Bipolar Disorder and Children: Part I of II
Are Children Negatively Affected by a Parent with Bipolar Disorder?
Recently a reader asked about possible risks to children being raised by someone with bipolar disorder. In general, children's emotional growth and development can be impaired if they are raised by someone with any major mental illness. Some of the best studies concern unipolar depression. Children of women with untreated depression do worse with regards to multiple measures of behavioral, intellectual, and emotional development. However, the good news is that these effects are greatly reduced in children of women who are being effectively treated for depression.
Raising a family is a wonderful experience for most people, but the demands of childrearing are associated with a great degree of physical and emotional stress. People suffering from major mental illnesses experience this stress in addition to the demands of living with their illness.
Untreated or undertreated bipolar disorder can be associated with a range of risks to children, especially during manic episodes. At these times, parental judgment can be dramatically impaired, and psychosis may further cloud one's decisions. Rarely, parents have seriously injured their children as a result of mania and/or psychosis.
A more likely but less obvious risk to the child of a parent with untreated bipolar disorder is related to the effects of being raised by an impaired parent. While careful studies are able to describe developmental differences among groups of children raised by treated or untreated parents, it is very difficult to examine an individual child and identify specific problems they may be experiencing as a result of suffering along with their parents.
It is common for family members or friends of a sufferer of mental illness to be concerned about the effects on the sufferer's children. The response to these concerns needs to be graded according to the level of risk and the immediacy of the risk to children. In the worst-case scenario, the family member or friend needs to call the police if the sufferer's behavior poses an immediate risk to the child.
For less emergent situations, the best strategy is to try to constructively engage the patient to seek treatment. An attempt should be made to help the patient understand the effects of their illness on their children, with an appeal to seek treatment if not for themselves, then for the benefit of their children.
In an ideal situation, the patient will decide to seek treatment, but it is common for people to refuse treatment. If a patient poses an immediate threat to themselves or others, they can be hospitalized involuntarily according to laws that vary slightly from state to state. Obviously, this is the worst possible way for a patient to try to establish a therapeutic alliance with a psychiatrist, but does provide a mechanism for the protection of children. For less acute concerns, child protective services can be contacted to make a determination if a parent is able to adequately care for their children. Overall, these situations are difficult, and frequently don't have perfect solutions.
Please keep your questions coming I may not get to every individual question, but when I see popular themes, I will give you my impressions on issues faced by people with bipolar disorder.