Parenting Bipolar Children - Transcript

George Lynn, psychotherapist and author of Survival Strategies for Parenting Children with Bipolar Disorder was our guest. The discussion focused on how parents of bipolar children can best cope and effectively deal with mood issues, behavioral problems, and learning disabilities that are inherent with this mood disorder. We also talked about parents' self-esteem and being accused of "poor parenting," threatening behavior by bipolar kids, bipolar support groups, and having the other parent be non-compliant with bipolar medications.

David Roberts is the HealthyPlace.com moderator.

The people in blue are audience members.

online conference transcript

David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. Our topic tonight is "Parenting Bipolar Children." Our guest is author and psychotherapist, George Lynn, M.A., C.M.H.C. He has written Survival Strategies for Parenting Children with Bipolar Disorder.

Good evening, Mr. Lynn and welcome to HealthyPlace.com. We appreciate you being our guest tonight. I'd like to start with you telling us a bit more about yourself and your experience with tonight's subject matter.

George Lynn: Thanks, David. I have a psychotherapy practice in Bellevue, WA and work with adults and kids with Bipolar Disorder, Aspergers, ADD (Attention Deficit Disorder), and other neuropsyche issues. My journey started with my own son's diagnosis in '91 with several of these conditions.--Tourette's Syndrome, ADHD, Asperger's, and mood issues.

David: In your practice, what are you finding to be the most difficult issues facing parents of bipolar children?

George Lynn: The most difficult issues are the isolation of parents, the lack of understanding by schools and doctors, and the issues of the bipolar child.

David: When you say "isolation of the parents," what do you mean by that?

George Lynn: Kids with the rage, psychotic manifestations, chronic paranoia, and learning issues that come with Bipolar Disorder serve to distance other adults from the family. People who do not have kids like this do not understand but are often full of judgments about what needs to be done. Then parents start showing signs of posttraumatic stress disorder and no one understands why.

David: I asked that question because we have many parents of bipolar children write us saying they feel all alone and that there is no support system for them. I want to get right to some helpful suggestions. What would you suggest for dealing with the lonliness and isolation?

George Lynn: Thank you. First thing is to tell people who can listen what is going on. Do a write-up on your child for his teacher and other professionals, then develop assertiveness skills so you don't let people trash you with their advice. And deliberately cultivate your own interests, even if these do not involve your child.

David: What about dealing with the feelings that "you are the only one going through this?"

George Lynn: Well, now there is a proliferation of great bipolar support groups on line and local Bipolar support groups are forming all over. I tell people in my workshops who are computer un-savvy to get one and learn how to use it to link up to others. It will be a life saver! And attend local meetings of ChADD and other groups who will have parents with kids on the spectrum.

David: I remember seeing a program on parents of bipolar kids about a year ago. I'm sure several in the audience saw that program too. It seemed very stressful to be dealing, day in and day out, with the behavioral problems associated with the mood disorder. How does a parent constantly cope with that, or how can they better cope?

George Lynn: The most important thing is to develop an attitude of hardiness. This means that you come at the problem as a challenge, that the facts are friendly, that if you need help from the community you call for it, even if it's 911 or if you have to make a scene at the school district. Parents have to develop a certain "warrior" persona to deal with these issues, and they need to have a lot of love in their own lives and a sense of purpose. Oftentimes, Dads get to go to work and escape the major day-to-day stress. Mothers need to be very vocal about their need for help. Dad may have to take time off occasionally. If push comes to shove and other measures, such as residential placement, are indicated, these need to be pursued. Everybody gets to live!

David: We've talked a little about what parents can do to help themselves. What are some behavior management tools for working with their bipolar children that might prove effective?

George Lynn: Essential number one: Kids have to be willing to talk to a therapist who can help them. They have to believe that person can help them escape the inner feeling of chaos and get a handle on their reactions, as well as develop awareness of mood shift and normalize. I use a lot of scales, measurement devices, and body awareness techniques, depending on the age of the child, and I tell parents that stability is the most important factor in their child's life. They absolutely have to insist on it, no violence tolerated. We listen, but will not let you do violence to us. We know you are suffering. Your brain is having something like a seizure of emotion. You are not insane. We will help you, but you need to pitch in.

