One year ago today I wrote my first post for this blog.  I remember thinking at the time that I wanted to try and post almost every day but wondered how I would possibly think of something to say or post every day.  Oddly, it really has not been a problem.  In fact, very rarely do I even think in advance about what I’m going to post anymore.  I usually just have so much stuff rolling around in my brain that when I sit down to write, out it comes.   Anyway, in commemoration of this day I thought I would answer some questions that I have been asked  over the past year via email about us and about the blog.   Often times people don’t feel comfortable commenting on this site due to the nature of the subject matter so they just email me.  And that’s fine.   Anyway, here goes.

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Q: Why do you blog?

A: I blog to keep a journal of our lives and to record the stories and events in our lives as they happen.  I blog to let people know they are not alone in raising a bipolar child and that it can be done with dignity and respect for the child.  I blog to share our ups and our downs and hopefully in doing so raise awareness of bipolar disorder in children and teens.  I blog to let people know that bipolar children and teens can be the most wonderful and creative people they will ever know and that they have a great deal to offer this world and the communities around them.  I blog to let people know that bipolar disorder affords our society some of the greatest and most interesting people we have and we should honor and respect our differences and value what these differences bring to our society.

Q: Why do you blog anonymously?

A: I blog anonymously because Rye’s story and Don, Rye’s and my family story are not mine to tell except in an anonymous format.  When Rye is old enough, he can share his own story if he wants to.  And if he never wants to, that’s fine too.  But this way he is protected.

Q: Do you believe that Early Onset Bipolar Disorder exists?

A: Yes, I do.  I believe that it is not common and I believe that it is more common in children that have a biological parent or direct relative that has bipolar disorder or depressive disorder (unipolar). I also believe that it does not always have to be medicated in the early years or even continuously medicated throughout life.  I believe it all depends on the child/teen and how much their emotions and behaviors are interfering with their quality of life, their thought processes, their safety, and the safety of those around them.

And, for people who do not believe Early Onset Bipolar exists, I challenge you to start attending some bipolar support meetings in your area and ask all of the adults there when they feel they began to deal with bipolar disorder.  Most will say in the teen years or early adulthood but many will say they have had bipolar disorder since as early as they can remember – even as a young child.   So this is not a new phenomenon.

Q: How do you feel about psychiatric medications and children?

A: I have mixed feelings about psychiatric medications in general.  And I think some are better than, more researched and safer than others.  Done correctly, the right medications can literally save a child’s life and/or their quality of life.  There is no denying that.  And we see that now with our son.  So in that respect I am for it.  That said,  I also believe that medications can be overused and have been overused in children.  Particularly young children.  I  think we often create bipolar disorder in young children by prescribing them antidepressant [SSRI] and stimulant medication too readily and at too young of an age when the child does not really need it.   I also believe, as our psychiatrist believes, that if your child has a paragraph long list of medications they are taking, at least some of the medications aren’t working and you should rethink your strategy.  Piling psychiatric medication on top of psychiatric medication is not a good treatment plan as your brain reorganizes and accommodates for every psychiatric medication it is exposed to.  Psychiatric medications all come with issues that may not be evident in the short term and the benefits as well as possible side effects and problems created by the medicines should be taken into account at all times.  And all psychiatric medications have withdrawal effects that can be dangerous if not handled with care.

Q: Do you believe in using natural healing methods for bipolar disorder?

A: Yes.  I also think that they work for some people better than others.  I think that treating bipolar disorder is not a one size fits all strategy and that the disorder exists, like everything, on a continuum.   So what works for one person may not work for another.  Also,  what works at one time in one’s life may not work in another time.  One person may be able to completely control their symptoms using natural methods while another may not.  More often than not I think it’s a blending of methods that works best.  Especially in the teen and young adult years when there is a high flux of hormones in a person’s system.  Medication combined with natural techniques is what we use with Rye.

Q: Do you believe in always listening to you child’s psychiatrist?

