Bipolar Disorder and Teens- a guide for parents.

I did two newsletters on teens a few months ago. The response was amazing. There is not enough information for parents or teens with bipolar. He is a quick tip on how to distinguish ‘normal’ teenage behavior as compared to ‘bipolar’ teen behavior.

It can be difficult, but it’s not impossible.

It’s all about degrees- ‘normal’ teens and bipolar teens act in similar ways, but not at the same intensity.

Here are some examples:

 It’s not the behavior only- it’s the way the behavior is played out.  I know bipolar when I see it because I’ve lived it. If you’re a parent with a teen- start writing down the behavior you see in ‘normal’ teens- the ones who go to school, hang out with friends, have good relationships with their family,  don’t have a lot of fights, crying, etc. and then write what you see in your child.  You can find the difference there. If you’re a teen, you can do the same.

Adults with bipolar disorder have the same dichotomy of course- but we have more ability to recognize and change the extremes. For teenagers it’s all so new! These are often first time emotions.  If you’re a teenager with bipolar disorder, you will have to grow up faster than most people.  You will have to learn about your emotions sooner than other kids in your life.

You can do it. I’ll write a lot more about it in future blogs.

I made it through teenage bipolar disorder as did all of my friends. There is SO much more information now- if you were diagnosed in your teens- or if you care about someone who was diagnosed in their teens- it’s a really good thing to find out about the issues early and go from there.  I wish it had happened to me!

Julie

 PS: My Health Cards Treatment System for Bipolar Disorder is available at www.bipolarhappens.com. This is an exceptionally good system for teenagers with bipolar disorder and the people who care about them.

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 The interest in bipolar disorder and children never ends. It’s such a tough diagnosis.

I recently did an interview with Dr. Ajit Jetmalani on the topic of childhood psychiatric disorders.  Here is a link to the radio show- it is a great companion to the Newsweek article on bipolar disorder.

Childhood Psychiatric Disorders Radio Show

You may have to download this show onto your computer to listen.

Treating childhood bipolar disorder is complicated.

 Julie

In part one of this series, I told my story of how I was very obviously bipolar when I was a teenager- but had no idea what was going on! My mother read the newsletter and said, “We didn’t think there was something wrong with you- you just seemed typical- you weren’t way out there ever. You were bored, but not to the point that we thought we had to do anything about it. I had no idea about the mania. I wondered why you didn’t do more things with your intelligence and that kind of stuff- but not even to the point that you would even be classed as ADHD.”

She was right- I didn’t have severe depression.  I lived at home and all of my hypomania was away from home. She never saw me hypomanic until I was 23 - (wow, that was a bad one!) All of my mania happened during trips. I was wild at least a few times a year, but never in the presence of my family! I find it amazing that I started with more mania than depression, because once I hit my later twenties- it was 99% depression. What a tricky illness.

A Friend’s Story

I asked a friend of mine who has bipolar I to tell me her teenage story. She said, “I was mostly depressed when I was a teenager. I don’t remember being manic.” After she wrote out her story she called and said, “Julie. I can’t believe it. I can see I was manic. I went to five proms!”

Here is my friend’s story:
 
I had my first depressive episode at 17.  I was so depressed I couldn’t understand anything in school, even though I had been an honors student.  When my sister, my main support, left for college, I didn’t want to live.  I overdosed on Contact and when I realized what I had done, I called an ambulance and got my stomach pumped.  And then, as though it never happened, I started feeling better.
But then I lost my period for 8 months and was feeling depressed the following year.  At the same time the following year, I overdosed on pills and went through the same thing over again.  My parents, divorced then, stood over the hospital cot, blaming each other.  But get this, even though I had two major depressive episodes, I ended up going to five proms, yes five.  And I did well in school, taking all the AP classes. Because I had some upswings. I can see that now. I believe I was undiagnosed as BP, and had been treated by an incompetent doctor for a couple of years.  I don’t remember what he put me on.  I remember feeling sedated in high school.  It wasn’t until 1990, when anti-depressants were spoken of that I started taking them which then in turn made me go manic and was finally diagnosed as having bipolar disorder.

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If you’re a parent of a teen with bipolar disorder, here are some tips for helping your child while helping yourself. These are general tips. I know that many of you are in crisis. That is a separate topic- one I will address in the future.

#1 Know that your teenager may have no idea what is happening: Being a teenager is confusing. They are just beginning to learn about themselves and how they interact with the world. Their brains are immature- in other words they are literally still growing. Because of this, the maturity to deal with the symptoms caused by bipolar disorder is very limited. They don’t want to hurt you- they don’t want to run away or refuse meds. They want to be happy. Doesn’t everyone? So, when they yell, act up, leave, take drugs, have promiscuous sex, hear voices, have nightmares, flunk out of school, say mean and untrue things, try to kill themselves or make you feel like a terrible or ineffectual parent- remember, this is an illness. This doesn’t excuse their behavior at all- it still hurts and damages families- but you need this understanding before you can start a successful treatment plan with your child.

