10 Questions on Parenting a Grown Child With Bipolar Disorder
Maybe your grown child rarely speaks during family events—or she’s out partying for days without sleep. Moods can swing without warning or explanation, vacillating between debilitating depression and unexplained bursts of energy. And then there’s the drug and alcohol abuse—you haven’t seen it firsthand, but you suspect it’s happening, maybe to self-medicate—and other risky behaviors. If your adult son or daughter has bipolar disorder—newly diagnosed or yet to be—you’re a parent who’s likely worried about their emotional, physical, educational, and professional well-being, especially if they no longer live at home. How can you help?
Bipolar Often First Appears in Young Adulthood
According to the National Alliance on Mental Illness (NAMI), symptoms of bipolar disorder typically first appear around age 25 (although they can sometimes emerge earlier), which can make navigating this condition’s unknowns extra tricky for parents. You likely no longer have legal authority over your child, yet you’re concerned about how bipolar may affect their life and livelihood. Know this: While they may push back against your efforts, your grown child might need you more than ever during this turbulent time.
How Much Emotional Space Should I Give My Bipolar Adult Child?
Ideally, you’ve got a supportive, friendly relationship with your grown child that promotes maximum independence, says Robert Hamilton, M.D., a psychiatrist at OSF HealthCare in Normal, IL. How involved you should be depends on how well your son or daughter can function, what their needs are, how well you get along, and what you’re able to handle, Dr. Hamilton says. “The family’s role—parent, partner, sibling, or close friend—is to be a consistent source of support and encouragement through the good and the bad,” says Teri Brister, L.P.C., national director of research and quality assurance at NAMI.
How Can I Guide My Child While Still Respecting Them as an Adult?
Keep communication with your child open and non-judgmental so they know their well-being is your main concern, and that you’re in it for the long haul, advises Dr. Brister. Ask your child to name you as a personal representative and grant permission to treatment providers for you to communicate with them, ask questions, and share your concerns. (How to get official HIPAA authorization varies, depending on the provider.) If you see worrisome behavior, point it out to your child with compassion, and offer to help discuss it with a professional, says Dr. Hamilton.
If My Child Wants to Move Out, What Do I Do?
Remember that confrontation, arguing, and criticism usually aren’t helpful in any circumstance with your child, says Gregory Simon, M.D., a psychiatrist and researcher at Kaiser Permanente Washington in Seattle. “We can’t force others to do what we want them to do, but we can provide guidance and encouragement,” Dr. Brister says. Share your concerns with your child and talk about what involvement you’ll have once they’re living independently. If you don’t yet have your child’s permission to talk to their providers, ask for it now—in case you need to step in and help.
How Can I Help Them at College?
If your child is away at school, open up a direct communication line with staff at the health and counseling centers on campus, says Dr. Brister. Your kid might exhibit behavior at school you don’t see at home, which could be an early sign that symptoms are returning. “Early symptom recognition is important, knowing when things are changing and working with the treatment team to address what’s going on before things get worse,” she adds. “Navigating mental illness involves everyone who loves and cares for the person. It takes a village.”
What Should I Do if My Child Stops Taking Their Meds?
It’s common for a person with a mental illness to stop their medication, so expect this to happen at some point—and be prepared, advises Dr. Brister. Talk to your child about the consequences of stopping medication and give feedback on the positive changes you see from treatment, Dr. Hamilton suggests. “Remember, this is your child’s life—treatment choices are ultimately theirs to make,” Dr. Brister adds. “Like any other choices our adult children make, we may not always agree. And this doesn’t mean that they aren’t doing ‘well’.”
What if My Adult Kid Is Exhibiting Unhealthy or Even Dangerous Behaviors?
If there’s a risk of harm to themselves or others, you need to get help immediately. Otherwise, Dr. Brister advises you make a distinction between behavior you disapprove of and behavior that’s actually dangerous for your child. This is where having communication privileges with healthcare providers is helpful so you can share what you’re observing, from violent episodes, to substance use, to erratic sleep patterns. Even if you don’t have permission, Dr. Brister says you can still legally talk to your child’s providers, though you won’t get any information from them.
Should I Blame Myself if My Adult Child Is Not Doing Well?
While it’s important never to enable unhealthy behaviors—like turning a blind eye to drug use—it’s equally important to remember your son or daughter’s choices are not your fault. It’s can be tough to confront such issues head on but compassionately addressing problems shows love and concern, and may encourage your kid to get help. “We can’t control the behavior of other adults, even if they are our adult children,” Dr. Brister says. “We can be there to help pick them up when they make choices that have negative consequences.”
What If I Need to Legally Intervene?
If your child’s behavior is truly out-of-control, you might wonder how—or even if—you can step in to help. In cases where the behavior definitely looks like it’s leading to harm, Dr. Hamilton says you can seek involuntary treatment, putting your adult son or daughter in inpatient or outpatient treatment without their consent. (How to do this depends on your state.) Dr. Brister maintains this should only be done as a last resort—and only when your child’s, or other people’s, safety is an issue. You can also seek court-appointed guardianship if your child seems incapable of making competent decisions.
Where Can I Find More Information About Bipolar Disorder?
The best thing you can do for your child is to learn as much as you can, says Dr. Brister. Check out courses like NAMI Basics or NAMI Family-to-Family, which are led by family members of people with mental illness and teach you everything you need to know. “Most important, they provide support for the family as they navigate this with their loved one,” says Dr. Brister. Dr. Simon and Dr. Hamilton recommend resources from the Depression and Bipolar Support Alliance (DBSA), as well.
How Can I Take Care of Myself So I Can Be There for My Child?
“Dealing with mental illness is very difficult,” acknowledges Dr. Hamilton. “Parents need to receive support, educate themselves about the illness, and may want to get counseling themselves.” He encourages parents to talk to other parents who’ve shared similar experiences. Don’t be afraid to ask questions and, since a supportive community is essential, consider joining a support group, adds Dr. Brister. “The important thing is not to give up.”
Bipolar Disorder Onset: National Alliance on Mental Illness. (2017.) “Bipolar Disorder.” nami.org/About-Mental-Illness/Mental-Health-Conditions/Bipolar-Disorder
State Standards for Involuntary Treatment: Treatment Advocacy Center. (2018.) “State Standards for Initiating Involuntary Treatment.” treatmentadvocacycenter.org/storage/documents/state-standards/state-standards-for-initiating-involuntary-treatment.pdf
DBSA Support Groups: Depression and Bipolar Support Alliance. (n.d.) “Support.” dbsalliance.org/support/