Imagine that you have a happy-go-lucky child entering adolescence. Out of the blue, he becomes moody, alternating between high and giddy and negative and irritable. When you ask him what’s going on he simply says, “Nothing, Mom.” You suspect that his moods are just part of a normal adolescence until you notice changes in his behavior.
This is what happened to me before my son was diagnosed. At first, I wasn’t sure why he was constantly getting hurt by pushing himself to do extreme moves in skateboarding, or why some of his friends no longer wanted to hang around with him because of his anger. He had never been an angry child, but he became moody and insolent. He had trouble sleeping and started to isolate himself from the family. I took him to a psychologist who gave him a battery of tests, but she concluded that nothing was wrong and told me he would grow out of it. It wasn’t until he was diagnosed bipolar that I understood his mood swings and his almost addictive need to push physical limits. His impulsivity and inflated sense of his abilities negated his acceptance of boundaries.
Here are some things you might not know about bipolar illness that could be puzzling to you before your child is correctly diagnosed.
1. Although he is probably very smart, creative, dynamic and charismatic, even seductive at times, these characteristics may mask the illness.
2. He may feel that he is different from his peers but doesn’t understand what it is about him that is different. Therefore, he may hide his fears about what is happening to him, feel lonely, and be unable to ask for help.
3. There is both pain and terror involved in having this illness. His friends find him humorous and magnetic one moment and cynical and “too much” in the next. This is very confusing, and he has a hard time understanding their reactions.
4. He may have difficulty expressing emotions and become irritable, easily frustrated and have outbursts of anger. He has little insight about how his moods and actions affect others.
5. He may withdraw from siblings and the rest of the family because he can’t trust he’ll be able to manage his moods. He doesn’t like crowds because there is too much stimulation.
6. His judgment may be clouded resulting in impulsive behavior and a lack of ability to think through consequences. He may seek out and engage in physically dangerous activities because of an inflated sense of his own abilities and a desire to eliminate emotional pain. He may appear grandiose and think he can do things that others would deem dangerous or unreasonable.
7. He may have sleep difficulties: difficulty falling asleep or staying asleep because of an inability to quiet his mind. In the manic phase of the illness, multiple ideas come so fast it is difficult for the brain to rest.
8. He may use street drugs to self-medicate both cycles of his illness. However, when drugs are involved, it’s harder to manage the mood swings that come with bipolar illness.
9. He needs a creative outlet to manage his mood swings: listening to music, doing artwork, playing an instrument, being in a band, dance or theater company, or participating in challenging physical sports.
10. When he is diagnosed correctly, he may refuse to comply with a medication regime because he doesn’t want to numb the euphoric state that comes with manic episodes. It may take several hospitalizations for him to accept the ongoing chronic nature of his illness.
Bipolar illness does not go away, but it is treatable. Your child needs compassion and empathic support from his family, a psychiatrist who prescribes the correct medication and a good therapist who can help him recognize the changes in his moods and how to manage them. Since bipolar is a brain disorder, it is important for your child to take his medication, get enough sleep, eat healthy food, avoid drugs and alcohol and stay away from stressful situations. You can help your child by finding out everything you can about the disorder, educating your family members and treating the disorder like any other. If your child had heart disease, you would get him the best treatment you could afford for his heart. This is a brain disorder, so help him get the best treatment possible for his brain.