#2  Write down your teenager’s symptoms: All of them. As you know from the Health Cards, we can only treat what we understand. Get out a yellow pad and on the top of each page write: depression, mania, OCD, anxiety and psychosis. Then, on each page write as much as you can regarding what your teenager says and does. Once you have a list, memorize it- this is how you know what is bipolar behavior and what is teenage behavior. For example, typical teenagers get angry, but they don’t beat up strangers; typical teenagers have ‘low self esteem’ but they do NOT try to kill themselves; typical teenagers may want to stay up all night- but they get tired. Kids with bipolar can stay up all night and not get tired - or simply can’t sleep at all. As you can see, you can learn the differences. I use the Health Cards for this- and yes, I started with yellow pads!

#3 Read books on bipolar disorder - all that you can find. Especially mine as they are written by someone who was a teenager with the illness- even if your child will not listen to you or even admit they have the illness after they are diagnosed, you have to know all that you can. This helps you have compassion and understanding versus constant confusion and frustration. Remember, just because you may have a teenager who won’t read- you can. You have to know what you’re up against before you can help your teenager get better.

#4 Give your child a yellow pad with the same words on the top that you used and say, “Please tell me what you feel when you have these mood swings. I want to know what you’re going through.” Many kids can write down what they can’t say. There are many teens who have bipolar disorder and accept the diagnosis, but they are often very confused and not aware of their symptoms. Seeing them in black and white is comforting- especially if they can compare them to a list from someone else with the illness. You can then compare your lists and actually talk about the illness and how you’re going to treat each mood swing separately- this is the foundation for my treatment plan. It changed my life and the life of my family.

#5 Take care of yourself first. This is an amazingly hard thing to do when you have an ill child. But you have to do it. Or you will get sick - you will lose your relationships and have trouble at work. You will lose YOU. This means you have to get used to feeling guilty, worried, lonely, worthless, hopeless and very scared. These are often the feelings that come up when you put yourself before your child. I don’t mean to do this all of the time- but you have to do it often enough to be well enough to get through a crisis. You need to do this so that you can provide the stability your child desperately needs.

It’s Not Fair!

Life is not fair when your child has bipolar disorder. It certainly hasn’t been fair for my family, but we have survived. We get along well - and that is amazing considering that I was untreated for over 15 years! Creating a management plan that can be used for the whole family takes a lot of work, but it can be done. No matter how hard it is now, always remember, your teenagers will not be teenagers forever- and if you have a plan in place, they will appreciate it so much when they are adults. 

The next newsletter will address the big stuff: refusing the diagnosis, drugs and alcohol, running away and jail, just to name a few. You are not alone- at all- if your teenager with bipolar has these problems.  Never forget- there is HOPE. It takes a management plan and a lot of love- but you can have a stable and happy family.

I started to get depressed around age 16. It was assumed that I was just an unhappy and typical teenager- my depression was never suicidal, so it really wasn’t even seen as depression- instead I was just difficult and negative. I just remember being so UNHAPPY. I didn’t like myself or my body- I had a lot of friends - but never felt good enough. I didn’t date - despite interest from guys and I certainly didn’t do the wild stuff that other kids my age did. I wasn’t morose- I can’t even say that I was depressed enough for others to comment on it. My dad was in the military so we moved all of the time- this made it hard to tell if my unhappiness was from the moving or from something truly wrong.

It’s hard to put it all in words. I just don’t have good memories of age 16.
Year 17

Then everything changed. I went to Europe in 1980 when I was 17. For one month I was terrifically happy. I lost weight. I made a ton of friends. I loved every second of the trip. And even now, I remember almost every day of the adventure with photographic memory. It was my first hypomanic episode- and no one knew it- certainly not myself- because I was in Europe and none of my family saw my behavior. When I got back to Hawaii, where I went to high school- the happy feeling ended. I just couldn’t understand it. What happened? I got unhappy again and though there were certainly many good times, I was depressed off and on until I graduated at age 18.

Year 18

I left home as soon as I finished high school. I loved my parents, but couldn’t wait to get away. I went to Auburn University in Alabama for the summer quarter and my gosh I had fun! I got to stay with my grandparents- I fell in love with a football player- I had roommates and did really well in my classes. I felt like a new person! Of course, you know what this means- it was my second hypomanic episode. And just like the first one, I have a photographic memory of the time. When my crush on the football player ended -he told me he had a girlfriend who would be there the next week- I just went down - way down. We had never even had a date- but we certainly flirted daily. I was truly stunned by his not telling me the truth. I was pretty naïve! This was my first down swing caused by a situation with a guy. I had no idea it was bipolar of course- so I had no way of understanding my intense reaction to the situation.

