I still remember vividly the moment when our daughter was diagnosed with bipolar disorder. I felt stifled by a thick, heavy fog of emotions – fear (make that terror), heartbreak, confusion and questions (oh so many questions). Only a small ray of light broke through, powered by a sense of relief that we finally knew what we were fighting. My husband had his own reactions and emotions, some parallel to mine, others very different. But there was one thing we solidly shared – an acceptance of the diagnosis. Over the next 12+ years there were times when we questioned aspects of the diagnosis, disagreed on treatment approaches, debated (or flat out argued about) parenting strategies. However we never stood at odds over whether or not our child had a serious and debilitating illness. At the time we had no idea just how much this would benefit our daughter and our family.
Since that day, I’ve had the opportunity to connect personally and professionally with 100’s of parents whose child has been diagnosed with, or shows significant signs of, mental illness. A large number of these families are what I would call ‘stuck in the starting gate’. By this I mean that one or the other parent is unable to pursue getting an assessment, unable to accept (or even consider) a diagnosis, unable to ask the question ‘now what’, unable to process the emotions. The parents generally agree that something is not right with their child, but from there their paths diverge.
There are a variety of reasons for this parental gridlock including:
- fear of the unknown – what if my child can’t/won’t live out the hopes and dreams I hold for them?
- lack of information or understanding about mental illness – mental illness is what we see in the news, the violence, the sociopath, the addict, the homeless . . . ;
- fear of stigma, of their child being ostracized, excluded, labeled for life – how will my child ever have friends, have a job, graduate from high school . . . I believed no one would ever trust my daughter to babysit (I was wrong);
- personal beliefs and experiences, including how we ourselves were parented or how our family of origin handled problems – more/less consequences, discipline, limits, freedom;
- insecurities and self-doubt over our own parenting abilities – this will reflect directly on me, my parenting abilities, my genetics, will people think I too have a mental illness or what if I DO!!??;
- general feelings of helplessness or lack of control
It helps to recognize that leading up to this point the family has likely been in some level of chaos or stress. That was certainly our case. Unlike strep throat, a broken arm or mono, symptoms of mental illness aren’t usually clear cut nor can they be measured by a throat culture, x-ray or blood test. Rather, the family has been struggling with challenges such as unpredictable, frightening or risky behaviors, extreme emotions, school refusal and/or dramatic changes in sleep patterns. Routines such as family dinners, getting to work on time (or at all), helping siblings with homework, celebrations or socializing with friends are disrupted or have completely fallen by the wayside. Conflict within the family is on the rise and rather than coming together as a team it’s every man, woman and child for themselves.
Whatever the underlying reasons, the cost of parental gridlock is immense and impacts the entire family. For starters, treatment is delayed, misguided or withheld entirely. There is no shortage of evidence showing that early intervention improves outcomes, slows or even reverses the progression of the illness and limits the disruption of a child’s normal developmental path socially, emotionally, physically and academically. Whether the intervention is therapy, medication, academic support, hospitalization or family counseling, the key point is to start rather than delay the process of assessing the situation, ruling out possible causes, developing a support network and working towards an accurate diagnosis and appropriate treatment options.
The longer that disagreements continue between parents, the deeper the divide, the more extensive the erosion on their relationship. I’ve seen couples recover, I’ve seen couples heal even if the marriage or relationship doesn’t survive. It can be done. But I’ve also seen far too many children caught in the crossfire of conflict. Parental fighting ranks as the biggest stressor for children of divorce. Before or after the marriage ends. This applies not only to the child with the illness but to siblings who cannot avoid being impacted by the stress and disruption of the family.
Another casualty of parental disagreement is the lack of safe boundaries for the child. Mental illness can be confusing and frightening. Think about it – most of us, at least for the majority of time, understand our emotions, why they change and what the root cause is. A child with anxiety, depression or bipolar disorder lives with emotions that play tricks and surprises on them. A panic attack comes on without warning in the middle of recess; the crushing weight of depression makes getting out of bed impossible, much less going to school; mania shows up without warning in the form of extreme irritability and anger that is targeted at friends and family. When parents can’t agree on how to parent through these stressful and frightening times, the child receives any number of mixed messages ranging from empathy and compassion to frustration, punishment and blame, to bribes, pleading and tears. This unpredictability leaves the child feeling as though they are in a room with no walls. No safety net, no predictability, no routine.
So what’s the solution? It’s no surprise that there isn’t a simple, one size fits all answer. However, there are some steps that families can take towards getting unstuck.
- Awareness: Acknowledging that differences exist is a starting point as well as recognizing fears that may contribute to strong reactions or inflexibility.
- Find a common goal: Rather than working against each other, find something that brings you together. Often, your child’s wellbeing or a calmer home life is a great starting point.
- Learn: Knowledge is a powerful antidote to fear. The more we know the better we can assess the situation in a calm and thoughtful way. We found that getting 2nd and 3rd opinions was a very effective way to put together the pieces of the puzzle. Common threads emerge leading to diagnosis and treatment.
- Compromise: Parents don’t have to agree on everything, and a certain degree of questioning or introducing other perspectives is helpful. Be open to trying different options, giving each sufficient time before switching gears. Remember, it’s not about either parent ‘winning’, it’s about the family winning through successful treatment.
For us, we found that working with a clinician (therapist, social worker or psychiatrist) was immensely helpful. Having an objective third party to moderate, provide feedback and offer insight made a world of difference.
Our world is not made up of exact science. There are ‘best practices’ for everything from education to open heart surgery to how to roast a turkey. But in reality, we have to find the ‘best practices’ that work for our child, for our family. The only guarantee that I can offer is that staying in gridlock will ensure that your child will not receive the help they need, whatever that help may be.