Should we tell children about a loved one’s (or our own) bipolar diagnosis? Just like discussing sex with children, talking with kids about mental illness is fraught with difficulty. But does it need to be? In this episode, Gabe and Dr. Nicole discuss when kids are old enough to be told, what you should tell them, and why it may be dangerous to avoid the topic.

Gabe Howard

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.

He is also the host of Healthline Media’s Inside Mental Health podcast available on your favorite podcast player. To learn more about Gabe, or book him for your next event, please visit his website,

Dr. Nicole Washington
Dr. Nicole Washington

Dr. Nicole Washington is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Washington has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions.

Find out more at

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to Inside Bipolar, a Healthline Media Podcast, where we tackle bipolar disorder using real-world examples and the latest research.

Gabe: Hi everyone. My name is Gabe Howard and I live with bipolar disorder.

Dr. Nicole: And I’m Dr. Nicole Washington, a board-certified psychiatrist.

Gabe: So, I have bipolar disorder, but I don’t have kids. You don’t have bipolar disorder, but you do have kids. So, an episode on how to talk to your children about bipolar disorder would not be complete unless we could find somebody who has both bipolar disorder and children. And we did not. I don’t know if maybe this was like a misprint on our part, but I have kids just not like my own. I have I have nieces and nephews. I have a granddaughter. I tell you I have a granddaughter? I have a loophole granddaughter.

Dr. Nicole: Yeah. I’m not quite sure how you have grandchildren without children, but I’m sure you’ll tell us.

Gabe: No, no, no. It’s because children, everybody told me children are awful. My parents told me children were awful. Matter of fact, they said it a lot. It was kind of painful. A little bit. But grandchildren, they love grandchildren. So, I join the Big Brothers and Big Sisters program when, you know, I was younger and he was six years old. Now he’s now 28 and he has a child. And that child calls me grandpa because I was like a father to him, I guess. I know it’s a

Dr. Nicole: Oh.

Gabe: Very sweet story, but I, I have codified this into loophole grandchildren. You skip the horrifying teenage years, the expense of children, and you go right to the loving, hugging, spoiling,

Dr. Nicole: Yeah.

Gabe: Sending you home part. It’s wonderful.

Dr. Nicole: So, you have children in your circle who you may or may not want to share about your illness with, right?

Gabe: I do. And of course, I want to share with them and not just because of my job. Obviously, somebody who has a podcast about living with bipolar disorder and speaks about living with bipolar disorder, wrote a book called Mental Illness as an Asshole. I mean, I talk about living with bipolar disorder a lot. So, there’s really no way that I could have kept it from them. But I talked to lots and lots of people who live with bipolar disorder and they’re like, look, it it’s awkward when the kids come up, you know, mom, dad, grandma, grandpa and uncle, brother, sister, they’re all willing to talk about it, but then they start to save the children routine. Well, maybe the kids shouldn’t deal with something so adult Maybe, maybe, you know, that’s for a later time. We’ll bring that up at a later time. Well, do they really need to know? I mean, what benefit does it serve if they know that their uncle has or their and that’s, of course, very painful to people. It’s also impossible. The reason that it’s impossible is because kids know kids are going to figure it out. Now, Dr. Nicole, when we sat down and prepared for this episode, we really likened it to the sex talk.

Dr. Nicole: Absolutely. Everything you said could be applied to the sex talk, right? Like, do they really need to know where babies come from? Do they really need to know the real name for their private parts? Can’t they just call it like their hoo-ha, their cookie or their willy? Or can’t they just call it something cute like that so they don’t make other people uncomfortable? Those exact same things apply here.

Gabe: And I love the way it makes people uncomfortable, because here’s the thing. It doesn’t make the children uncomfortable. It doesn’t. The people that it makes uncomfortable are the adults. So, we’re really sort of projecting our own insecurities and our own fears and our own discomfort onto our children, which is never a good idea.

Dr. Nicole: That discomfort comes from the shame that we learn as we get older, because when we’re little, we say all kinds of things, like kids say all kinds of inappropriate things that you shouldn’t say and talk about. And they don’t know what’s appropriate and what’s not. So, we really define that for them. So, if we talk about it earlier, we can really get to a good space once they are older. And that starts very, very young. If you think about it. It starts with what we call our private parts, right? It starts with do we do we teach our children the correct anatomical names? Are our little girls running around saying they have a hoo-ha or a cookie or whatever the heck other cute little name we come up with, do we teach them you have a vagina, you have a penis. Like that’s the beginning of the sex talk, right? So, the mental health talk, the do I share talk starts very, very young with the words that we use to describe people’s mental health.