David: It sounds almost like a "zero tolerance" rule. Is that what you are talking about?

George Lynn: Not really zero tolerance, but the parents need to draw the line and stick to it. Some families actually use a level system. I would have a hard time with that, but I do tell my son that despite his issues, there is only so much we can or will do. And, of course, this depends on the age of the child - the older, the more in control he can be. The little ones just need a lot of love and structure. Even the 8 year olds tell me this and worry that their parents aren't up to the task.

David: Here's a helpful link for parents of bipolar children. Thank you, Ginger, for this:

ginger_5858: There is help for parents. There is a website for bipolar support groups online at http://www.bpkids.org/

David: We also have a great site in our parenting community: The Challenge of Difficult Children. I encourage you to take a look. We have a lot of audience questions, George. So let's get to some of those:

CammieKim: George, if you are a single mom with a boy that erupts into violence at times, what do you do to uphold the zero tolerance? What can I do?

George Lynn: Hi Cammie. The first thing is to get behaviorally clear with him about what takes things over the line. I like the three foot rule. Hold out your arm and say, "Do not get any closer to me than that when you are upset." These rules are posted, discussed, and become a part of family dogma. Beforehand arrangements should be made for possible inpatient evaluation, if that is necessary. That argues for picking a psychiatrist who has privileges at a hospital, and oftentimes it's good to take the child on a tour of the facility.

When you are in the moment, I use a "battle plan" which I outline in my book. The most important thing is to stay in your power and your heart. This may sound woowoo, but it is essential. Nonverbal anxiety from parents can make the situation worse. Finally, have friends you can speak to who understand!

Krissy1124: That's fine, but what about when the child is 10, weighs 140 lbs and is throwing furniture, kicking holes in walls, etc.?

George Lynn: That's what 911 is for. It sounds brutal. It is a good reason to move to a place where the police have college educations. Oftentimes, their sheer size and presence will get his attention. And there are a set of measured responses that follow from this if he is arrested. I don't mean to overdo the meet violence with strength part, but I don't know any other way. Finally, your local crisis center may have a child response team. It is a good idea to call and find out how it works.

ginger_5858: You can also ask that the police that come to the house be trained in mental illness; this is being done in a lot of areas.

George Lynn: Right on, Ginger!

thrbozmo: Mr. Lynn, I have a 12-year-old with Asperger's Syndrome and an 11-year-old with Bipolar Disorder. How does your approach to behavior management differ from positive behavior support?

George Lynn: Positive behavior support may work well with an Asperger's kid. Asperger's kids may be very gentle, they just lack the map of how to get from here to there. Kids with bipolar challenges are frantic for the encounter and they may either be too impulsive or too depressed (I call it "aggressive depression") to respond to positive measures. The areas of their brain involved are different, the amygdaloidal complex is unregulated in Bipolar Disorder. They are not thinking. You need to be able to calm the limbic system in the Bipolar kids and this is why the massive show of force may be necessary.

David: George, is the juvenile justice system the best place for these children? Many workers aren't suited to deal with mental illness properly.

George Lynn: No, the juvenile justice system is not! This is one of the huge shames of our culture. They need most probably to have a lot of outpatient, non-shaming intervention, but given the crunch on resources, parents ability to get understanding from the juvenile system may have to happen.

David: Here's an audience comment relating to this, then we'll continue with the questions:

Susan0: 911 got my son hospitalized where they undiagnosed him, withheld meds, and made him worse. It makes no sense if a kid needs treatment--not punishment.

David: Here's a question from Susan:

Susan0: In some areas, most doctors refuse to believe that Bipolar Disorder occurs in kids. Why is this?

David: And we've even had doctors come on our chat conferences and concur with that. I'd like your opinion, George.

