Stigma Sucks

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Mental illness doesn’t mean exotic or strange– but it does mean different. It doesn’t make one bizarre, or odd. Coming to faith in Christ really settles this issue for most. While our mental illness is flaring up, yet we are still being changed by the Holy Spirit.

We can’t really nullify the work of God. It takes as much grace to change a “normal” man as a mentally challenged one. God does not have to work any harder; there are no lost causes or last chances. All require the same grace.

Since I’m bipolar I’ve become aware of BP throughout history. Many painters and poets, inventors and doctors have come from the ranks of bipolar disorder. Many of those with manic depression and sufferers of depression have excelled; we would not have harnessed electricity if it wasn’t because a bipolar/ADHD created the light bulb.

But we are different. But we also can bring a giftedness that is necessary. We are not pariahs or leeches, but rather we are unique. Typically we may be passionate and sensitive. We are touched by something creative. Some have called bipolar disorder as those “touched by fire.”

Mental illness should be more of a mental difference than a liability. We are not crazy or lunatics running amok. Sometimes others pity us; often when they do they shut us off and seal us into a weird sense of extreme wariness. This should not be.

13 “You made all the delicate, inner parts of my body
    and knit me together in my mother’s womb.
14 Thank you for making me so wonderfully complex!
    Your workmanship is marvelous—how well I know it.”

Psalm 139:13-14, NLT

God has created each one. We are all “knit together” by the hand of God. There are no second rates– prototypes, not quite His best work. The blood of Christ works in spite of handicaps and personality quirks.

Some may hesitate about this. But it is essentially an act of faith. The treasures of the Church are unique. They are the blind and the lame, the ones not always stable. What others consider marginal, or lacking are really the valuable ones. It’s these that the Church should glory in.

I encourage you to broaden your thinking on this. To stigmatize others is never a healthy or God honoring attitude. It indicates a small heart.

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Being Honest As I Can

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 “So stop telling lies. Let us tell our neighbors the truth, for we are all parts of the same body.”

Ephesians 4:25, NLT

I intend to be simple.  I am worried and distressed by my own confusion and a simple disorientation about my own detachment to what is spiritual.  I confess a trust in Him, but am wary of  an evil attachment to things that take me away from Him.  I know this sounds confusing, please bear with me.

I turn to Him, and yet I know that I know that a small part of me does not really belong to Him.  I want to belong, but am conscious that I just don’t work into the Kingdom.  I am a liability.  I quickly will admit to some confusion, but I have no real intention to deceive anyone.  I desperately want to be His, but I’m aware of issues that would defy such a connection.

I have an incredible infatuation with Jesus, and His teaching.  He is the most amazing man to step out out of the ‘river’ of the human race.  I see in Him so much, and deep down I want to fall on my knees and worship Him.  The things He did are honestly the most sublime in the history of man.  He is astonishing.

And yet, I continue to struggle.  I see all of this and yet I’m confronted with my own issues.  I know what I would like to be.  But if I press, I begin to short-circuit.  I do, certainly turn it over to Him.  But I also am aware of a certain antipathy or rebellion (although that word seems too harsh) against the whole idea of grace.  I can not figure ‘grace’ out.  Grace perplexes me.  It is the ‘Gordian Knot’ of the entire human race.

But I do connect with Him.  My bipolar would quickly render me a traitor.  I vacillate much more then the average person.  Ultimately, I do turn and trust Him.  He has led me to a wonderful place.  If it is all a delusion, then so be it.  But I will still believe in Him who gave Himself for me.

If that makes me a disciple, then so be it.  But I know I am the least of His.  I guess faith would venture more.  But I scrape up all that I have and a saving hope it is enough.  I look at the accounts of Him and am pretty much astonished.  Jesus did things, consistently, above others before Him and after Him.  He is quite exceptional.

I am a follower.  I will struggle, and then have to deal with that sin.  But I do believe and intend to keep believing.  I only wish I was more consistent.  I sometime wonder that in the “Book of Life’ if my name would include an asterisk.  (“Made it, but by the skin on his teeth.”)

