Psych Central

Structure for the Bipolar Child

By Sherrie Mcgregor, Ph.D.

You can structure your family life and community support system in ways that provide the best possible environment for a child or adolescent with a bipolar disorder. Some of these structures may be very different from what popular parenting books recommend.

First, you need to establish you and your spouse or partner, if any, as the authority at home. Being an authoritative presence in your child’s life is not the same thing as being a dictator! It simply means that like a team captain, you’re calling the plays based on your knowledge of the situation at hand and the input of your team members. An authority sets and enforces rules with compassion and fairness, and builds in enough flexibility to meet the needs of those in his care. An authority leads by example, not just by decree, and certainly not by force unless there’s no alternative.

House rules should be the same for everyone (as you surely know already, bipolar kids will beat the issue of perceived unfairness into the ground). The rules should be prominently posted, just like they are at school or at the public pool. The list of specific rules should be as short and simple as possible, with a catch-all rule like “Treat others as you would like to be treated,” to cover the gray areas. Rules should be discussed, role-played, and discussed again. You can bet that they will be tested!

You need to choose your battles carefully. Make hard and fast rules only on those items that simply can’t be challenged. For most children and teens with bipolar disorder, the short list includes sleeping and waking times, eating, taking medication, avoiding dangerous behavior, and attending school. The rest of your rules–chores, activities, clothing style, avoiding profane language, even homework–need to be a little more flexible. There will be times when your child can gladly comply with your requests, and others when he needs your help to de-stress his life. Be observant and sensitive. Use the hierarchy idea presented at the beginning of this chapter to set your priorities. Safety and health come first, the rest is all gravy.

Many parenting experts recommend family meetings, but they aren’t always a great idea when your child has a bipolar disorder. Family meetings foster a feeling of equality between family members. Usually, that’s a good thing, but when children or teens have problems with grandiosity, one of the most visible ways it’s expressed is in feeling and acting as though they are equal or even superior to their parents. Family meetings can actually contribute to this notion. You may be able to structure family meetings more carefully to ensure that children’s contributions are heard and valued, while adults still retain the ability to make decisions. It’s not the democratic family structure that many of us would prefer, but in this situation it may be essential to keeping peace in your home and keeping your child safe.

Many parenting experts decry the concept of scheduling children with many activities, but rigid scheduling is exactly what works best for most people with bipolar disorder. That doesn’t mean every day must be a blur of activity. In fact, scheduling down time for relaxation is extremely important. Instead, each day should have a predictable pattern, from what time you get up in the morning to what you do after school. The earlier in life you begin to set these patterns, the easier it is for your child to get comfortable with them.

Older children can often help you figure out where the lines should be drawn. You might also want to check with their friends’ parents about issues like bedtime, late-night weekend activities, and the like. If all of you can present a united front, it will cut off the ever-popular “but Mike’s mother lets him do it” argument. It also reinforces your choices, and will probably help your child feel more comfortable with them as well.

Older children, and even some grade-schoolers, can benefit from using a daily planner to keep track of their schedule. When they can look forward to a predictable pattern of school, play, enjoyable activities, and goals, it’s reassuring.

Your child should make as many choices about her schedule and activities as possible. Someday it will all be up to her, and she’ll need the skills to make wise decisions about managing her time to promote optimal health. As she nears adulthood, talk often about how you handle your own scheduling conflicts and stresses.

 

APA Reference
Mcgregor, S. (2007). Structure for the Bipolar Child. Psych Central. Retrieved on April 18, 2014, from http://psychcentral.com/lib/structure-for-the-bipolar-child/0001024
Scientifically Reviewed
    Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
    Published on PsychCentral.com. All rights reserved.