This post is Part Two of a six-part series: Pediatric Bipolar Disorder: A Guide for Children’s and Youth Pastors and Volunteers
Put yourself in the position of a kid with bipolar disorder.
Much of the time, your mood is likely to be sad, unhappy and for the most part, irritable. Odds are that you have more difficulty on a day to day basis maintaining your focus and concentration in school thanks to your ADHD. You have to work a lot harder than your friends to get the same results in school. It takes lots of mental effort to hold your behavior in check all day, and you still get into more trouble than anyone else. Because of your mood, you’re not the first person people seek out in the cafeteria at lunchtime.
And then you get to go home.
My ministry teammate and colleague, Katie Wetherbee, works off three basic assumptions about kids when she’s training ministry staff or classroom teachers:
Kids want to be competent, effective learners
They feel upset when their behavior gets in the way
They fare better when they learn problem-solving strategies
With rare exceptions, kids want to be good. They want their parents to approve of them. They want other kids to like them and want to be with them. They want to be normal.
Bipolar disorder has nothing to do with intelligence. But kids with bipolar disorder often have more difficulties sustaining their concentration in school. Problems with sleep lead to forgetfulness. They may miss more school than other kids because of disciplinary actions or with exacerbations of their illness. 30-40% will have specific learning disabilities. School often presents another challenge to overcome as opposed to representing a strength they can build from.
Kids with bipolar disorder often become more easily irritated by relatively innocuous requests, comments or noxious stimuli in the environment. They may act in ways that come across to peers as being rude or thoughtless. They get tired of being judged by teachers and peers. The end result as they get older is often a retreat into alcohol or drugs as an escape from their emotional pain.
Axl Rose, the iconic lead singer of Guns N Roses, has reportedly been treated with lithium for bipolar disorder. The following is from an interview in Rolling Stone magazine:
“I’m very sensitive and emotional and things upset me and makeme feel like not functioning or dealing with people… I went to a clinic, thinking it would help my moods. The only thing I did was to take one 500 question test – ya know, filling in the little black dots. All of a sudden I’m diagnosed manic-depressive. ‘Let’s put Axl on medication.’ Well, the medication doesn’t help me deal with the stress. The only thing it does is help keep people off my back because they figure I’m on medication.”
At home, kids with bipolar disorder encounter parents who express frustration with their conduct and disappointment with their academic performance. The parents themselves may be struggling with their own mental health issues, along with the isolation that frequently goes hand in hand with having a child with a serious mental illness. A church served by Key Ministry recently welcomed a mother of a child with bipolar disorder to a respite event, representing her first opportunity in three years to go out without her son.
Finally, kids with bipolar disorder struggle to accept the need for ongoing treatment and tolerate the effects of available treatments. As I mentioned earlier, kids want to be normal. In a kid’s mind, the daily ritual of taking medication (the primary treatment for Type I bipolar disorder) serves as a constant reminder that they’re different or broken. The side effect profile of the FDA-approved medications for bipolar disorder often wreaks havoc upon their bodies. One study examining side effects of the most commonly prescribed medications for bipolar disorder in kids taking medication for the first time showed average weight gain ranging from 10-19 lb. in the first eleven weeks of treatment. I’ve seen kids who have gained over 100# after being started on medication for bipolar disorder. Think about the impact of weight gain on the self-confidence and body image of a teenager with a condition that already interferes with their social life. Some medications increase levels of prolactin, the hormone women produce when pregnant so they can breast feed. Boys often get breast enlargement, girls stop having periods. The biggest complaint I get from kids about medication is that they lose the “highs” that occurred during their cycles and only experience periods of depression or an overall sense of being blunted, not themselves, or in an emotional straitjacket. As a result, 2/3 of kids diagnosed with bipolar disorder stop taking medication regularly. Kids don’t necessarily appreciate the time or effort involved in more psychotherapeutically-based treatment.
I had a kid…we’ll call him Irv. He’s now an adult and is treated by a psychiatrist with expertise in bipolar disorder. He’s highly intelligent, very creative, very gifted, and experiences feelings far more intensely than most kids do. HATED feeling depressed, which would result from his tendency to obsess about his future (he also has OCD and ADHD). He repeatedly stopped taking his medication, despite the violent outbursts, suicide threats, risk-taking behaviors, family conflict and police involvement that usually resulted. In his mind, the brief times, maybe a half a day, maybe a day in which he’d feel alive and creative off medication were worth all the other stuff he had to experience.
Bottom line: Along with very thoughtful mental health care, kids with bipolar disorder need a place where they can experience unconditional love and a little grace. Any ideas about where they might go to find that?
Next: Part Three: What Challenges do Families of Kids with Bipolar Disorder Face?
Updated February 24, 2016