The effects of Parental Bipolar Disorder is not extensively covered. Most articles understandably are about managing the condition and ‘doing for’ the sufferer. But many sufferers out there have children and it is easy for their needs to go unnoticed especially given as they are often silent about them and do not express that they have any. Every family has different experiences with children with different personalities but many of the core issues are the same even if they manifest differently in the child. I am going to share my personal experience and some of the things we have learned with the help of a therapist in the hope that they might be useful to someone else.
6 weeks after my daughter was born I had a depressive episode and went into a mother and baby unit for a few weeks to change my medication at speed but it was quick and did not seem to have an effect despite my initial worries. My husband came every day and the nurses facilitate as much normal interaction with your baby as possible. When she 18 months, bigger and more aware, I was in a mixed state and needed a residential treatment for 3 months, I was overwrought with worry about attachment but also very unwell. But my husband brought her to see me everyday and I was reassured by professionals that as long as the child had one strong attachment there shouldn’t be a problem. Obviously this has implications for those with young children who are single parents.
The professionals were right though we picked up the pieces and carried on as normal and had no problems in our relationship at all. There were no further admissions in the years that followed and during times when I was very ill at home my husband stepped in and she appeared to find this security enough to compensate for the fact that I was ill and out of action.
The problems appeared after my husband died. Piglet (that is her code name as she likes the character from Winnie the Poo), has found it much harder to cope with my illness since I have become a lone parent. She has lost her support system, her Dad who would take over as the pillar of strength and security when Mummy was ill. Now she is effectively home alone with it as so many children are. It started about 18 months ago. I was rapid cycling quite fast. She appeared to be coping as she has on all subsequent episodes. But as I came out of the episode the problems started. She had a genuine fall and fractured her leg. But following this there were two questionable hand fractures.
The Consultant said it was unlikely the hands were fractured at all. They had looked like it on the emergency room x ray but in the Orthopaedics follow up 10 days later there was nothing. He said the amount of pain she was reporting was excessive. Too high compared to what the xray showed and was anything going on at home as he felt it was Psychosomatic. Some time after this she started vomiting her food and becoming randomly more labile in mood. She also didn’t want to leave me, becoming distressed if she had to and was declining sleepovers which she previously loved.
I found her an excellent counsellor thinking it was delayed grief. But as we went through the process the counsellor reported that she felt a more present issue than the Grief was Piglet dealing with my Bipolar episodes. She has never been very good at talking about her feelings and obviously with this she didn’t want to upset me. Her emotions were coming out physically and in behaviour. Interestingly she waited until I had recovered so she knew I could take her anger.
She attended counselling for a year and we did some really useful sessions all together looking at the illness, talking about it, learning about it and acknowledging it, as well as finding useful strategies for Piglet. It really made me think too. We get so absorbed when we are in an episode and no matter how much we love our children sometimes even meeting their basic needs is hard let alone considering what their emotional needs are resulting from what is happening to us. If they don’t show signs it is easy to think they are ok.
Everything went back to normal until I had a very severe episode this Autumn. I was virtually catatonic for the entire first month when Piglet was returning everyday from her first month at secondary school. A time when you really do need your Mum and your routine, she had none of that. I continued to be ill for a further month. Piglet appeared to be fine. Coping with her new challenging travel arrangements, being in a bigger school with many many more children, new children, new teachers, more homework. As soon as I was somewhat recovered from the episode it started, the vomiting, her being moody, exhausted, not wanting to get up in the morning. It took me a while to realise what had happened. This was the transition from me recovering to being well and all my mothers instincts kicking back in.
I just looked at her one day and couldn’t believe how fragile she looked. It was this post episode stress thing again. I named it. She denied it. I pushed a little and said “Look of course its been stressful, you’ve had all this on and your coming home to a Mum with Bipolar Disorder who is not well and not giving you all the support you need”. I put everything I had into re-establishing a routine, dinner at 5.30pm, bed at 8.30pm, asked the school to give her a break from week day homework and just giving her my full 100% attention. I offered her to return to counselling which she declined. But she really responded to those normal things that I just can’t put in place when I’m ill. She fends for herself a lot when I’m ill as I think a lot of children of Bipolar parents do. We just manage, somehow get by. But these are little beings with big needs and it has to come out somewhere somehow.
I feel lucky that we have come to the point where we can talk about it. Children with Bipolar parents tend to want to protect the parent. Initially they may feel they did something wrong. Even once they are past that stage they don’t want to make it worse. They want to protect you. They notice the parents fragility and that is why they hold in their own feelings until the parent is strong again and then it just comes out. My daughter has spent a lot of time denying that my illness has any effect on her whatsoever or that I am difficult to be around in any way. I don’t think she wanted to upset me.
I am still having to reassert “It’s normal to find it stressful to live with someone with Bipolar Disorder”. “Coming home everyday from school and finding me exactly where you left me cannot be nice”. We are slowly starting to laugh about things and this time she gladly accepted my post episode nurturing and did not deny my assertions that she was suffering from stress and exhaustion. I think she even used the phrase “I’m feeling better now” by which of course she inadvertently acknowledged that something was wrong.
I’ve just had a significant manic episode and she appears not to have found that difficult at all. I always think that’s easier for her as I can be super functional and if not super extravagent and superfun but I am mindful that it is still a big change and may be somewhat unsettling. It is something I want to explore. It stands to reason it will be effecting her I’m just not sure how.
I’m not sure how much I can change ‘in episode’. But I do want to look at her support systems and have them more robustly established. We did a little bit of work on this on therapy and used some during the depressive episode but it was still a little ad hoc. I’d like to think I can try and find the energy to keep her evening routine a bit better during episode. But that is easy to say now and harder to do when I can’t get out of bed. Some of the things below are things we have done that have been useful that might be food for thought. You will need to adjust for age.
Strategies for supporting children of Bipolar parents
- Brainstorm “What does Depression look like?” “What does Mania look like?” Try and get the child to find words that go with each polarity. What is Mummy like when she is well? Get the child to find 3 positive words to describe Mummy? Mum find 3 positive words to describe the child.
- Self Care Take a piece of paper each and spend time writing down and drawing images to show the things that make you feel good, things you like to do etc.
- Who can you call? Agree together 3 people the child can call if they are worried about your behaviour or want to chat to someone when you are ill. Get them to store these numbers in their phone if they have one. Ideally the child will choose and you will agree but if you are really not happy you could say “Can you think of anyone else?”. Emphasise to the child that it is really ok if they need to call these people when you are ill either because they are worried about your behaviour or simply because they want someone to talk to.
It is also a good idea to tell the child that Bipolar disorder is an illness like any other illness. It is not a secret and they can talk to whoever they want to talk to about it as wherever they can find some support is a good thing. Some children might even need to know that you can’t die from it, they can be secretly harbouring this as a worry but be afraid to ask. Ultimately we all have to find our own way to parenting the best we can whilst suffering this disabling condition. But the key thing in my opinion is communication. Communication takes the fear away. Communication breaks some of the power of the illness down and gives you and your child the feeling like you are back in charge. And finally of course Communication is the key to any good relationship. Despite everything we go through, I am proud to say I have the most amazing relationship with Piglet. I’m far from perfect when I’m ill but I make up for it when I’m well, we have the best of times, she has the best of experiences. We adore each other and I don’t think she’d want anyone else. She has said she thinks I’m brave and she is proud of me the way I battle this illness. I just want to ensure that her needs continue to be met and the impact on her is reduced. This will be vital in maintaining her mental health and reducing her risk factors for inheritance.