Helpful Parenting Strategies

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Parenting a child with bipolar disorder can be a stressful and frustrating experience. First and foremost, it is important for parents to remember that they are not to blame for their child's difficult behaviors. It is also important to remember that these children are suffering from an illness that can get in the way of their behaving appropriately. Although their behavior in the moment can be quite outrageous, children often feel very remorseful or ashamed once the crisis has passed. In addition, the following general parenting strategies may be helpful.

Maintain structure and regularity in activities. As with adults, children with bipolar disorder are vulnerable to disruptions in their schedules. They may benefit from a predictable schedule of activities that is not too hectic but avoids long periods of downtime. This can be particularly important during the weekends or vacation. Relaxing or soothing activities can also help a child during stressful periods or during particularly difficult times of day. Keep a mood log. A mood log or brief journal will help you identify patterns in your child's moods, identify potential triggers, and become aware of early warning signs of mood episodes. Plan ahead. As much as possible, avoid unnecessary situations that are likely to trigger meltdowns. If a difficult situation is unavoidable, prepare for it in advance (in collaboration with your child if they are old enough to do so).

Decrease family conflict. It is important to decrease overall family conflict and stress because these can destabilize the moods of both children and adults with bipolar disorder. Pick and choose your battles carefully before imposing a limit. Be consistent in the limits you set, and enforce them in a firm but nonaggressive and nonconfrontational manner. If possible, involve your child in solving issues to teach him or her problem-solving skills. Remember that parents serve as models for child behavior, so, as much as possible, work to provide your child with frequent examples of step-by-step problem solving and conflict resolution (family therapy may help to a great degree here). If arguments become aggressive, implement strategies to de-escalate tension (e.g., a family time-out until all parties have calmed down). If parents disagree about how to handle a problem, avoid arguing or discussing this in front of your child.

Remember your child's strengths. Encourage your child to channel their energies into appropriate tasks and activities. Remember to praise appropriate behaviors, and point out talents and positive traits.

Be aware of stressful events outside the home. Stay in close contact with the school because stressors at school or with peers can lead to meltdowns at home. Talk with your child about these stressful events and ways of managing them.

Facilitate transitions. Because transitions (including daily transitions) can be particularly difficult, provide plenty of warning for upcoming transitions (ranging from larger transitions such as school onset and offset and vacations to nightly bedtime) provide sufficient time for the child to transition at their speed, limit the number of unnecessary steps during transitions, and try to keep routines as consistent as possible.

Monitor your teenagers behavior. Because teens with bipolar disorder are especially vulnerable to alcohol or drug abuse, as well as other risky behaviors, it is important that parents be aware of their peer relationships and behaviors outside the home. Also keep close tabs on internet, instant messenger (IM), and cell phone use because impulsive behaviors can get your teen into trouble.

Have a crisis plan in place. If your child can become violent or suicidal, develop an emergency plan ahead of time (be sure to include his or her treatment providers in this plan). Know which hospital you may want to use for an inpatient stay for you child, and know the steps needed for admission (see Chapter 8). At crisis times, make sure that dangerous items (e.g., knives and medications) are out of the reach of children. Maintain the safety of siblings and pets. Avoid confrontations in potentially dangerous situations (such as while driving in the car). Be aware of unrealistic expectations. It may be tempting to compare your child to other children (or his or her siblings). However, remember that just because you or others feel that a child should be able to do something does not mean that they can. Understand your child's special needs and work with them to achieve what they can at their own pace. Set intermediate goals that the child can work towards, step-by-step. Take care of yourself. Parenting a bipolar child or adolescent can be exhausting, stressful, and isolating. It is crucial that parents take time out for themselves to "recharge their batteries." Obtain support from family or others who understand what it is like to have a child with bipolar disorder. Consider additional resources in the community, including therapy, after-school programs, or support groups.

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