A: Yes, if you have a good doctor that you trust. And I believe that your relationship with your child’s psychiatrist should be a partnership so that your doctor  always listens to you as well. One aspect of a good doctor is that they are ok with being challenged and they value your opinion as a parent and are flexible.  If your doctor is not ok with being challenged and questioned and is not flexible or does not listen to your concerns regarding medications or your child, get a new one.  As a parent, always, always listen to your inner voice and know that you know your child best.  If your doctor is not working in the best interest of the child or you feel it just doesn’t ‘feel right’, it’s not right.  You are your child’s best advocate and doctors are flawed like everyone else in the world.  They are human.  They make mistakes.  They have a certain perspective and mind set they come from and they are influenced by.   Know that, accept that and work with it.  If a medicine isn’t working for my child, it’s gone.  I’m not going to wait around for it to do permanent damage to my child.   Your doctor can’t fix that once it’s done.

Q: How do you feel about psychiatric hospitals?

A: I think the treatment model used in inpatient psychiatric hospitals today in the United States is often inhumane, outdated and harmful.  I think psychiatric hospitals should only be used as a last resort as they can cause more damage than they ever help.   I’ve heard more horror stories about psychiatric hospitals than I would ever care to share.   They are not a place for healing.  And ironically teaching hospitals can often be the worst.

Q: Do you believe in therapy?

A: Yes.  I believe a good therapist can help all of us, bipolar or not.  I do not believe, however, that behavioral therapy or psychoanalysis/talk therapy in and of itself can cure or control the all of the symptoms of bipolar disorder in children and teens.  Children and teens do not have the capacity to think their way out of being bipolar and it is important to have a therapist that understands this.

Q: Do you think environment is important in controlling bipolar symptoms?

A: Yes, very much so.  Stress is a major, if not the primary, trigger for bipolar symptoms and controlling one’s environment and mitigating the stress within that environment is very important in controlling these symptoms.

Q: What’s your favorite thing about blogging?

A: It’s fun.  It’s creative.  It’s personal.  And I have met some really interesting people through it and learned a lot.  I love getting emails from people saying they like the blog and feel it’s accurate and helpful.  That’s the best part.  Well, that and looking back on all of stories, happenings, etc.  The recording of our life story.

The gist is this, when it comes to making decisions in life, ask yourself what you would want your own child to do if you had a child (in Rye’s case, he should ask himself what he would tell his own son to do) and then tell your self to do that same thing.  In other words, give yourself the same advice you would give an outer, dependent child.

For example, sometimes I ask Rye when he is struggling with a decision….even before this session…’If you had a son or our positions were reversed and you were my parent, what would you tell that son or what would you tell me to do in this situation?’  Inevitably he comes up with better advice for me or his hypothetical child than he would actually give himself in real life.  So, the idea is that he should give himself that same information or advice that he would give me in a parent or caregiver role and follow it himself.

He should love himself.  This is a way of showing love to himself.

Now, granted, there are a lot of kids that just do this naturally.  Many kids out there, myself included as a young person [although in my 20's I did struggle more with this], do not struggle with impulse control issues or being drawn to dangerous things or making the right decision as much as bipolar children and teens often do.  So they don’t really need this so much.  It it just obvious to them that they should make healthy and safe decisions.  However, my child is not like this.  He struggles.  He often wants to do the right thing but is also quite drawn to the darker choice.  And so this advice, behavioral training, and practice is good for him.

And, let’s not discount the effects of medication.  We also saw the psychiatrist yesterday and we discussed this as well.  Without the medication, making the right decision or well thought out decisions can be next to impossible.  However, the problem with the medication is that  it is not always right.  It is not always at the right level or working right or whatever the case may be so one needs to have other techniques to use as well – and in addition to  – the medication.  The psychiatrist yesterday said that Rye is still hypomanic.  But we can only go up so fast on the Depakote.  So these behavioral techniques are helpful.   Even if they don’t work as well as if he weren’t hypomanic.  They are still are much, much better than nothing.  And honestly, I can’t remember a time in my life when Rye wasn’t hypomanic so I’ll be blown away when we get to where he’s not.

The therapy is useful.  Rye may not be able to put every technique into practice at all times but I know he really hears the therapist and it is all going into his mind. Bit by bit.  Session by session.  Techniques for how to deal with life, decisions, feelings and dificult situations.

It’s all good.