Gabe: I do think that it is very much like the sex talk, because I also believe that it should just be this ongoing conversation. I, I liked it when you said, like cookie and hoo-ha and your, you know, little boys get, you know, your willy, your thing. I believe that the reason that we refer to children’s genitals using those words is not for the child. It’s because the adult feels uncomfortable and research has uncovered time and time and time and time again that if you want children to take sex seriously, if you want them to understand it, if you want them to know what’s going on, you can’t diminish it. Applying that over to bipolar disorder, I think whether you love somebody with bipolar disorder, have bipolar disorder or know somebody with bipolar disorder, you should talk about mental health, which is going to include serious and persistent mental illness, which is going to include bipolar disorder. And you should use the correct language so that if they have a question about mental health, a mental health crisis or bipolar disorder, or they see something they don’t understand something, they have the language in the words, which is the identical the identical theory behind helping your children understand, you know, sex and genitals and sexuality and gender and all of those things at a very, very young age, because then they just know.

Dr. Nicole: All right.

Gabe: But that’s easier said than done, because I think, you know what I’m going to say, Dr. Nicole? We can’t get people to have the sex talk,

Dr. Nicole: No,

Gabe: Right?

Dr. Nicole: We can’t.

Gabe: We just can’t we can’t get people to it’s still a Willie a thing and a cookie and a front butt and everything. We can’t get people to use penis in vagina. How are we going to get people to use bipolar disorder, psychosis, hypersexuality? How are we going to move that needle? And we have some ideas. They’re not great ideas, but there are some ideas.

Dr. Nicole: That’s not true. They may be great ideas. Wait a minute. You just discounted everything we were going to say before we even said it. Don’t listen to him.

Gabe: I’m setting expectations.

Dr. Nicole: We have great ideas.

Gabe: We have wonderful ideas, but I understand where people are.

Dr. Nicole: Yes.

Gabe: I really do. And so first and foremost, my family didn’t even know that they needed to have the mental health talk. Hard stop like, they thought that everything there was to know about mental illness was already well understood by all of their children. And that’s it happens to bad families. We were not in a bad family. No further education needed. Now I’d like to believe that a lot has changed in the last 35 years since my parents made that decision, and in some ways it has. For example, this podcast now exists that it didn’t 35 years ago. There’s we have social media influencers who are really getting the word out and helping people feel not alone. We have websites like Healthline where people can get information of the privacy of their own homes. That said, there’s still a significant number of people who believe that mental illness is something that happens to someone else.

Dr. Nicole: Right.

Gabe: So, it’s very difficult to split this episode up because are we talking to people who want to pretend that it doesn’t exist or are we talking to people who are like, No, I’m ready. I want to talk about it. You don’t need to convince me. Just maybe give me some conversation starters. I think we should go both ways. Which way do you want to go first?

Dr. Nicole: Yes. So, I think we’re splitting this into. The person who wants to share with children in their lives. And that is even split into when they’re your children versus someone else’s children.

Gabe: It’s complicated, right?

Dr. Nicole: That is very complicated.

Gabe: Let’s address from the people who are concerned about it, because that’s the group that I run into the most,

Dr. Nicole: Okay.

Gabe: The people that are like, Look, look, I’m not ashamed of my brother, sister, mother, father, but kids can handle it. I always get that one. You know, it’s not that I’m ashamed. It’s not that I don’t love them. I just I don’t think it’s in the best interest of the children. I’m thinking of the children. It’s not my discomfort. It’s the children. It’s Save the Children. So, we’re going to call this little segment the getting over the Save the Children mentality. And I want to start off by saying, quite frankly, the children already know

Dr. Nicole: Yes.

Gabe: They don’t have the words, they don’t understand it, but they know damn well something’s going on.

Dr. Nicole: Yes.

Gabe: Kids are not as stupid as we want to believe that they are. Wish they were. They

Dr. Nicole: Right.

Gabe: Figure out everything so they’re already aware. What they don’t have is education and understanding. But they absolutely know that something’s going on.