George Lynn: Yes, I had one of the on-call docs at a local children's hospital suggest milk and cookies and a story when my own son went off. You have to do the upfront work to find a doctor who believes you and who is accessible. There is another aspect of the psychology of bipolar kids that needs to be mentioned. They can often pull back their behavior if the disincentives are great enough. If you don't have medical resistance, you are better than half way to success, but if you have it, a kid may have to learn that the community cares. It will not let him run amok. It will intervene. Judges hate being put in this position and are usually eager for a non-punitive solution if a kid is diagnosed with Bipolar Disorder.

David: Here are a few audience comments on what's been said:

frazzwell: Not the judge we had.

Susan0: We tried every psychiatrist within a hundred miles - either full-practice or, in the case of the dozen we saw, useless.

star445ca: Susan is right, our General Practitioner still does not believe our daughter's diagnosis. She is in RTC now.

David: Here's the link to the HealthyPlace.com Bipolar Community. You can click on this link, sign up for the mail list at the top of the page so you can keep up with events like this and take a look around.

We have lots of information in the bipolar community. I invite you to look through the sites on the left hand column and also the conference transcripts from previous conferences. We've had some excellent guests.

Mr. Lynn's website is here.

Josefina: We have a thirteen-year-old daughter, recently diagnosed as Bipoar, but she refuses to take bipolar medications. We are going crazy. Any suggestions?

George Lynn: Josefina, med resistance is like having a kid with an eating disorder. You go slow and wait for your opportunity. You point (slyly) to how it will improve her social life. You may position incentives or events that you will not let her do unless she is on meds. Give her a lot of leeway and information, dealing with the major biggies of weight gain and zits. And get her talking with a female psychiatrist who is not you, but who will devise strategy with you.

David: For some people wondering what it's like being on the other side, living with bipolar disorder, I invite you to visit Catching A Darkness: Glimpses of My Sister's Mania, Boris Dolin's site in the HealthyPlace.com Bipolar Community. It's a photographic essay that you'll never forget.

truckdog: Should we film our kids if they do not have any memory of their episodes? Will seeing the film hurt their self esteem?

George Lynn: Truckdog, video-taping your child should be done at his request or he will just block it out. Denial is big in Bipolar Disorder, but if you and he agree on how significant the problem is, taping may help.

David: Here are a few audience comments on the videotaping question:

Susi: We found video taping the rages was THE best tool for diagnoses.

Susan0: Videotaping our son was the only way we got him treated--we showed the doctor, but our son declined to watch--wisely.

ginger_5858: Filming them might help get them the right diagnosis though.

George Lynn: First, I've got to say thanks for the notion of using the videotaping for diagnosis. That had not occurred to me. Rage is dramatic! Thank you Susan.

David: One other thing I want to mention, and I don't know if you caught it George, but the Surgeon General came out with a report a couple of days ago,'Crisis' in Kids' Mental Health. It said 1 in 10 children in the U.S. have a mental illness, but only 1 in 5 get help because of money issues, the stigma attached to mental illness, and more.

George Lynn: Yes, one thing parents can do is de-stigmatize it by describing it more as a seizure disorder than as a mental defect. Parents need to let go of their illusion that the child is normal. It's cruel to say, but this illusion can stand in the way of remembering how bad it can get.

Public funding is a big priority. Hopefully our policymakers will understand this when they gab about violence prevention in kids.

SpaceCowgirl: I am a 36 year old Bipolar mom with a 13 yr old Bipolar son and an 8 yr old ADHD daughter. I have had the worst luck in finding doctors that will listen, including my current doctor who thinks the internet causes more harm than good. How can I find a doctor for both my children and myself?

George Lynn: SpaceCowgirl, you gotta network! Go to your local ChADD group or manic depression association (National Depressive and Manic-Depressive Association, NDMDA) and pick up names. Persistence is essential. Knowledgeable doctors are out there. Look for course that deal with the subject of parenting difficult kids or call your county medical society and ask for a specialist referral.

David: Here's a great question. Unfortunately, many parents face this situation:

Debyyntodd: How do you deal with outsiders or even family that say nothing is wrong with the kid except poor parenting?

George Lynn: "Nothing is wrong except poor parenting" is a comment you will hear a lot. Don't take it on. Mention your success with your other kids. If it comes from a family member who really cares, let that person care for your child for at least a couple of weeks, past the honeymoon stage.