I remember ending the summer wondering where the good feelings went. I didn’t connect the time in Europe with this summer at all. That is the danger of hypomania! It just felt so good and so real- so I naturally thought it was the real me! It’s usually possible to tell that depression is unnatural- but hypomania feels too good to be unnatural. I chased that hypomanic feeling for over 15 years before I knew what it really was.

At 18 I went to another college in Washington State. I was excited about my new life. I started to date- and started a pattern of extremely erratic behavior with men. I had no judgment and my moods were very dependent on the behavior of others. I spent more time worrying about guys than going to class. I got my first boyfriend - a pretty amazing guy in Canada and started to fail all of my classes. It was so bad I actually went to a counselor at school- I was not even asked questions about my mental health- just questions about my ‘life.’ Why didn’t I try harder? Why couldn’t I just go to class like everyone else? etc. There was absolutely no talk of bipolar II at that time- and for the first time and certainly not the last- I slipped through the cracks of the system. My parents had no idea what was going on- my grandparents were upset- and I was pretty much out of touch with reality. I flunked out of school and moved in with my boyfriend in Canada. When he finally broke up with me- deservedly so- I went into a suicidal episode that lasted for months.

Year 19

I moved in with my parents and I remember riding my bike down a small highway thinking- “I wish a bus would hit me and I could die. I want to die. I want to die.” I never actively thought of killing myself, thank god, because I certainly would have tried if my brain had told me to do it. I was 19- I had flunked out of school! This just didn’t happen in my family. My parents had no idea with to do with someone who was, “so smart!” I was constantly asked what was wrong- but I just didn’t know. Eventually I went back to normal and took a job in Montana as a manger of a small diner at Glacier National Park. Guess what happened? A blissful summer full of drinking, men, money and fun. This doesn’t sound too healthy now- but it wasn’t atypical for a 19 year old- everyone else was basically acting the same way! So, once again, I was just seen as a wild girl who drank too much and couldn’t get her act together! “What is wrong with you Julie!” was a typical question. “What are you going to do with your life!” I came back from Glacier and had a period of stability. I then moved to Seattle- got a waitress job and went into a pretty normal teenage life: drinking regularly, lots of boyfriends, parties, wasting money and always looking for fun. (I’m joking when I say I was a regular teenager!) I never saw the previous three years for what they were- three years of constant rapid cycling bipolar disorder. No one saw it- least of all my parents. How could they? I was a teenager and this is just what troublesome teenagers did, right!

To be honest, I did a lot of dangerous things during this time- unprotected se**x, excessive drinking and drunk driving, theft - and then things would even out and I would go back to normal. I remember being so high that I would stay out all night partying. And I remember being so down I would sob until I choked. Who knows what was immaturity, stupidity or bipolar? I can only look back and wonder.

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That is the story of my teens- I feel sadness when I see it in black and white- because it’s all so obvious now - and it just wasn’t obvious then.

My Story is Not Abnormal! (At least not for teenagers with bipolar disorder)

I tell my story so that parents can know that what their teenage children with bipolar disorder go through is probably similar to my story to some degree. It’s a confusing time- being an adult with bipolar disorder is hard enough - being a teenager with the illness is …. difficult.
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The next newsletter will give parents tips on how they can differentiate ‘normal’ teenage behavior from bipolar behavior. This is the only way a teenager can get the help needed to manage bipolar successfully. The good news is that there are MANY, MANY ways you can help a teenager manage the illness successfully.

And…… If you’re a teenager with the illness - I hope it helps to read my story. You’re not alone!

Julie
www.bipolarhappens.com

My bipolar disorder symptoms started with hypomania at 17. I didn’t realize this until I sat down and really thought about my teenage years. Many people have their first major episode in their 20’s- mine started earlier. My ex partner had a lot of depression before he had his first major manic/psychotic episode at 22. That was a terrible time for sure. When I think back of what he told me about college- he was definitely depressed for a long time. He told me he thought about suicide when he was a little kid. He didn’t have an episode after that for a long time- then college at 19 and he got depressed and left school.

If you have bipolar disorder, it’s really interesting to write a paragraph about what you remember between the ages of 13-19. What was the first sign you had bipolar and how long did it take from that time for you to get diagnosed?

If you have a child with bipolar disorder, what were their teenage years like?

I had my first hypomania at 17 and was finally diagnosed at 31. Not cool.