Dr. Nicole: Of course they do, because you have no idea the things that your children here and talk about at school, even at a very young age, if you just ask your elementary school aged kids, especially once we get to middle school in high school. But you ask those little kids what kinds of things people talk about, you will be floored at some of the things. You can ask your kid, Do you know what depression is? They probably have a definition of what they think it is already. So, you know, just asking those simple questions. But yeah, we completely underestimate how much stuff kids know. I mean, I knew a lot more as a kid than I should have, and much more than my grandparents and parents knew that I knew. Sometimes maybe we forget how much we knew and how much we heard. And today is totally different. We didn’t have Internet. We didn’t have, we just didn’t have any of this. Like, these kids all have smartphones and YouTube and Internet and they’re exposed to things that parents most of the times have no idea that their kids are accessing. So, they know so much more. And we just have to, like, get our heads out of the sand, get out of ostrich mode, and just really, really recognize that our children know a lot.

Gabe: One of the scenarios that I want to use in this is the overheard. They only have to overhear one word during a tense moment between mom and dad or between the adults in their lives. I’m going to pick on myself. Right. Let’s say that I live with bipolar disorder and my sister decided that she didn’t want to tell my niece. Now she did the exact opposite. We don’t have to worry about this. My sister handled it beautifully and I am so thankful. Just speaking to somebody who lives with bipolar disorder, I want to say to a moment that my family’s openness is it is one of the keys to my wellness because I know that I can come to them. Right. But let’s say that my sister said, you know what? We’re not going to tell your niece you’re still allowed to see your niece. We want you to love your niece, but hide this whole part of your life from her. And then I’m going to say in my loud, booming voice, you don’t want my niece to know him Bipolar. That’s so hurtful. And my sister says, You know, Gabe, I love you. I just I don’t think she can handle it. She’s only six, six years old. Eight years old. I’m like, you know what? Bipolar disorder is part of my identity. And my sister’s like, look, I’m sorry. She’s my daughter. I have to make the decision and you have to accept it. And I say, well, you know, living with bipolar disorder is a big, big part of my life. And she says, I know. Now all of us, we’re just thinking, all right, we just have this conversation.

Gabe: We’ve come to an agreement and it’s over. And Eva, which is my actual niece, she hears everything. She got super ears and she’s got an uncle with super lungs. And those two things have caused more problems in my family than I care to confess to. Just because the bipolar wasn’t one of them doesn’t mean that she didn’t overhear the word bipolar. So now you got an eight-year-old with an iPad, a telephone school. She’s running around what’s bipolar? And imagine this scenario: my niece goes to school. She’s got this word bipolar stuck in her head. And she says, hey, what’s bipolar disorder? And somebody says to her, that’s what murderers have. That’s what shooters have. That’s what evil, violent people have. And you think to yourself, well, who would say that to a six or an eight or a ten-year-old? Well, another six-, eight- or ten-year-old. But here’s the thing. Adults are saying it. We have a huge problem with discrimination and stigma in this country. So even if she gets to an adult, she might not get to an adult that understands why she’s asking this question. The adult could think, oh, she’s asking this question because she’s traumatized by the violence that she saw in the news. Well, I will explain that she doesn’t need to worry about people with bipolar disorder because they’re not anywhere around her. As long as she stays away from them, she’ll be safe.

Dr. Nicole: Yes.

Gabe: And now my niece, for reasons we don’t understand, doesn’t want anything to do with her previously favorite uncle. Do you want to spend the night at Uncle Gabe’s house? No, I don’t. All right. She doesn’t want to spend the night. And we don’t realize this for months. I know this is a really, really long story, but I’m telling you, it’s so simple that it would happen that way, and that would cost everybody involved a lot.

Dr. Nicole: Yeah. And to me, I think it’s more important in general when I’m talking to people and they say, Well, I just don’t think I want to go there with my kids. I just don’t think I want to go there with my own kids. Or in your example, my sister doesn’t want my nieces and nephews to know, and I just encourage them to have the conversation with that person. They’re going to know something.

Gabe: Right.

Dr. Nicole: The question is, do you want them to have accurate information or do you want them to get misinformation and then walk around for the next however many years ignorant to what mental illness is actually like? Just like the sex talk. We all know teenagers and adults who have some very outlandish thoughts about sex because they learn things wrong from peers when they were ten, nine, 11, 12, however old. They’re going to know something. The question is, will they know information that is correct or will they be certain that they know something and they really sound foolish? It’s up to you.