Don’t fret, I am under His hand.  He deals with me, and fully intends to lead me, home.  I so do want that.  If on that Day, you hear someone hollering, it will be me back in the 715,426,488th row, shouting ‘I am finally here”, in the fellowship of heaven.

Some will understand this:

He who has this disease called Jesus will never be cured.”

Doestevesky

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Being Sick

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Potter shaping a ceramic plate on a pottery wheel
“So Miriam was kept outside the camp for seven days, and the people waited until she was brought back before they traveled again.”

Numbers 12:15

To be numbered among the chronically ill often can mean a transition into frustration. We can not do what we want, we are ‘trapped’ by a disease we never asked for, and held hostage by our minds and bodies. It seems apart, from the management of our symptoms, we have little time to do anything else. We once had a job– a career… and our time was occupied by that. We were accustomed to something more than this illness.

I once was a pastor of a small church here in Homer, Alaska. I also taught Gospels for many years at the Alaska Bible Institute. I loved both. They defined my identity and gave me purpose. I loved helping people and teaching the Word. I strived to be faithful in the ministry. My wife and two children were also significant and all of these things led me to think they would always be there. I was living my dream (in a good way.)

With the sudden onset of a brain tumor, followed up by a diagnosis of Bipolar disorder (BP), I knew I had to step out of the ministry. I simply could not function. My depression grew more profound with the stillborn death of our third child. Things suddenly ground to a stand-still as we tried to process what has happening to us. I guess I just couldn’t understand and more or less just shut down. I spent months in bed, unable to function.

Some people were jewels. Others were mean and uncaring. (I had to learn to take the good with the bad.) I suppose I should have been more forth-coming, but things were so tangled up inside I couldn’t verbalize a thing. The post-op surgery was an ordeal, as I had to learn many things all over again. Years later I ended up on disability; I was unable to work, and no one would hire me. My symptoms were so unpredictable, and things were too erratic. The BP was giving me it’s customary depression, as well as paranoia and hallucinations.

Sometimes, like Miriam, we are quarantined by the Lord for his purposes. The isolation is worse that the pain it seems. We wonder why this is happening, and fabricate lies about our worthiness or God’s goodness. In our isolation things seem polarized to extremes. Our value seems to be ripped apart by our illness. We can feel cursed, or worse.

I have been slow to learn this: God brings good out of the dark. I’m embarrassed by my lack of acquiring this truth.

“We now have this light shining in our hearts, but we ourselves are like fragile clay jars containing this great treasure. This makes it clear that our great power is from God, not from ourselves.”

2 Corinthians 4:7

This light must shine. The treasure is found in clay vessels. Brokenness only means the treasure is now seen clearly. It’s important to note: treasure loses none of its value by being surrounded by broken clay.

“We are pressed on every side by troubles, but we are not crushed. We are perplexed, but not driven to despair. We are hunted down, but never abandoned by God. We get knocked down, but we are not destroyed.”

2 Corinthians 4:8-9

Troubles of various ilk come to us. They are variegated and unplanned. No matter what their nature, God holds his people in place while everything else is falling apart. But there is no magic wand; the pain will probably continue. But for the broken believer, there comes another dimension; a new supernatural layer of grace to bolster our beleaguered faith. We will triumph through this thing, and we will stand– because He makes us stand.

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The Mangled Earrings of Joni Eareckson Tada

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Joni’s Mangled Earrings

I once admired the earrings my friend, Ann, was wearing – they were square, smooth, flat, and made of gold. When I remarked how beautiful they were, she replied, “They’re yours!” Ann then proceeded to take them off and put them on my ears! Humbled by her gift, the earrings became a treasure. Once while wearing them at work, one slipped off my ear – looked but couldn’t find it, so I wheeled to my office door to ask for help.

