Parent's Advocacy in the School

Book Review of

THE UPS AND DOWNS OF RAISING A BIPOLAR CHILD: A Survival Guide for Parents

This book is written by Judith Lederman who is a freelance writer and the parent of a bipolar child and Candida Fink, M.D . who is a psychiatrist with a private practice and was on staff at a Residential Treatment Program. It gives us the commonsense perspective of someone who has the experience of parenting a child with bipolar disorder along with the expert advise of a psychiatrist who has been treating children with bipolar disorder for many years.

The best news for parents in this "Survival Guide" is that the "treatment success rate for bipolar disorder is 80 percent . and the vast majority of people with bipolar disorder respond to treatment and are able to live comparably stable lives." Bipolar disorder can be a very confusing and disabling mental illness for those diagnosed with it later in life, but for children it often goes undiagnosed and can be a great cause of turmoil for everyone in the circle of family and friends. This book goes a long way to help parents sort out the issues that can arise when dealing with the world of a bipolar child. These are not issues that are addressed in the usual parenting courses or books.

In the first section, this book walks us through the symptoms and the complications involved in arriving at a diagnosis, as well as how to find competent psychiatrists, social workers and therapists. We are told that misdiagnosis and co-morbid diagnoses are common. A co-morbid diagnosis occurs when more than one disorder coexist. In "one study, eight of ten children with bipolar disorder are actually suffering from bipolar disorder and ADHD (Attention Deficit Hyperactivity Disorder) together." We are told how to chart mood swings, given general guidelines for medication considerations, as well as a detailed description of the different types of medications and even a short summary of non-prescription medications and alternative therapies. Misdiagnosis and improper medications can cause symptoms "far worse than anything the child has experienced before."

We learn that daily structure is important and that "routine is everything." Special occasions, holidays and even nighttime can be very traumatic for bipolar children. More than half of the several hundred respondents who participated in an online questionnaire by the author at www.parentingbipolars.com , "indicated that their children have been hospitalized at one time or another for their bipolar disorder." The chapter on Hospitalization gives us clear information on when, how and what to expect when a hospitalization is required.

Each chapter ends with "Notes from the couch: a psychiatrist's point of view" and in Chapter 5 entitled "The Structure of Daily Life" we are told that the best advise to parents of a bipolar child with reactive moods is to "Stop talking! If you have made the decision that a particular behaviour is under his control and needs correcting, state the behaviour, outline the consequences and walk away. Don't get caught up in a verbal barrage. Ignore it. Later you will mete out consequences and talk to the child when everyone is calm."

Part Two: Your Child in the World divides into 3 chapters covering first Daycare, Schools and Camps , then Friends and Family and finally The Law. These heading themselves give us an indication of the unknown areas in which we can be led when we are the parents of a bipolar child. The first chapter states "the revolving door of child care situations is often the first indication that something is terribly wrong. Often Moms are forced to quit jobs and end careers to stay home with their child". This has certainly been true in my case. When our 14 year old son was 3 years old, he went through 3 different babysitters in a 9 month period, while I was working at the only full time contract position I have been able to accept since he was born. The section on Schools gives "general information" that must be contained in an Individualized Education Plan (IEP) for a Special Education Program. For a more comprehensive description and a complete IEP see The Bipolar Child: The Definitive and Reassuring Guide to Childhood's Most Misunderstood Disorder by Demitri and Janice Papolos.

One of the most challenging things about this disorder is explaining it to friends and family. The advice given in Chapter 8 will help families make good decisions about who to share this sensitive information with. The author divides them into 3 categories - those to "Tell / Tell as Needed / Don't Tell". Those included in the Don't Tell section are "Casual friends and Work acquaintances." This is probably good advise, but not always practical when coworkers are wondering what is happening. On a personal note, my husband felt the need to explain to his coworkers what was going on with our son when they overheard an emergency phone call from our daughter. He was discussing whether or not she should call 911 and how much blood was on her face after she had an altercation with our son. Grandparents are in the "Tell as Needed" section and we found that my husband's mother had to be told in more detail when she began to wonder why we had to cancel a get together.

In Part Three: Your Family , the author gives us a new perspective on being the parent of a bipolar child. She tells us that another author has suggested that bipolar children are "in fact doing their parents a favour by teaching them that things can change in a heartbeat.. One of the lessons the rest of the world learned from the terrorist attacks on the World Trade Centre and the Pentagon, parents of bipolar children already knew from day-to-day dealings with their children. If anyone understands the nature of constant change, it is parents of bipolar children." I totally agree and have noticed that they also teach us things about our own nature that we may or may not want to learn like patience, compassion and how to be firm and loving at the same time.

The ways in which relationships and siblings can suffer are also examined. The five-stage process of grieving: denial, anger, bargaining, depression and acceptance are applied to the cycle parents go through when they first realize that their child has a mental illness that they will have to battle forever. It certainly is true in our case, that for our 16-year-old daughter "having a bipolar child for a sibling [has resulted] in a fast-forward maturity process. [As a sibling] she has needed to develop special coping skills." The chapter on Siblings: Parenting the " Normal " Ones goes through the feelings that a sibling may have including embarrassment and resentment. It takes parents through some issues that they may have to navigate like copycat behaviour, abuse and making friends and keeping them. The good news here is that "those who grow up with a sick brother or sister often excel in many areas, perhaps because of the very challenges they faced as children." Once again the positive side is emphasized when we are reminded that siblings who are taught that "helping those who are most vulnerable, will be blessed with understanding beyond their years."

The last section Part Four: Money Matters discusses balancing careers with looking after and advocating for your bipolar child. Being the parent of a bipolar child is described as being "the biggest job you'll ever have." The often-unexpected costs associated with caring for a child with special needs can be expensive and the chapter on Family Finances helps with some of those concerns.

As you can see from this review, this book contains a wealth of valuable information for parents as well as others involved in the world of a bipolar child. It helps parents cope with a very difficult disorder that is made even more difficult because of the lack of information about early onset bipolar disorder. Because bipolar disorder in children often goes misdiagnosed or undiagnosed, more information is definitely needed. This would also be a good book for interested family and friends to read in order to answer their questions or dispel any doubts they may have. Bipolar disorder is an invisible disability made even more difficult because there can often be no symptoms obvious to those outside the family for long periods of time.

Book review by Susan Partridge

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