Sponsor Message: Hey everyone, my name is Rachel Star Withers and I live with schizophrenia. I’m also the host of Inside Schizophrenia, a podcast that dives deep into all things schizophrenia. Featuring personal experiences and experts to help you better understand and navigate schizophrenia, Inside Schizophrenia is a Psych Central and Healthline Media podcast and we are available right now on your favorite podcast player. Check us out!

Gabe: And we’re back with tips and advice on how to talk to your children about bipolar disorder. There’s so much that I have to say on this from the perspective of the person who lives with bipolar disorder and the children in my life knowing so much first as a mental health advocate. This is inspiring. I would love to tell you that my eight-year-old niece is like an expert on bipolar disorder. She’s not. She doesn’t care. I would love to tell you that she understands mental health better than all the other eight-year-olds. Maybe. But I got to tell you, I doubt it. The latest YouTube star and something called Bluey occupies a lot of her time. And turning red. She watches turning red a lot now, just like on a loop, like over and over and over and over. But here’s what I do know. She has no problem asking me anything, including sex questions, including questions about bipolar disorder, including questions about what she saw on the television and just the and sometimes they’re uncomfortable. I don’t even know why I said sometimes they’re they are almost always uncomfortable. I just just I am shocked what children are exposed to

Dr. Nicole: Mm-hmm.

Gabe: And. The fact that she’s willing to talk to me about it, the fact that she’s willing to talk to my sister about it, the fact that she’s willing to talk to my brother-in-law about it. I really see this as an excellent example of something having been done right. And as somebody who lives with bipolar disorder, I can only imagine how she’s going to be when she’s 12, 14, 16. Now, I’m not trying to wish mental illness on my niece. I hope to God she is mentally healthy, sincerely. But I really wonder what would have happened to me if I understood bipolar disorder when I was eight?

Dr. Nicole: Right.

Gabe: Like, where would my trajectory have gone? So, in the in the unlikely event that she does suffer some mental health crisis or mental illness issues, I really feel like she’s going to be in a better position to articulate that to the right people and get help in a way that I was not able to. But, you know, let’s forget all that just for a quick second. It just makes me feel good. Like

Dr. Nicole: Right. Well, it should.

Gabe: I love that my family wraps their arms around me. Like play this for all your family members who are like, I don’t know if my children are able just for real. Like, do you love me? Like, why are you making me hide myself? Like, I can give you a million examples in society right now. Don’t tell somebody something that means you’re ashamed of it. Like, that’s the only thing that’s left to me. And so, I’m glad that my family is ashamed of me for other things, but not for

Dr. Nicole: But not that?

Gabe: Living with bipolar disorder.

Dr. Nicole: I mean, it should. And really, that does two things, right? Your scenario does two things. One, it de-stigmatize this mental illness for her because she will forever. If somebody says something negative about someone with bipolar disorder, she will think to her favorite uncle Gabe and how he has bipolar disorder. And he’s none of those things.

Gabe: Right.

Dr. Nicole: It destigmatize mental illness. It probably makes her an advocate without you realizing you’re making her an advocate because she’s going to grow up with these very fond memories of her fun Uncle Gabe, who is none of the things that we read about in the media or we see on TV. So, she’s going to do that. And you’re right, it does kind of open up the discussion about mental illness. And if she’s not feeling mentally well at some point, hopefully opening up the discussion for her. For her to feel comfortable sharing that with you or her mom or whoever else. I do think it’s important, though, to point out that you’ve put a lot of work in into your recovery.

Gabe: I did.

Dr. Nicole: You are in a space now where it’s a lot easier to have that conversation. Everybody is not in a good space when they want to have that conversation or when they want to to kind of share and open up. And so, I think we have to respect the other person’s viewpoint because they may be saying, hey, you’re not you’re not ready yet to do all of this. Like you’re not ready.

