bipolar disorder All adolescents “try on mental illness.” This is why all diagnoses are provisional in adolescence. In other words all adolescents have their crazy behavior, language and thinking process.  Think back to what was important to you when you were a teenager?  I bet it has changed! Many of the hundreds of patients and families I have seen over the last 35 years want definitive answers, but the behavior has to exist for many years before you can truly know if it is bipolar disorder or a really difficult adolescent. I have treated hundreds of families who have a loved one with “bipolar disorder” and the issues change over the years.  Wait until they are 22 to 25.

IF it is a real bipolar disorder, this is the trend that I have observed:  The parenting issues come in stages. There is the “what is wrong with my child?” phase. When you are having struggles and don’t know what to do.  You think it’s you or think its them or the marriage or the community.  Some people suffer in silence and others go for help.  For many people who go for help they are both relieved and saddened by the diagnosis.  The label says there is something wrong and it isn’t my imagination (which can be validating) but it is also painfully sad.  Parents (and siblings) experience a mourning process.  A loss of a dream of who you hoped your child/sibling would be.  The mourning process hits people in different ways but as a family therapist I watch it destroy marriages and families.  My first advice for couples and families is stop blaming.  This isn’t about blame, its about coping minute to minute or day to day.  Work together as a team and be on the same page.  It isn’t in anyone’s best interest for the child’s illness to have that kind of control over the family.  You need to actively educate yourself, seek help, look hard for everyone’s strengths, take care of yourself and don’t forget humor.

The next phase is putting a great support system in place both professionally and personally.  Find a psychiatrist and a therapist for you and for your child.  The concept of high maintenance parenting means that you need to spend more time and energy on yourself to see choices. For example, your child asks you to stop at Dunkin’ Donuts on the way to the therapy appointment and you don’t have time–so you say no–and they have a full-fledged tantrum in the car or at the house.  You don’t have time to think about the best approach, you just react, the decisions have to be made in a second. The tantrums or manipulative behaviors can hijack you at any moment.  And we all know you cannot negotiate with terrorists so you have to learn to see choices in the moment. That takes work. You can take her home and take the appointment yourself, you can drive there and leave her in the car, you can stop and get the coffee and then talk about it later… but the problem is that you have to accept that you are not going to resolve this in a logical,calm manner.  If you keep yourself healthy, you will be a good role model and you will handle their outbursts or mood swings in a healthier way.

Support systems also mean friends and family.  If your friend likes to brag about her child who just won the Nobel Prize and is judgmental of you, then its time to minimize your contact with her and find a new friend.  Don’t get rid of her but minimize your exposure. There are support groups on line and in your local area, go check one out!  If your mother blames you or the medicine for your child’s behavior then make that topic off limits–change the subject.  Answer the phone from a position of strength.  If you are having a bad day, use your caller ID and let it go to voicemail and go for a walk, take a shower, phone a friend  or make an extra appointment with your therapist.  Having a support system doesn’t cure anything but it makes life more manageable.

My father used to say, “There is more than one way to live a life.” He gave me that wonderful gift of perspective. I love that, because accepting each other for who we are is truly the key to peace of mind.  Accepting the diagnosis does not mean giving up or ignoring them.  It means you need to look at them and figure out who they really are and adjust your expectations and behaviors accordingly.  SEE THAT YOU HAVE CHOICES! You have choices about what YOU do with your time, energy and money. When children are little they can’t do anything themselves, we need to do it all and can’t even go to the bathroom without an ear to what they are doing.  When they are older our job has changed without our consent. We need to detach with love to let them live “their way to do life.”  Use a good support system to define who your child is, pick your battles (the laundry isn’t a battle I would pick, taking your medicine is one but even that is complicated),  play to their strengths and your own! Take it one decision at a time.

Most of my clients who went through the mourning process when their children were diagnosed have learned to have a healthier perspective to make their lives and their children’s lives more manageable. Those in the the midst of adolescence need to batten down the hatches through the storm.  Adult children need a very different approach.  More manageable does not mean that they are living the way YOU dreamed  they would, it means that they are being who they are.  There are a lot of talented and successful people who have had this disorder.  Challenge yourself to see that you have choices and accept your child.  It is the key to peace of mind!


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