It’s interesting, though.  He is very much a behavior based therapist.  In other words,  he minimizes the effect of medicines as he believes they don’t control you.  You control yourself, regardless of medication.  Now, as much as I would like to believe this is wholly and completely true, I know it’s not.  We have learned the hard way that it’s not.   And I’m not sure the therapist completely believes it either as I know he know a great deal about bipolar disorder.  Rye is actaully able to make much better decisions and control himself better now with the medication.  Even he says he can feel it and can feel that he has better control of himself  and we can very, very much see it.  So while I think it’s a good idea for Rye to know that he controls himself and that this premise is what makes the actual behavior therapy work, the medication is what makes the therapy doable and we all know that.  Even Rye.

Anyway, so what have we learned so far?

Well, one of the best things from the first session was Practice Makes Perfect.   As he explained it, if Rye starts making good decisions now and practices working on making good decisions as he grows until he is 18 by the time he is an adult  he will be very good at making good decisions.  Making good decisions will be what he does well at the time of adulthood.  Conversely, if he starts now at 12 years old making bad decisions and practices making bad decisions over and over again from now until he is 18 years old, and surrounds himself with others that make bad decisions so the behavior becomes normalized, by the time he is an adult he will be an expert at making bad decisions.  And this will set him up for a very difficult adult life because the one thing he will be an expert at by the time he is 18 is making bad decisions.

I love this concept as it really is so true but I had never really thought of it in that way.

In the second session, today, he worked on reinforcing the concept of making good choices.  We also implemented a system of earning rewards and privileges (verses losing privileges or punishment which is where we were before).    We examined Rye’s behavior over the past week and looked at what he could have done differently and what Don and I as parents could have done differently (because let’s face it, we are learning here too).  We also talked about the fact that if the public school Rye goes to continues to be a total disaster in the fall (he wants to go back to school with his friends) then we should look at private school options.   In fact, he suggested a school that he said is great and so we are going to look at it in a few weeks.  We talked about football and sports, as Rye is really excited about that, and making good goals for yourself.  Keeping commitments.  Showing good character.   These are all things that Don and I talk about with Rye as well but it’s amazing how having an independent third party reinforcing the child and holding them responsible can have such an impact.

And the best thing about the therapist, the piece I just love and that makes Rye want to go and also leave the sessions feeling all warm and cozy, is that although the therapist is pretty hard on behavior and complying to rules and holding Rye accountable for what he does and says, he is also extremely good at positive visualization and enabling Rye to see what a great person he is now and can be in the future, what goals he can accomplish, what heights he can reach and how successful and wonderful he will be in the future as an adult.  It is really great.   He has Rye envision himself relaxing and following the rules and accomplishing whatever goals he wants for himself and having a very successful life.

I love it.

Accountability, following rules, responsibility, caring, empathy, hard work, respect for others, respect for one’s self, and good character, all coming together to create subsequent limitless success in life.

The possibilities in life are limitless if you do the right thing.

I liked him.

He is an older man.  A psychologist (PhD).  And has over 30 years of experience.  He has a very relaxed energy, seemed very confident in what he does and was very personable.   He seemed to be of the ‘been there, done that’ variety and displayed an ease of the soul that comes only with experience.  I feel confident that he will be able to match Rye’s wit and yet challenge him as well.  But I guess we’ll see.  He had some good tales of intrigue regarding family members and colleagues being raised by less than stellar parents and coming from less than stellar genetic lines and then going on to make good life choices for themselves, choosing the right thing, and leading healthy, productive, successful lives.  These stories will be well received by Rye as he is really grappling with his identity right now including, but not limited to, how that relates to bio-dad and the choices he made and continues to make (amazingly, despite the fact that Rye has not seen him since he was 6 and Don and I are Steady-Eddie as all get out .  Filed in:  never underestimate the power of the absent bio-parent).

And the best thing of all…I asked him how he felt about bipolar disorder.

His reply?

‘Bipolar disorder is interesting.  It is often an affliction of the most intelligent and most creative people.  Some of the most interesting people of our society have bipolar disorder.’

And to that I say, let the festivities begin!

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note: the above photo is of the Bob Newhart Statue in Chicago