Gabe: So, let’s talk about that for a moment. Eva was not born when I was committed to a psychiatric hospital. Eve was not born when I was suicidal. And in fact, my sister was overseas serving in the military. So, the worst of the worst of Gabe’s bipolar episodes. My sister didn’t even witness firsthand. And my family has this this uncomfortable way of not passing along bad news because they don’t want to ruin your day or, you know, keep you from having fun or they’ve got all these reasons that, you know, when grandma has a heart attack and goes to the hospital, they’ll tell you a week later when she gets home instead of, you know, the day she went to the hospital. I’m a little angry. I’m a little angry. Just I’m not going to lie. I’m, I’m a little angry. But I have talked to my mom and dad and my brother who were in charge of my niece and two nephews who are older, who were alive. And they were between the ages of, you know, four and ten why this was going on. And they admitted to me that they did, in fact, keep a lot of this information from them.

Gabe: They didn’t say, hey, Uncle Gabe is in the hospital. Uncle Gabe is in the psychiatric ward. Uncle Gabe has been committed. Uncle Gabe has been diagnosed. They did not tell them anything. Now, I have asked why numerous times and I asked them again in preparation for this show. And the answer, Dr. Nicole, is always some version of this. We didn’t know what to say. We were afraid that they would be scared and we would not have the answers. So, if we just didn’t tell them about it, they wouldn’t be scared. And I always give just a slight amount of pushback. And I was like, But is that discomfort for them or you? What’s the what’s the true motivator here? And I genuinely believe my family when they say that they were afraid that the children would become scared and that they wouldn’t be able to help them. I’m not saying that’s the only reason there could be multiple reasons, but I do believe that high up on the list was their concern that they would open up a can of worms that they wouldn’t know how to deal with. And that kind of makes me a little bit sad, right? Because they’re already feeling bad that their child has been, you know, committed to a psychiatric hospital. And now they’re afraid that this knowledge is going to harm the rest of the family and they’re not going to be able to support them. Mental illness is very, very messy. And I can I can kind of see that kind of.

Dr. Nicole: It is messy, but I do think sometimes people think they have to either be all in or nothing. Right. Like we don’t have to go from Hey, Uncle Gabe is a perfectly normal appearing and I’m in, quote, air quotes here to the kiddo. We don’t have to go from doing that to saying, Oh, your Uncle Gabe has a bipolar disorder. He had he’s manic, he’s hypersexual, he’s blah, blah, blah, blah. Like, that’s too much. We don’t tell a three-year-old about how they were born and how what dad did to mom to get them here. We don’t start off with that. Like, we don’t we don’t start off with diagrams of penises and vaginas and showing, you know, video. We don’t do the what’s the video that everybody watches the childbirth video. We don’t start that at four.

Gabe: Oh, that scares me to this day.

Dr. Nicole: We don’t start that at four.

Gabe: To this day that video gives me nightmares.

Dr. Nicole: Right. But we give it in bytes. We give it an age-appropriate bites. And so, whether it’s talking about sex with your kids, whether it’s talking about suicide with your kids, whether it’s talking about bipolar disorder with your kids, we do it in bites. It could be as simple as Uncle Gates not feeling well. He’s at the hospital. You know, if Uncle Gabe had a heart attack or if Uncle Gabe had his appendix giving him issues or his gallbladder, we’d say, Oh, Uncle Gabe’s in the hospital. He had a tummy ache. And the doctors are working to get him feeling better and he’ll be home and we leave it at that and we wouldn’t think twice about it. I think we can very simply say Uncle Gabe is in the hospital. He was very sad and he needed to go into the hospital for a few days and once he feels better, he’ll be out. That could easily be given in a bite. Well, what are they going to do for him? They’re going to talk to him and they’re going to help him feel better. And he’s going to work on not being so sad. And, you know, I mean, you can leave it at that. Like, I don’t think we have to go into the serotonin theory of depression and, you know, antidepressants and we don’t have to go give them a whole med school lecture, but we can give it to them in bites that they can handle. And sometimes that’s where we fall, because people in their nervousness, they say too much. They won’t just leave it at what it is.