That’s when I felt a clunk-clunk-clunk. The earring was impaled on my tire; it was ruined! That weekend I took it to a jeweler and asked, “Sir, can you make this mangled earring look like the smooth one?” He rubbed his chin and said, “I can’t make that one look like this one… But I can make this one look like that one!” He then took a mallet and hammered the smooth, square earring into a mangled mess! At first I was horrified, but now I realize that the misshapen earrings reflect the light more beautifully than when they were ‘normal.’ It’s a lesson reflected in this timeless poem:

When God wants to drill a man,
And thrill a man, and skill a man,
When God wants to make a man
To play the noblest part,
When He yearns with all His heart
To build so great and bold a man
That all the world shall be amazed,
Then watch His methods, watch His ways!
How He ruthlessly perfects,
Whom He royally elects;
How He hammers him and hurts him,
And with mighty blows converts him
Into shapes and forms of clay
Which only God can understand
While man’s tortured heart is crying
And he lifts beseeching hands…
Yet God bends but never breaks
When man’s good He undertakes;
How He uses whom He chooses,
And with mighty power, infuses him,
With every act induces him to try
His splendor out,
God knows what He’s about.

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Visit Joni Eareckson Tada and Friends at http://www.joniandfriends.org/. Her bio can be found at http://www.joniandfriends.org/jonis-corner/jonis-bio/.

When you visit this site you will find a lot of helpful resources to some pretty useful materials on the disability needs on an international level. 

Emails, Facebook, Podcasts, TV Series, and great teachings are just part of the daily ministries available. Anyone interested in being discipled with a strong disability emphasis not always heard anywhere else really should visit.

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Jamison and Steel: Interviews on Suicide

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NAMI’s Interviews With Danielle Steel & Kay Jamison

Last year, Steel published His Bright Light, a memoir of her son, Nick Traina, who committed suicide at age 19 after a life-long battle with bipolar disorder (manic depression). More recently, Jamison has published Night Falls Fast: Understanding Suicide, combining research, clinical expertise and personal experience to explore one of the world’s leading causes of death.On February 8, the Senate Appropriations Subcommittee on Labor, Health, Human Resources, Education & Related Agencies will hold a hearing on suicide prevention that will include testimony from best-selling author Danielle Steel and Professor Kay Redfield Jamison, author of several academic and popular books on mental illness.

Interviews with Steel and Jamison have appeared in “Spotlight,” a special supplement to The Advocate, the quarterly publication of the National Alliance for the Mentally Ill (NAMI). Conducted by NAMI executive director Laurie Flynn, they offer a possible preview of Steel and Jamison’s testimony on Tuesday. Excerpts follow below.

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Dr. Kay Jamison

NAMI’s Interview with Kay Jamison
Spotlight (Winter 1999/2000)

NAMI: What do we know about the linkage between suicide and mental illness?

Jamison: The most important thing to know is that 90 to 95 percent of suicides are associated with one of several major psychiatric illnesses: depression, bipolar illness, schizophrenia, drug and alcohol abuse, and personality disorders. These are obviously treatable illnesses. Another thing people don’t think about enough or emphasize enough is that because cancer and heart disease hit older people, they are seen as lethal illnesses. Because the age of onset for mental illnesses is very, very young, people don’t tend to think of mental illnesses as the potentially lethal illnesses they are. It’s important for people to understand that they have an illness to begin with and then that they get good treatment for it.

NAMI: You have spoken specifically of suicide and college students.

Jamison: Yes. Suicide is the second major killer of college aged kids. It’s the second leading killer of young people generally.

NAMI: You also have pointed out that, worldwide, suicide is the second leading killer of women between ages 15 and 45. These statistics are staggering, yet most people don’t seem to be aware of it.

Jamison: Absolutely. Across the world. There are almost two million suicides a year worldwide. I think people just don’t have any sense of the enormity of it. Suicide unfortunately has been so individualized and, because of the early suicide movement in this country, so separated from mental illness. People working in the field of suicide concentrated on existential factors and vague sorts of things, when in fact the underlying science is very clear that they’re associated with a few mental illnesses.

NAMI: Knowing what we do about illness and its treatability allows us to be able to discuss preventing suicide.