Be assertive and know in your own heart that you're a good mom or dad, and put out your feelings with that kind of confidence.

Debyyntodd: They would never survive it, or never offer.

David: Some more audience comments on what's been said tonight:

C.Gates: I always say, "If you lived with my child, you would feel differently about it." Plus, if your child rages and does not remember it, and you accuse them of it, they will resent you for it. That will hurt them and you more than a hidden video.

carol bova: When it's appropriate, I just tell people what the disorder is. If they care, they will try to understand; if they don't, then its not worth the effort.

1789: I am putting in some webcams so that I can randomly monitor my son's afternoon activities from work.

Batty: It's hard to talk about success with siblings when you have an only child who is BP!!

Mell: My in-laws blame me for the weight gain and refuse to believe it's the bipolar medications.

Susan0: We mentioned our success with our daughter and they said she just hadn't exhibited problems yet!

David: I also want to touch on school issues tonight. One of the toughest problems some parents have is getting the school to work with them. Do you have some suggestions on that?

George Lynn: As always, a good evaluation is very important. The specific educational deficiencies that a child has must be documented, and many kids with Bipolar Disorder challenges have ADD-like learning issues.

That's number one. Number two is getting across the idea that schools destabilize our kids and that unique structures have to be put in place to insure stability on a day-to-day basis. Doing this will require a write-up from your psychiatrist. Finally, you face all the issues people do with NB involved kids. Schools are big bureaucracies. See chapter 15 of my first book for hard-learned lessons of ways to deal with the bureaucratic part.

David: By the way, we have an excellent site in our ADD community, but it's appropriate for any child with a learning disability. It discusses dealing with the school system and getting what your child deserves and is entitled to. The Parent Advocate site is run by Judy Bonnell. I encourage you to drop by and read through her site. She is extremely knowledgeable about the subject.

Mell: I can understand this zero-tolerance policy schools have, but if a 6-year-old threatens to blow up the school, why would they take it seriously?

George Lynn: IMHO schools are trying to deal with overcrowding by using methods that lose sight of the situation of individual children. The only way to deal with this is as an issue involving your child's civil rights and his rights under the IEP law. You provide documentation that he is not dangerous. You require the school to continue to educate him until they are satisfied that he can return to class. You may be able to compel his return. The important thing is to know that you do have rights in the situation.

Oftentimes, we take it for granted that the system can get away with this kind of "Spartacus like" treatment of our kids, but we all have rights.

David: Some comments on how schools react to threatening behavior:

C.Gates: Yes, they do take it seriously here in Houston, Texas.

frazzwell: My son went to jail for 3 weeks for writing "bomb" on a bathroom wall. They called it a bomb threat.

thrbozmo: ABSOLUTELY the schools take threats seriously. I've advocated for kids that young who were suspended for making such comments. Total BS.

sebastian: It's important to educate the teachers and staff about childhood Bipolar Disorder. Give them written information about it. CABF has very informative handouts from their site to use. I did this and it really helped the teachers to better understand why my son does some of the things he does.

Kris23: Do you find that many Bipolar kids are also gifted? Also learning disabled? How do we reconcile all these aspects of the child?

George Lynn: Oh yes. They most often show gifts as (believe it or not) little philosophers or writers. They are heavy into truth. They cannot tolerate absurdity. Learning disabilities often involve short-term memory issues and all the ones caused by impulsivity. When I am working with these gifted kids, I try to give them a story line about themselves and confidence that things will work out. Fact is the research is positive for bipolar children who get medical attention.

One more thing I have noticed is that the parents of these kids themselves are often outstanding in some area. The good and the bad come down the tree.

David: I also forgot to mention, but in the bipolar transcript section of our site, you'll find the transcript from our conference with Pete and Pam Wright, who are legal experts on kids with learning disabilities. There is a lot of good information there.