Gabe: I’m really liking the comparison of the sex talk, because the sex talk is something that needs to happen and it’s uncomfortable. We don’t want to think about children having sexuality and we do need to start small, right? Calling it a penis and vagina is vital. It’s vital so that they understand and then build on that knowledge eventually. Of course, we did have to tell the kids now they were 600 miles away, so it made it really easy to hide. But eventually my mom did go with your method, which is, you know, Gabe’s not feeling very well and we have to go help him. This this came up because my parents eventually had to come to Ohio. They had to make the 600-mile trek, and they had to explain to the grandkids where they were going and why they were going to see Uncle Gabe and why they couldn’t go along. And this did work. They were like, Oh, well, we want to pray for Gabe. We want to we want to talk to Gabe. They started doing all of the things that you would expect children to do. And what I can tell you unequivocally is that it did not harm them. We eventually filled them in with more information as we got it. I can say fairly unequivocally in my family, they were just super uncomfortable with the idea that their son, their child, their grandchild, their loved one, was super sick and they didn’t know what to do.

Gabe: And passing this along to the younger generation, the under 18 crowd on their life was just not a high priority for them. It was a lot about their emotions, their fears, their misunderstandings, their preconceived notions. They had to get over all the stereotypes. I, my mom genuinely thought. She’s like, Well, I must have failed as a mother. The proof is in the pudding. My son’s in the psych hospital like that. That’s how you know. That’s how you know, I’m a bad mom. That’s a pervasive myth. And I say this to all the people living with bipolar disorder, because I do believe that there is a contingent of people that aren’t sharing this with other people, and especially with children, because they’re uncomfortable, but not for the reasons that we believe. I know my mom and dad have expressed multiple times that they just didn’t know and they feel so badly for not knowing. And there is a large part of them that wishes that they could just bury that and pretend that it all turned out okay. Rather than admit that their mistakes put their son in harm’s way. Could have led to my death and absolutely contributed to some of my suffering. So just remember, they’re dealing with all of that at the same time. They’re maybe not telling a six-year-old. It might just be the thing that they leave out because something has to give.

Dr. Nicole: No, I mean, that makes perfect sense, but I think it’s always okay to say, I don’t know. It’s perfectly fine if your kid asks you more questions than you say. I don’t have the answers to those. We just don’t know. We have to wait and see, because I think that also teaches them that we don’t always have the answers. Sometimes we have to be patient and we just have to let things unfold. And you can say, well, we’ll talk about this again and we’ll, you know, once we get more information, we’ll keep you posted. We can tell that you’re really worried about, you know, Uncle Gabe. And we’ll we’ll you know, we won’t we won’t just not mention it again. We’ll keep talking about it, but we just don’t know. We have to wait and see. I think that’s a valuable lesson to learn that everything in life is not. I want an answer, and I want it right now. And we do feel guilty. I mean, I’m a parent like I it sucks to tell your kid like, I don’t know, they ask you a question, you’re like, Oh, that’s why you tell them, Go look it up.

Dr. Nicole: I don’t know. But in that in this case, not in this case, but, you know, it is not uncommon for kids to ask you things that you just don’t have the answer to. And it is hard to say. I don’t know. But it’s okay. Like you don’t know everything and that’s okay. And I think it’s okay for them to know that we don’t have all the answers and it’s okay for them to know that mental illness is an evolving thing, that it’s something that that is going to change over time. Answers will change. I may give you an answer today that may be different two months from now. I think it’s important to give them all those pieces. I just think kids can handle a lot more. You don’t have to give them all the details and the gory stuff and specifics as to what Uncle Gabe did that got him in a hospital or what. You don’t have to go there. You can be very vague. I just think they want to feel like you’re being honest with them. And so, if the honest answer is I don’t know, it’s I don’t know.

Gabe: I think it’s important to acknowledge two people living with bipolar disorder When they see family members not sharing this information. It feels so personal. It feels like an insult, it feels like an attack. And I want to validate those feelings because I understand and I felt that way before, and I will probably feel that way again. I do want to remind people that families are already messy. I’ve used the example in my own family of not telling me that my grandmother had a heart attack or was in the hospital for a week that had nothing to do with bipolar disorder. They just didn’t want me to be worried about grandma. And I have more than one example. That’s just the biggest example. There’s other examples of people getting hurt, people having surgery. Oh, we didn’t want to tell you because you had a test. We didn’t want to tell you because you were on a deadline. We didn’t want to tell you because you were traveling. And I’m just like, how? How could you keep this information from me? But still, I speaking to all the people who live with bipolar disorder, I understand that it hits and speaking to all the family members of people living with bipolar disorder.