Jamison: Right. [U.S. Surgeon General] Dr. David Satcher’s emphasis has been very strong on three fronts. One is public awareness. Secondly, intervention and all that’s involved in making doctors and others more able to ask the kinds of questions needed to uncover mental illness. And then, thirdly, to support the science that’s necessary to study suicide.

NAMI: What else can policy makers and public officials do?

Jamison: I think we have to have public officials talking about it. When you have someone like Jesse Ventura out there saying these outrageous things-I think it’s really beyond the pale-we’ve got to have the president of the United States saying look we’ve got a real epidemic here, and there’s something we can do about it. People are dying from not gaining access to treatment-or from having three days in the hospital, and then going out and dying.

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DANIELLE STEEL

NAMI’s Interview with Danielle Steel
Spotlight (Winter 1999)

NAMI: “His Bright Light” is a very personal story about a very painful subject, the mental illness and death of a child. What did you hope people would learn by sharing your story?

Steel: I hoped first of all that people would come to know my son, and learn what an extraordinary person he was. I wrote the book to honor him, and to share with people what a remarkable person he was, in spite of his illness. I also wrote it to share with people the challenges we faced, so that they feel less alone and less isolated with their pain, in similar situations. I wrote it to give people hope and strength as they follow a similar path to ours.

NAMI: What did you learn from this painful tragedy?

Steel: I’m not sure yet what I learned from the tragedy, except that one can and must survive. But from his life, I learned a great deal about courage and perseverance, and love.

NAMI: Lots of people in America might be facing signs of a mental illness in one of their children. What about Nick’s behavior made you realize that it was more severe than just the normal growing pains of a child?

Steel: Nick was different. Always. His moods were more extreme. I sensed from early on, that despite his many wonderful qualities, there was something very wrong. I knew it in my gut, as I think many parents do.

NAMI: How long did it take for Nick to be diagnosed as manic-depressive and receive treatment for that condition?

Steel: Nick was not clearly diagnosed as manic depressive until he was 16, a good 12 years after we began the pursuit of the causes for his ‘differences’. He received no medication until he was 15, and did not receive the most effective medications until he was 16. A long and very painful wait for all concerned!

NAMI: Prior to knowing of Nick’s manic depression, what did mental illness mean to you? Did you associate stigma with mental illness?

Steel: I don’t think I realized, before Nick, that one could still be functional, or seemingly functional, if mentally ill. I thought of it as something totally incapacitating, and of people who were shut away. I don’t think I realized how intelligent and capable mentally ill people can still be. I’m not sure I did associate a stigma with mental illness. It just seemed like a sickness, and not necessarily a shameful one. I just thought of Nick as sick, whatever it was called, and wanted him to be cured.

NAMI: How did Nick deal with the knowledge that he had a mental illness?

Steel: For a long time, Nick himself was in denial about his illness. And eventually, he accepted it. In the last year, he told people he was manic-depressive. Before that, when he felt ‘normal’ on medications, he believed he was cured. He had a hard time accepting at first that he would be manic-depressive all his life.

NAMI: Are schools able to cope with the mental illness of a child?

Steel: In most cases, I don’t believe they are. It is a huge challenge for all to meet, and certainly hard on the other kids to have one child acting out. We were very lucky, in Nick’s high school years we finally found a wonderful school that understood the problem, accepted him as he was, and was willing to work with him in a framework he could cope with. They were remarkably flexible and creative. But for most schools, it’s asking a lot to expect them to adapt to a mentally ill child.

NAMI: If you could tell a family member who is caring for someone who is mentally ill one thing, what would that be?

Steel: Never give up. Get the best help you can. Keep trying, keep loving, keep giving, keep looking for the right answers, and love, love, love, love. Don’t listen to the words, just listen to your heart.

NAMI: What do you think support groups like NAMI can do for families coping with the mental illness of a loved one?

Steel: I think groups like NAMI can provide support, both emotional and practical—the knowledge that you are not alone. And resources, where to go, who to talk to, what works. You need all the information you can get, and it is just about impossible to do it alone.