I see we have a few proud parents of gifted bipolar children with us :)

SpaceCowgirl: Yes, my son pulls A's and B's and has since 2nd grade. He is a perfectionist about his grades and beats himself up if they aren't at least A's and B's.

carol bova: I had to fight to have my son put into the accelerated math class in 6th grade; the teacher said he had all the tools to do the work but had a bad attitude.

sebastian: My son is in the gifted program at school, but currently is not doing well in math and reading. It seems it is getting more difficult as he gets older. Medications also affect their cognitive abilities.

Batty: There is a great book, Uniquely Gifted: Identifying and Meeting the Needs of the Twice-Exceptional Student by Kiesa Kay, that addresses gifted children with learning disabilities!!

sqhill: Please provide us parents with some positive statements to help us to continue to be the best advocates we can for our children. We are the only ones who can help our children even though it is so difficult for us. I always wonder if I am doing everything I can because the process is so slow.

George Lynn: Sqhill, there is a trick process here in terms of parents' self-esteem. On one hand, raising kids like ours can be bruising. We just want to get away from it. On the other, it really helps to keep a vision of what is possible for your child, and to document his accomplishments and yours. Keep your sense of humor and try to find the central patterns in his personality that are unique.

Oftentimes our kids can think deeper and be more creative than "neurotypicals," so holding that vision is very important. When you look at how civilization has progressed, you find bipolars all throughout the map. Yours may be such a one! And you are right, no one is going to be there for him if you're not!

MB0821: Mr. Lynn, what advice can you offer to single parents of bipolar children, especially where the non-custodial parent is bipolar and non-compliant with bipolar medications?

George Lynn: Educate your child about the situation as best you can. Teach him to monitor himself when he is with your ex. Wear your cell phone so he can call if he has to, and try to control medications from your end so that he is less dependent on your ex to get them. If the ex is un-medicated, your child may be in danger. This is a pattern I see in some situations. Oftentimes the ex may be diagnosed "borderline personality disorder" or show symptoms of this. Follow the situation very closely and get involved legally if you have to. Once again, having a supportive professional in the picture is essential.

ginger_5858: Having supervised visitation with an unstable, non-custodial parent might be a good idea.

spmama123:The biggest problem is my ex doesn't believe in bipolar medications or that there really is a problem.

janice34: I have an ex that just doesn't believe there is a problem, first off, and secondly, that meds are not the answer - discipline is.

Batty: Keeping a sense of humor and a positive vision is helped greatly by support from places like CABF--and in my area we have even started local support groups. It's wonderful and life-saving, to say the least. Thanks !

C.Gates: Let the non-custodial parent take the child for a few weeks off of the meds and they will change their minds. I know that one untreated bipolar can not handle another untreated bipolar.

MB0821: At what age do you begin discussing the more technical aspects of the bipolar disorder with children?

George Lynn: MBO81, you have got to make sure that your timing is right and that the way you explain it is understandable to the child. There is not particular age, but it is important for him or her to have the issue put in terms that are age appropriate. I talk a bit about this in chapter 1 of my book.

Kids with these challenges are usually eager to make sense of the situation, so I will tell them that their brains just have a tendency to overheat at times, or that they are like big ships and it is hard to stop them once they get going, and that the bipolar medications and their self-control strategies help them so they can have friends and be successful.

flyingfingers: Mr Lynn, my husband and I had the privilege of attending the Chadd conference in Chicago last month where we heard you speak. We have an 18 year old who was diagnosed with Bipolar Disorder last April, after years of being labeled ADHD and ODD. One of our many problems is that our 24 year old son, who is living at home while he finishes nursing school, has little patience with his brother. He is also very critical of our parenting decisions. Any ideas on how we can help him see life through his brother's eyes?

George Lynn: Your question points to the essential presence of a good family therapist who understands Bipolar Disorder and sibling issues. I would address the issue to your 24 year old as a professional consideration. What can he learn from his brother about the kinds of people that he will treat in hospital? Sometimes it takes distance for siblings to overcome their resentment and you may just have to wait it out and give information to the 24 year old when he can hear it.

sebastian: I also printed out information from CABF for my son to read. Also, NAMI's family-to-family class has wonderful information about how the brain works and how medications affect it. The light bulb went off for him, and he accepted his diagnosis better.

carol bova: My son often asks, "Whats wrong with me?" He's 11 and knows something is not right; he becomes frustrated from not knowing why he feels the way he does.