Gabe: I want to say that it does hit differently. It just does. It may not be reasonable. It may not be fair. And of course, the famous. You didn’t mean anything by it. I get it. But it feels like you did. And I think acknowledging that is important. I hope at this point we’ve convinced people who are afraid to tell or don’t want to tell to tell. Now let’s talk to the group of people who are like, Look, dude, stop selling me. I’ve already bought the car. You don’t need to show me the feature. I’ve bought it. Gabe, shut up. Let Dr. Nicole talk. How on earth do I talk to my children about this? What would you recommend to have this conversation and like specific words to say?

Dr. Nicole: The very first thing I typically recommend is to just assess what they already know. Right? So, are you educating from ground zero? Are you adding to what they already think they know? Are you having to debunk some of the myths that they think they know? So, I usually start with just asking some questions. You know, what are you you know, tell me, you know, do you know have you ever heard of depression or have you ever heard of bipolar disorder? What do you think mental health is like? Have you heard people talk about those things? And if they start saying yes, usually I start asking then where did you hear about them? Like, how did you hear about them? Because I think it’s important for parents to get a feel for where are my kids getting this information from? Is it other kids at school? Is it TV? Right. Because it’s everywhere. A lot of times parents watch stuff and we think that kids can’t hear the TV or they’re not paying attention because they’re playing off in the corner. They’re absolutely paying attention. That’s how I learned everything I learned as a kid that I wasn’t supposed to know. I was listening to all kinds of stuff, but kids are smart and they’re sneaky.

Dr. Nicole: They’re little ear hustlers. They hear all kinds of things that you don’t think they hear. So you want to ask, you know what they know. Ask them some general definitions. Have you heard of this? Where have you heard of it? That will give you the perfect place to start. That’s your foundation of your conversation, because you at least can assess what do they already know. And then I think you give it to them in bites that they can that they can deal with. Now, what that may mean is your eight-year-old may have a separate conversation than your 12-year-old. I don’t know that I would have kids that far apart together in the conversation, because I think what a 12-year-old can handle versus what an eight-year-old can handle are very, very different. There’s a lot that happens to you mature wise from third grade to seventh grade. Like there’s a lot that happens to you. So, I think separating them, if they’re that far apart in age. And second, you give a you give it to them in the in the age-appropriate manner what you think they can handle.

Dr. Nicole: But I also think you have to then come back around third and you have to ask them if they’ve ever felt any of those things. Like, I think it’s important to just check in if you’re going to be talking to them about how, you know, Oh, Dad had some depression and Dad was in the hospital and this is what was going on. I think it’s important to ask like, hey, have you? Have you ever felt sad like that? And you couldn’t figure out why or you felt sad and cried for no reason or you thought about hurting yourself or anything like that? I think that’s a perfect time to check in with your kids on those issues. And then the fourth thing, I think you just have to make sure that you’re checking in with them periodically on the issue. You can’t just talk about it one time and let it go. I think you have to make sure that you schedule time to make sure you’re bringing it up, even if it’s just once a quarter that you just check in on their mental health or, you know, anything new about. Have you heard anything else new about mental health at school or have you seen anything on TV or heard anything that you have questions about? Just checking in. So, I think those are kind of the four the four things I typically would recommend.

Gabe: I love what you said, Dr. Nicole, about how this has to be an ongoing conversation. So many times, when we talk to people about mental health, we think it’s like a one-shot deal rather than this should be something that happens often. We should be checking in with our children. We should keep the door open for them to check in with us. We should give them. Maybe we could find articles. I do this all the time as an adult where I’ll read something online or hear a podcast and I’d be like, Oh, this is what I was trying to explain to my friend, mother, father, and this person does such a better job. I’m going to go ahead and forward them this article. Depending on the age of your child, you can print it out for them and maybe read the paragraphs that are relevant, whatever it is. You can also join a support group. You can ask a psychiatrist and you can let your children know if they have a question that you don’t understand, that you are still a resource because you will find them an answer and make this part of every day. Many families are behind the eight ball on this. My family was behind the eight ball. But if you’re listening right now, you’re part of the solution. You’re trying to figure out how to move forward and how to have these conversations. The best thing to do is to start.

Dr. Nicole: Yes.

Gabe: There’s a proverb: The best time to plant a tree is 20 years ago. The second-best time is today. I really, really hate proverbs, but I feel that this one is super, super relevant because the longer you put it off, the harder it’s going to be. The more entrenched opinions become, the more feelings can become hurt. And you don’t want any of that. Just get it out of the way, rip the Band-Aid off, move forward.

