Explaining bipolar disorder to children

Bipolar Disorder: An Information Guide

Explaining mental illness or bipolar disorder to children can be awkward and difficult. To protect their children, the affected and well parents may say nothing and try to continue with family routines as if nothing were wrong. This strategy may work in the short term. Over the long term, though, children can feel confused and worry about how their parent’s behaviour has changed.

Children are sensitive and intuitive. They quickly notice when someone in the family has changed, particularly a parent. The atmosphere in the family may not encourage talk about this subject. If so, children will draw their own, often wrong, conclusions. Young children, especially those in preschool or early grades, often see the world as revolving around themselves. If something bad or unpleasant happens, they assume they caused it. For example, a child may accidentally break something valuable. The next morning, the parent may seem very depressed. The child may then assume that breaking the object caused the parent’s depression.

Children need to have illnesses explained to them. It is best to give them as much information as they are mature enough to understand. For example, toddlers and preschool children understand simple, short sentences. They need concrete information and not too much technical language.

“Mommy is sick and feels sad - just like when you have a cold, you don’t feel well.”

“Sometimes when Daddy is feeling sick, he gets tired and mad. He will feel better later.”

It is best to explain simply and then try to normalize the situation. Moving on to do something special that the child enjoys can make things feel better for the child.

School-aged children can process more information than younger children. Yet they may be overwhelmed by details about medications and therapies.

“You know how sometimes you feel very happy or very sad? Well, Daddy has a kind of sickness where he sometimes has those same feelings, but they are much stronger and can last a really long time. Those strong feelings can make him say or do things that can be upsetting. He doesn’t really know when it will happen, but he takes some medicine to help make him feel better.”

Teenagers can generally manage most information. Often, they need to talk about their thoughts and feelings. Teenagers worry a lot about what other people, especially their peers, will think of themselves and their families. They may ask about genetics. They may also wonder how open they should be about the situation and worry about the stigma of mental illness. Sharing information encourages talking further.

It is helpful to cover three main areas:

Children must know that the family member has a sickness called “bipolar disorder.”

The parent or family member behaves this way because he or she is sick. Bipolar disorder makes people feel one of two ways. They may be very depressed, or sad, sometimes for no reason. They may cry a lot, sleep all day and have trouble eating or talking to people. At other times, they can become very loud and happy. Small things can irritate them and make them angry.

Children need to know that they did not cause the illness.

Children need reassuring that they did not make the parent or family member sad, angry or happy. They need to be told that their behaviour did not cause their parent’s emotions. Children think in concrete terms. If a parent is sad or angry, children can easily feel they did something to cause this, and then feel guilty. Bipolar disorder needs to be explained as an illness. It just like having the chickenpox or a bad cold.

Children should be reassured that it is not their responsibility to make the ill person well.

Children need to know that the adults in the family and other people, such as doctors, are working to help the affected person. It is the adults’ job to look after a person with a mood disorder. Children need the well parent and other trusted adults to act as a protective buffer between them and the parent’s symptoms of depression and mania. It is very hard for children to see their parents distressed or in emotional pain. In the same way, children have trouble coping with the irritability of a parent struggling with mania. Talking about what they have observed and experienced with someone who understands the situation can help sort out the child’s confused feelings.

Many children are scared by the changes they see in their parents. They miss the time previously spent with this parent. Taking part in activities outside the home helps because children are exposed to other healthy relationships. In time, as the ill parent recovers, gradually resuming family activities can then help mend the relationship between the children and the affected parent.

Both the ill and the well parents should talk with the children about explaining the illness to people outside the family. Support from friends is important. However, bipolar illness can be hard to explain, and some families are concerned about the stigma of mental illness. Each family must choose how open it wants to be.

Finally, some parents struggling with bipolar depression may not be able to tolerate their children’s noise and rowdy play, even though such disturbances are part of children’s everyday activities. Special measures may be needed to buffer the ill parent from situations that may lead him or her to be irritable and abrupt with the children. At times, children may need to play outside the home. Or the ill parent may need to rest for part of the day in a quiet area of the house.

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