NAMI: Stereotyping the mentally ill as violent and dangerous is pervasive in America. How do we change this perception?

Danielle: Information. Obviously there must be some mentally ill people who are violent and/or dangerous. But I suspect that most are not. Nick certainly wasn’t either of those, he was gentle, loving, smart, funny, compassionate, extremely perceptive about people, and very wise. I cannot conceive of Nick as ‘dangerous,’ although ultimately he was a danger to himself. But for the most part, I think the turmoils of the mentally ill are directed within and not without.

NAMI: What do you think the average American should know about mental illness?

Steel: I think most people should know how common it is…I also think people should know how serious it is when it goes untreated. And how potentially lethal it can be. It is vitally important to get good treatment, the right medication, and good support. If you let a bad cold turn into bronchitis and then pneumonia, without medication, it can kill you. If you do not treat serious diabetes, it can kill you. If mental illness goes untreated, it can kill you.

NAMI: We know that having “hope” is important to battling any disease. What hope do you see for people with mental illness?

Steel: I see a huge amount of hope. The medications today can give people whole, happy, productive lives. There are lots and lots of people with mental illness holding down good jobs, even with important careers, happy family lives, and doing great things. It is possible to lead a good and happy life if you are mentally ill. If those who are doing just that would speak up, it would give great hope to all those who are still groping their way along in the dark.

NAMI: What is Nick’s legacy?

Steel: Nick’s legacy is the love we had and have for him, the word we have spread of what a terrific person he was. In his lifetime, he touched countless lives, with his warmth, with his mind, with his music, with his words. Through his experiences, others have and will learn. Through the Nick Traina Foundation, hopefully we can bring help to others, in his name.

 

For more information or assistance, please contact NAMI at: http://www.nami.org/

 

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The Only Army that Shoots its Wounded

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By Dwight L. Carlson

From an article in Christianity Today, February 9, 1998

The only army that shoots its wounded is the Christian army,” said the speaker, a psychologist who had just returned from an overseas ministry trip among missionaries. He summed up the philosophy of the group he worked with as:

1. We don’t have emotional problems. If any emotional difficulties appear to arise, simply deny having them.

2. If we fail to achieve this first ideal and can’t ignore a problem, strive to keep it from family members and never breathe a word of it outside the family.

3. If both of the first two steps fail, we still don’t seek professional help.

I have been a Christian for 50 years, a physician for 29, and a psychiatrist for 15. Over this time I have observed these same attitudes throughout the church—among lay leaders, pastors, priests, charismatics, fundamentalists, and evangelicals alike. I have also found that many not only deny their problems but are intolerant of those with emotional difficulties.

Many judge that others’ emotional problems are the direct result of personal sin. This is a harmful view. At any one time, up to 15 percent of our population is experiencing significant emotional problems. For them our churches need to be sanctuaries of healing, not places where they must hide their wounds.

THE EMOTIONAL-HEALTH GOSPEL

Several years ago my daughter was battling leukemia. While lying in bed in the hospital, she received a letter, which read in part:

Dear Susan, You do not know me personally, but I have seen you in church many times….I have interceded on your behalf and I know the Lord is going to heal you if you just let Him. Do not let Satan steal your life—do not let religious tradition rob you of what Jesus did on the cross—by His stripes we were healed.

The theology behind this letter reminded me of a bumper sticker I once saw: “Health and Prosperity: Your Divine Right.” The letter writer had bought into a “healing in the atonement” theology that most mainstream evangelicals reject.

According to this traditional faith-healing perspective, Christ’s atonement provides healing for the body and mind just as it offers forgiveness of sins for the soul. The writer meant well, but the letter created tremendous turmoil for my daughter. While evangelicals have largely rejected “health and wealth” preaching—that faithful Christians will always prosper physically and financially—many hold to an insidious variation of that prosperity gospel. I call it the “emotional-health gospel.”

The emotional-health gospel assumes that if you have repented of your sins, prayed correctly, and spent adequate time in God’s Word, you will have a sound mind and be free of emotional problems.

