Q: Mental illness, including bipolar disorder, runs in my family. How and when should I warn my 12-year-old son about his troublesome genes?
-- A Mother in Raleigh, N.C.
A: Share small doses of personal stories and clear the way for questions. Don't sound an alarm that overwhelms your son.
Tell your child in a gentle, age-appropriate way: "This is something you may have to deal with," suggests Ken Druck, a psychologist and parent educator.
Avoid abstract, clinical terms, suggests Druck, author of "How to Talk to Your Kids About School Violence" (Onomatopoeia, 2003). Instead, use simple language and anecdotes your child can relate to: "Sometimes Daddy has a hard time. Sometimes his moods go up and down like a roller coaster." As you tell your own stories, ask: "Is this what you go through, too?"
Like all challenging topics, mental illness is not a one-time conversation at a certain age. Even from birth, Druck says, parents need to open the lines of conversation. That way, long before you need to talk about something as emotionally charged as mental illness, your child already expects you will be honest and let him react. And you'll have the kinds of connections with your child that will make it easier to recognize and cope with problems such as depression.
"Children need a safe place to explore and ask questions as they try to make sense of what you've told them," he says. "They need to be able to express any emotion, from confusion to anger to curiosity."
If one or both parents have bipolar disorder, an ongoing cycle of extremely high and low moods, the chances are greater that their children will develop the mental illness, according to the American Academy of Child and Adolescent Psychiatry. With a variety of treatment options, including family therapy, bipolar disorder and depression are highly treatable.
"If a child is struggling with anything, from obesity to depression or bipolar disorder, it's important for parents to be able to talk about themselves openly, especially if we're parents who suffer the same challenge," Druck says.
But don't play the psychiatric expert, he says. Suggest that you and your child do research together about warning signs of depression, for example, and talk to a mental health professional if you have concerns.
Bebe Moore Campbell of Los Angeles, who co-founded a local chapter of the National Alliance for the Mentally Ill, suggests that parents put a discussion of mental illness within a broader context of overall health.
Children need to know that mental illness is treatable, she says, that a diagnosis is not a "sentence to hell."
"If you don't talk about it, there's no information, even within the family," says Campbell, who says her group includes many adults who were left clueless about the mental illness in their families.
In addition to personal stories, fiction books for kids can spark conversations and understanding. One of Campbell's many books is "Sometimes My Mommy Gets Angry" (Penguin Putnam Books, 2003).
In Campbell's book, a little girl develops resilience and learns coping skills from her grandmother, despite her mom's mood swings.
The book is appropriate for children as young as age 4, Campbell says, but adults have also used it to help them heal after struggling with their own parents' mental illness.
Cheryl Coon, author of "Books to Grow With: A Guide to Using the Best Children's Fiction for Everyday Issues and Tough Challenges " (Lutra Press; 2004), says these three fiction books that deal with mental illness are all "winners":
"Memories of Summer," by Ruth White (Farrar, Straus and Giroux, 2000). The narrator is a 13-year old girl whose older sister becomes mentally ill. Ages 9-12.
"Pictures in the Dark," by Patricia McCord (Bloomsbury USA, 2004). A story about the impact on a family when one parent suffers from mental illness and the spouse doesn't realize the extent of the problem. Ages 9-12.
Can you help?
My son is ambidextrous and gifted, but he cannot focus on his school work even though it's easy. I want to know about options other than drugs to treat attention problems.
-- A Mother in Petoskey, Mich.
If you have tips or a question, call toll-free (800) 827-1092, send e-mail to firstname.lastname@example.org or write to Parent to Parent, P.O. Box 4270, Davidson, N.C. 28036.