Dr. Nicole: Absolutely. And you’re right, it’s never too late. And those steps apply to any age group. So, you know, if you say, oh, man, I should have had this first conversation when they were four, and now they’re 14, you can have the exact same conversation. You just are giving them more information and just be careful not to overload them and overwhelm them with all this age-appropriate knowledge because they’re a little bit behind on what they know. But these steps all apply. Whether your kid is 313, it just doesn’t matter. You can still start and you can you can apply those steps and do those things. And the earlier they start, you mentioned that being uncomfortable, the less uncomfortable it will be. I you know, going back to the sex talk and being a psychiatrist, my kids are very used to me talking about mental health and flat out asking them periodically about their mood and how they’re handling things and if they’ve ever had any suicidal thoughts or if they’ve ever felt hopeless or like, my kids are over it, they don’t want to hear it anymore. But the earlier you talk about those things, the less uncomfortable it gets. The conversations I have with my teenager and young adult about like sex related topics are things that people would cringe at.

Dr. Nicole: But because they’re comfortable with me and their dad, they ask us all kinds of things because they see stuff out, you know, on TV or they hear things and they say, Hey, I heard somebody talking about this. Like, what is that? I want them to come to me and say, I heard this thing about this guy who had bipolar disorder, who did blah, blah, blah. Like, Well, dad, do that or, you know, has dad done that? Like, I want them to come with come to me with those conversations. Now they might be uncomfortable and Dad will have to decide or Mom will have to decide, do they share and at what point do they share their past? But we all have that as parents. There are all kinds of things we did and have done as parents that we don’t necessarily go tell our kids about some stuff we take to the grave, some stuff we wait until they’re older. We don’t all disclose everything we did as parents, so you can decide what you share and don’t share. But, it just it just opens the door for them to feel comfortable, come and see you. And I think that’s the most important thing about this whole conversation.

Gabe: I want to say that if I was a father, I would be a father living with bipolar disorder. And I would hope that my children felt comfortable enough to come to talk to me. And if they didn’t feel comfortable enough to come to talk to me, that they’d feel comfortable enough to go to their mother and talk to their mom. But if dad and mom are not available and they don’t feel comfortable, I hope that all of us can put our egos aside and find somebody who can. For example, if my brother-in-law and my sister were uncomfortable talking about bipolar disorder, but they still wanted Eva to know, I would have gladly stepped up. I recognize I do this for a living, so that’s an easy thing to say. But could you imagine if they’re like, Look, we’re uncomfortable doing it and we’re also not going to let you because we’re the parents, so we should do it, but we’re going to just keep putting it off. I always throw that out there because so many people have the intentions. They’re going to do it. They’re going to do it. They’re going to do it. And I want to reassure you that there’s nothing wrong with letting the person who lives with bipolar disorder have their own conversation. There’s nothing wrong with finding another relative. There’s nothing wrong with finding a support group. There’s nothing wrong with scheduling an appointment with a family therapist, counselor, licensed social worker, and discussing it there. The real important thing is just to do it. You’ve got to figure out how you want to plan that tree, get it in the ground, water it, and let it take root and bear fruit. Dr. Nicole, thank you for hanging out with me.

Dr. Nicole: Always a pleasure. Always. Always.

Gabe: Thank you, everybody, for listening in. My name is Gabe Howard and I’m the author of the book “Mental Illness Is an Asshole and Other Observations.” You can get it over on Amazon, but if you want a signed copy with free swag, just head up my website at

Dr. Nicole: I’m going to go do that right after we disconnect. I’m going to go order my coffee so that I can get free swag. And I’m Dr. Nicole Washington, and you can find me on all social media platforms @DrNicolePsych to see all the things I have my hand in at any given moment.

Gabe: And do us a big favor. Wherever you downloaded this podcast episode, please subscribe or follow. It is absolutely free. And of course, we have a second favor because I’m going to push it. Tell the world about the Inside Bipolar podcast. We don’t have advertising money, but we do have our great listeners like you that can share the podcast on social media, tell people in a support group, email people, text people, you know what still works? Good old-fashioned word of mouth. We will see everybody next time on Inside Bipolar.

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