Usually the theology behind the emotional-health gospel does not go so far as to locate emotional healing in the Atonement (though some do) but rather to redefine mental illnesses as “spiritual” or as character problems, which the church or the process of sanctification can handle on its own. The problem is, this is a false gospel, one that needlessly adds to the suffering of those already in turmoil.

This prejudice against those with emotional problems can be seen in churches across the nation on any Sunday morning. We pray publicly for the parishioner with cancer or a heart attack or pneumonia. But rarely will we pray publicly for Mary with severe depression, Charles with incapacitating panic attacks, or the minister’s son with schizophrenia. Our silence subtly conveys that these are not acceptable illnesses for Christians to have.

The emotional-health gospel is also communicated by some of our most listened-to leaders. I heard one national speaker make the point that “At the cross you can be made whole. Isaiah said that ‘through his stripes we are healed’ … not of physical suffering, which one day we will experience; we are healed of emotional and spiritual suffering at the cross of Jesus Christ.” In other words, a victorious Christian will be emotionally healthy. This so-called full gospel, which proclaims that healing of the body and mind is provided for all in the Atonement, casts a cruel judgment on the mentally ill.

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Don’t Shoot the Wounded

Two authors widely read in evangelical circles, John MacArthur and Dave Hunt, also propagate views that, while sincerely held, I fear lead us to shoot our wounded. In his book “Beyond Seduction”, Hunt writes, “The average Christian is not even aware that to consult a psychotherapist is much the same as turning oneself over to the priest of any other rival religion,” and, “There is no such thing as a mental illness; it is either a physical problem in the brain (such as a chemical imbalance or nutritional deficiency) or it is a moral or spiritual problem.”

MacArthur, in “Our Sufficiency in Christ”, presents the thesis that “As Christians, we find complete sufficiency in Christ and his provisions for our needs.” While I agree with his abstract principle, I disagree with how he narrows what are the proper “provisions.” A large portion of the book strongly criticizes psychotherapy as one of the “deadly influences that undermine your spiritual life.” He denounces “so-called Christian psychologists and psychiatrists who testified that the Bible alone does not contain sufficient help to meet people’s deepest personal and emotional needs,” and he asserts, “There is no such thing as a ‘psychological problem’ unrelated to spiritual or physical causes.

God supplies divine resources sufficient to meet all those needs completely.” Physically caused emotional problems, he adds, are rare, and referring to those who seek psychological help, he concludes: “Scripture hasn’t failed them—they’ve failed Scripture.”

A PLACE FOR PROFESSIONALS

When adherents of the emotional-health gospel say that every human problem is spiritual at root, they are undeniably right. Just as Adam’s fall in the garden was spiritual in nature, so in a very true sense the answer to every human problem—whether a broken leg or a burdened heart—is to be found in the redeeming work of Christ on the cross. The disease and corruption process set into motion by the Fall affected not only our physical bodies but our emotions as well, and we are just beginning to comprehend the many ways our bodies and minds have been affected by original sin and our fallen nature. Yet the issue is not whether our emotional problems are spiritual or not—all are, at some level—but how best to treat people experiencing these problems.

Many followers of the emotional-health gospel make the point that the church is, or at least should be, the expert in spiritual counseling, and I agree. Appropriate spiritual counseling will resolve issues such as salvation, forgiveness, personal morality, God’s will, the scriptural perspective on divorce, and more. It can also help some emotional difficulties. But many emotional or mental illnesses require more than a church support network can offer.

I know it sounds unscriptural to say that some individuals need more than the church can offer—but if my car needs the transmission replaced, do I expect the church to do it? Or if I break my leg, do I consult my pastor about it? For some reason, when it comes to emotional needs, we think the church should be able to meet them all. It can’t, and it isn’t supposed to.

