and this is consistent with the idea that stressors can provoke episodes (although no stressor will make a non-Bi-Polar develop it).  Yet the parent must guard against the guilt of thinking that it might be all our fault (or our reviled ex-spouse, etc.); wherever we find ourselves hating so some other, we have an opportunity to do Shadow work.  If we want our kids to be free from guilt and to integrate their dark aspects harmoniously with their light, we must teach by example.

Given that Bipolar has not been selectively bred out of us humans, there is a case to be made that it serves something that we have not yet fully understood.  For example, scientists only recently discovered what the spleen is for (a repository of white blood cells on stand-by for emergency battle against infection); before they figured it out, they figured it wasn’t needed and was frequently removed… only those without it were much more likely to get sick and die sooner than their counterparts who have retained this previously seemingly “useless” organ.  Maybe orchids with Bipolar are like thoroughbred horses that can be amazing if their parents can learn how to become something akin to an “orchid whisperer”?  In this way the parent is called to his or her own initiation into higher spiritual evolution, a call to a hero’s journey (along the lines of Joseph Campbell) that the hero must heed, but still never relishes—it is scary, sad and dangerous and the hero would naturally rather live a “normal” life.  Remember, though, we are not called to be actual heroes (this would be grandiose inflation, the last thing we need in grounding those with Bipolar), we are called to recognize, and integrate, this archetype within ourselves.

While many people with Bipolar have achieved and contributed much to humanity, research shows that the highest incidence of scientific and artistic genius is to be found, not in the one with Bipolar themselves, but in their first-degree relatives (i.e. parents, kids, siblings).

This ties into the adoption issue.  You do not say at what age and under what circumstances you adopted your son, but it would not be surprising to learn that his biological mother or father had Bipolar, or an aunt, uncle, etc.  Additionally, the loss of the birth mother can be a large, albeit unconscious and often unresolved, psychological factor in helping adopted kids come to full resolution of their life-path.  Sometimes adoptive parents are ill at ease to leave space for kids to grieve and morn such losses. 

Another factor to keep in mind is that conditions such as Bipolar rarely present “clean,” and there are frequently other conditions as well, such as ADHD, substance abuse, etc.  Substances are particularly tricky as people will try to self-medicate and this often exacerbates the problem.  Sobriety is always important if one has a tendency toward addiction, but it is doubly important with Bipolar.  Where available, information on what medications helped, which did not, course of illness, other “co-morbid, ” or additional, conditions can aid in effective treatment.  

At 18, a young man may need a father figure to help consolidate his masculine identity, and if the divorce has left strained relations with his adoptive father and no biological father, he may be feeling rather like an emotional orphan.  Trying to keep in mind that even without Bipolar your son might be in a bit of an identity crisis at this point might help from him feeling like he is just some sort of unwanted or damaged person. 

Keeping an eye on self-esteem is critical, as struggles with Bipolar can leave a person feeling “less than,” and this is a distortion that must be gently, but consistently, countered.  Helping find success experiences (i.e. things he can take pleasure in and be good at) can help with this.  Our key parental input is not “I’m proud of you” when they do well, but rather, “I hope that you’re proud of yourself.”

While 18 sounds old to 18 year-olds, we ought to keep in mind that true adulthood in our culture begins at 27, and an 18 year-old is half ready to return to childhood and half ready to conquer the world—a confusing presentation to parents, even without Bipolar further muddying cloudy waters.

A good talk therapy can be helpful for your son, but you too might benefit (if you’re not already in therapy) with someone you speak to, at least partly, in the service of being able to be there for your son, despite the fear and thanklessness of the task of being a bowl for his spill-over feelings at times.  Kids often have an uncanny way of giving us their unwanted feelings, and all the more so if something like Bipolar is at play.  You may deepen your connection with your son if, when he makes you feel angry, confused, frightened and useless, you are able to recognize that these may be his own raw, undigested and unmetabolized feelings.  If so, think of Columbo, that detective with a knack for understatement (i.e. your kid is teeming with rage, and you lovingly wonder if he might be himself feeling just a little angry), if you get it right he won’t further escalate (that usually comes from feeling like you’re trying to cheer him up when he’s telling you he’s in the blackest despair imaginable), but instead he may actually get calmer.

I have known parents who joined NAMI (National Alliance on Mental Illness) and found it absolutely transformative to talk with other parents with similar struggles.  Community and support from those in the same boat is really worth considering.  See:  http://www.nami.org/.

Finally, yoga is starting to gather research evidence to show that it helps with anxiety, depression and a host of issues.  My Bipolar clients have invariably benefited from yoga.  One, who was quite prone to manic flights even with medications, really needed a lot of down dog to root her into the earth, another with terrible despair found little bits of hope and light in yoga practice, helping them continue one day forward at a time when this was not by any means something they were sure they wanted to do.  Such grounding is calming, and it also helps thicken a part of the brain called the insula, which in turn seems to help regulate against being swamped by disturbing thoughts and feelings.  The insula builds slowly, but the growth is irreversible and will help us who thicken it stay Zen throughout our lives.

I hope these thoughts bring some insight and/or comfort, but please know that there are many parents out there in your situation.  Try to visualize your son stable, happy, productive—even glad for the way he is, having one day learned from his situation.  My hope is that readers will join me in sending you and your son good wishes, and that we may all better realize our interconnectedness, perhaps even appreciating the possibility that those with Bipolar may carry more than their fair share of the madness that is in no short supply in our world, and in the shabby way we too often treat each other. 

So, in the spirit of compassion, let’s dedicate today to the well-being of kids with Bipolar, and to their parents, and also to those grown-ups who have loved and been wounded by Bipolar parents—in the service of all our collective children.

Namaste, Bruce