George Lynn: Some kids can understand the triune brain model. I tell them they have three brains - draw pictures of these. We have the cortex (the civilized brain), the limbic brain (the animal brain), and the base brain (heartbeat, etc.). I tell kids with Bipolar Disorder that, in their case, the limbic brain sometimes sits as an equal at the table with the cortex and that the medications help their thinking brain keep things in check.

Martha Hellander: George, I want to commend you for your first book Survival Strategies for Parenting Your ADD Child (as you call them "Attention Different") as well as your new one on parenting bipolar kids. The earlier one was the only thing I could find in 1996 when my 8-year-old daughter was diagnosed. Your description of the "limbic wave" was so approprate. I still refer to it often when talking to parents on the CABF message boards.

George Lynn: Thanks, Martha! The "limbic wave" that Martha mentions is how I describe the sudden explosivity of our kids.

MarciaAboutBP: We have a Bipolar parent who, in defending himself from a raging 16 year old child, threw up a forearm, which hit the child and broke her nose. The father was arrested for child abuse. How can parents explain when the child is so violent?

George Lynn: Marcia, you need keep a track record by way of a good psychiatric evaluation. The best thing to have is a witness.You are allowed to defend yourself. If you make it clear to investigating officers how you were defending yourself, you should not have a hassle. At the same time, you run the risk of at least having to explain this to a judge. The important thing is for parents to keep their own cool because the limbic brain does not think, and when one limbic brain is talking to another, tragedy can happen!

ginger_5858: The Dept. of Social Services tends to get in the way of this type of problem all over the country and tends to take the kids away from the family. They don't always listen to the parents.

Batty: My son gave his psychologist a bloody nose and now everybody believes us!

C.Gates: You must keep a copy of your child's medical record in a folder at all times and make sure your psychiatrist will write a letter to put in the folder. Also, have numbers for the police to call.

spmama123: That is a good question - I have given our local police dept a printout from CABF to help them understand.

George Lynn: All great approaches!

David: Here's a nice comment on your book, George.

KateIA: I have read your book with its unique perspective of both professional and parent. I especially appreciated your noting the many positive aspects of bipolar children and the need for compassion in dealing with them. When I feel discouraged, I find myself reviewing certain sections and immediately feel empowered and encouraged in managing my amazing 14 year old BP/TS/OCD son.

George Lynn: KatelA. Thank you. I think I know the type of kid your talking about!

Wish4ever: My daughter is never violent. She just feels that if she walks out the door nobody will miss her and someone will find her and cure her. Do most bi-polar kids feel this way?

George Lynn: Wish4ever, she is depressed. I don't think that all kids on the spectrum feel as she does, but those who do are at risk for suicide, and if she is impulsive, doubly so. You've probably heard it before, but she needs to be in a teen support group.

Laura (SW GA): Just how does a parent eliminate the nonverbal anxiety that you spoke of that makes things worse?

George Lynn: Laura, it helps to remind yourself to breathe. Have someone do that for you if you forget. Stay in touch with yourself, stay physically healthy. If you have problems with anxiety yourself, get treatment. Look at yourself in the mirror, breathe from your diaphragm, and feel compassion for yourself. In my book on Bipolar Disorder in kids, I have a section about how to ground yourself so that you are positive in the situation.

David: We had a lot of people tonight and a ton of questions. Obviously, we couldn't get to them all.

Thank you, Mr. Lynn, for being our guest tonight and for sharing this information with us. And to those in the audience, thank you for coming and participating. I hope you found it helpful. We have a very large and active community here at HealthyPlace.com. Also, if you found our site beneficial, I hope you'll pass our URL around to your friends, mail list buddies, and others: http://www.healthyplace.com/

George Lynn: Thank you for inviting me. Feel free to visit my site or email me at GeorgeLynn @ aol.com.

David: Thank you, Mr. Lynn. I hope you'll come back again. Good night, everyone.

Disclaimer: That we are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.