This is why the emotional-health gospel can do so much harm. People who need help are prevented from seeking it and often made to feel shame for having the problem. Thankfully, more and more people in the Christian community are beginning to realize that some people need this extra help. If professionals and church leaders can recognize the value of each other’s roles, we will make progress in helping the wounded. Forty percent of all individuals who need emotional help seek it first from the church, and some of these will need to be referred to mental-health professionals.

Church leaders should get to know Christian therapists in their communities so they can knowledgeably refer people with persistent emotional problems.

 

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Mental Illness in Children & Teens

Does your child go through intense mood changes?

Does your child have extreme behavior changes too? Does your child get too excited or silly sometimes? Do you notice he or she is very sad at other times? Do these changes affect how your child acts at school or at home?

Some children and teens with these symptoms may have bipolar disorder, a serious mental illness. Read on to understand more.

What is bipolar disorder?

Bipolar disorder is a serious brain illness. It is also called manic-depressive illness. Children with bipolar disorder go through unusual mood changes. Sometimes they feel very happy or “up,” and are much more active than usual. This is called mania. And sometimes children with bipolar disorder feel very sad and “down,” and are much less active than usual. This is called depression.

Bipolar disorder is not the same as the normal ups and downs every kid goes through. Bipolar symptoms are more powerful than that. The illness can make it hard for a child to do well in school or get along with friends and family members. The illness can also be dangerous. Some young people with bipolar disorder try to hurt themselves or attempt suicide.

Children and teens with bipolar disorder should get treatment. With help, they can manage their symptoms and lead successful lives.

Who develops bipolar disorder?

Anyone can develop bipolar disorder, including children and teens. However, most people with bipolar disorder develop it in their late teen or early adult years. The illness usually lasts a lifetime.

How is bipolar disorder different in children and teens than it is in adults?

When children develop the illness, it is called early-onset bipolar disorder. This type can be more severe than bipolar disorder in older teens and adults. Also, young people with bipolar disorder may have symptoms more often and switch moods more frequently than adults with the illness.

What causes bipolar disorder?

Several factors may contribute to bipolar disorder, including:

  • Genes, because the illness runs in families. Children with a parent or sibling with bipolar disorder are more likely to get the illness than other children.
  • Abnormal brain structure and brain function.
  • Anxiety disorders. Children with anxiety disorders are more likely to develop bipolar disorder.

The causes of bipolar disorder aren’t always clear. Scientists are studying it to find out more about possible causes and risk factors. This research may help doctors predict whether a person will get bipolar disorder. One day, it may also help doctors prevent the illness in some people.

What are the symptoms of bipolar disorder?

Bipolar mood changes are called “mood episodes.” Your child may have manic episodes, depressive episodes, or “mixed” episodes. A mixed episode has both manic and depressive symptoms. Children and teens with bipolar disorder may have more mixed episodes than adults with the illness.

Mood episodes last a week or two—sometimes longer. During an episode, the symptoms last every day for most of the day.

Mood episodes are intense. The feelings are strong and happen along with extreme changes in behavior and energy levels.

Children and teens having a manic episode may:

  • Feel very happy or act silly in a way that’s unusual
  • Have a very short temper
  • Talk really fast about a lot of different things
  • Have trouble sleeping but not feel tired
  • Have trouble staying focused
  • Talk and think about sex more often
  • Do risky things.

Children and teens having a depressive episode may:

  • Feel very sad
  • Complain about pain a lot, like stomachaches and headaches
  • Sleep too little or too much
  • Feel guilty and worthless
  • Eat too little or too much
  • Have little energy and no interest in fun activities
  • Think about death or suicide.

Do children and teens with bipolar disorder have other problems?

Bipolar disorder in young people can co-exist with several problems.

  • Substance abuse. Both adults and kids with bipolar disorder are at risk of drinking or taking drugs.
  • Attention deficit/hyperactivity disorder, or ADHD. Children with bipolar disorder and ADHD may have trouble staying focused.
  • Anxiety disorders, like separation anxiety. Children with both types of disorders may need to go to the hospital more often than other people with bipolar disorder.
  • Other mental illnesses, like depression. Some mental illnesses cause symptoms that look like bipolar disorder. Tell a doctor about any manic or depressive symptoms your child has had.

