Parenting with a mental illness

Parenting is hard. We have to keep our children safe and fed; we have to attune to their emotional needs. We sacrifice everything for them: our time, our money, our sleep. And we wouldn’t want it any other way.

Having a mental illness is hard. Sometimes getting out of bed is daunting. Acutely self-regulating one’s emotions is impossible. Reality might, at times, become a vague concept. Nobody asks for or deserves a mental illness. It is a painful and often incapacitating disability.

When my patients hear that they have a diagnosis of serious mental illness, say bipolar mood disorder or schizophrenia, one of the first thing they want to know is if their children will have it too. Chronic mental illnesses do have a genetic link. If one parent has schizophrenia, there is a ten percent chance of the child inheriting the illness.

I am more concerned about the increased rates of depression and anxiety in the offspring of mentally ill parents.

Having a mentally ill parent means a decidedly harder upbringing. It might mean an absent parent for long periods of time, either because of hospitalisations or inability to connect. Children of mentally ill parents often describe how they ended up parenting the parent. One patient told me how at the age of eight she would cook supper, feed her younger sister and lockup; her profoundly depressed mom who would just watch TV all day.

Sadly, when I recommend medication for mental illness, one of the first things my patients say is “I don’t want to become like my mom.”

It need not be that way. Many of my mentally ill patients are great parents. I stand in awe of how they get on with the parenting job despite all the odds. They do not indulge in denial or self-pity. One patient spent her twenties in and out of the hospital with rapid cycling mood disorder. She constantly went off her meds and would periodically abuse various drugs. After the birth of her daughter, she came to me and said: “This can’t carry on. How do I manage this thing?” She tackled her illness head-on. Over the last decade, she has needed only one admission. Although things have been rough at times, she has done everything she could to stay well. With tremendous benefits; she is mothering a happy, well-adjusted family.

• Actively manage your illness

Get to know your disease, your treatment, your triggers for relapse. Use your psychiatrist, your psychologist, your support groups, the library, the internet.

I love it when my patients are well informed. We can then form a real alliance in managing a difficult illness.

• Get your support networks up

Mental illness is isolating. It takes energy and inclination to nurture relationships, qualities often stolen by mental illness. Isolation is not good for you or your child.

“It takes a village to raise a child” is never truer than when you are suffering from a chronic illness. The more involved the co-parent, grandparents, extended family, and friends are in the everyday lives of kids, the less disruptive it is for the kids should you need recovery time.

Support networks also include paid for nannies, au pairs, aftercare. Have the systems in place before you need them.

• Put an emergency plan in place

Your illness might occasionally impair the way you think, feel or act. Openly discuss an emergency plan with those involved in it. One of my patients can get acutely psychotic, very quickly. Usually very insightful, it has been necessary previously to certify her to involuntary care. She has arranged with her mom to look after her kids should something like that happen again. She has written a letter to her kids explaining why she “disappeared” and promising to return healthy as soon as possible.

• Dealing with stigma

Stigma is real. Mental illness sometimes gets held against a parent. I have a patient going through a painful divorce. The stress of the divorce is destabilising her mental illness, but she is petrified to go into the clinic lest it is held against her in a custody battle. From experience, I know that it is easier to argue the good sense of a patient getting help when needed than it is proving her unfit for asking for that help. The risk is greater to the patient should they not get help and then things deteriorate to the point where they cannot manage.

• Talk to your child about your mental illness

The impulse is to protect your child from the scariness of the illness. But you can’t. They are living with it as much as you are. You can help empower them by educating them about it. Ask questions, try not to be bogged down by guilt and remorse at some of the more difficult answers. Instead, explain what happened: “When I am depressed I sometimes struggle to get out of bed. Depression is an illness which steals energy.” Or, “when I was shouting so much, it was because I was out of touch with reality. It wasn’t your fault.”

Your mental illness can steal your child’s childhood. Your child may have to compete with your symptoms for attention. When tackled head-on, mental illness forces one to be more self-aware. As soon as self-awareness happens, empathy and understanding increases, and ultimately can result in more attuned parenting.

A patient told me: “my mother taught me about bravery. She was severely socially phobic, but never missed one of my school events.” When your child is supported and contained through your illness, their resilience and empathy can be nurtured. Another patient of mine said: “I will never judge anyone with schizophrenia. I know how my father suffered.”

Having a mental illness is horrible. Parenting is demanding. Having a parent with mental illness is hard too. One in four people does have a mental illness at some time in their lives. So it is common, and you are not alone. If we remember the needs of the child and support each other as parents, then perhaps the next generation can grow up wiser and kinder.