Sometimes behavior problems go along with mood episodes. Young people may take a lot of risks, like drive too fast or spend too much money. Some young people with bipolar disorder think about suicide. Watch out for any sign of suicidal thinking. Take these signs seriously and call your child’s doctor.

How is bipolar disorder diagnosed?

An experienced doctor will carefully examine your child. There are no blood tests or brain scans that can diagnose bipolar disorder. Instead, the doctor will ask questions about your child’s mood and sleeping patterns. The doctor will also ask about your child’s energy and behavior. Sometimes doctors need to know about medical problems in your family, such as depression or alcoholism. The doctor may use tests to see if an illness other than bipolar disorder is causing your child’s symptoms.

How is bipolar disorder treated?

Right now, there is no cure for bipolar disorder. Doctors often treat children who have the illness in a similar way they treat adults. Treatment can help control symptoms. Treatment works best when it is ongoing, instead of on and off.

1. Medication. Different types of medication can help. Children respond to medications in different ways, so the type of medication depends on the child. Some children may need more than one type of medication because their symptoms are so complex. Sometimes they need to try different types of medicine to see which are best for them.

Children should take the fewest number and smallest amounts of medications as possible to help their symptoms. A good way to remember this is “start low, go slow”. Always tell your child’s doctor about any problems with side effects. Do not stop giving your child medication without a doctor’s help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse.

2. Therapy. Different kinds of psychotherapy, or “talk” therapy, can help children with bipolar disorder. Therapy can help children change their behavior and manage their routines. It can also help young people get along better with family and friends. Sometimes therapy includes family members.

What can children and teens expect from treatment?

With treatment, children and teens with bipolar disorder can get better over time. It helps when doctors, parents, and young people work together.

Sometimes a child’s bipolar disorder changes. When this happens, treatment needs to change too. For example, your child may need to try a different medication. The doctor may also recommend other treatment changes. Symptoms may come back after a while, and more adjustments may be needed. Treatment can take time, but sticking with it helps many children and teens have fewer bipolar symptoms.

You can help treatment be more effective. Try keeping a chart of your child’s moods, behaviors, and sleep patterns. This is called a “daily life chart” or “mood chart.” It can help you and your child understand and track the illness. A chart can also help the doctor see whether treatment is working.

How can I help my child or teen?

Help your child or teen get the right diagnosis and treatment. If you think he or she may have bipolar disorder, make an appointment with your family doctor to talk about the symptoms you notice.

If your child has bipolar disorder, here are some basic things you can do:

  • Be patient
  • Encourage your child to talk, and listen to him or her carefully
  • Be understanding about mood episodes
  • Help your child have fun
  • Help your child understand that treatment can help him or her get better.

How does bipolar disorder affect parents and family?

Taking care of a child or teenager with bipolar disorder can be stressful for you too. You have to cope with the mood swings and other problems, such as short tempers and risky activities. This can challenge any parent. Sometimes the stress can strain your relationships with other people, and you may miss work or lose free time.

If you are taking care of a child with bipolar disorder, take care of yourself too. If you keep your stress level down you will do a better job. It might help your child get better too.

Where do I go for help?

If you’re not sure where to get help, call your family doctor. You can also check the phone book for mental health professionals. Hospital doctors can help in an emergency.

I know a child or teen who is in crisis. What do I do?

If you’re thinking about hurting yourself, or if you know someone who might, get help quickly.

  • Do not leave the person alone
  • Call your doctor
  • Call 911 or go to the emergency room
  • Call a toll-free suicide hotline: 1-800-273-TALK (8255) for the National Suicide Prevention Lifeline.

Contact NIMH to find out more about bipolar disorder.

National Institute of Mental Health
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663

Phone: 301-443-4513 or
Toll-free: 1-866-615-NIMH (6464)
TTY Toll-free: 1-866-415-8051
Fax: 301-443-4279
E-mail: nimhinfo@nih.gov
Web site: www.nimh.nih.gov

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