My sister has bipolar disorder-part 2

My sister many times attempted to commit suicide, and every time I heard of one attempt I used to have crying spells. Other times I used to walk around my apartment complex in circles. I used to feel so angry, scared, lonely, and lost. But looking back I do realize that I never was alone. I had great parents and my aunt and grandma were always there, no matter how bratty I was. And trust me, I used to hate my family—I had nowhere else to show my anger, fear, and frustration! My family taught me that it is not a sign of weakness to seek help and to talk about your issues. And I'm a talker! In fact I won't shut up:)

 Therapy was exactly what I needed, and I found an amazing therapist who worked with me and helped me let go of a lot of anger. I came to a stage where I could see clearly how much my family tried to adapt and help both me and my sister. And that they didn't sacrifice me at the altar of my sister (which is what I used to think back then). This is not to say I let go of all the grief that had built up, but I made progress.

I used to be very bitter when everyone used to talk to their siblings, especially when they had a good bond. I had tried many, many times to forge a good bond with my sister. I used to feel like I have all these memories of the two of us…but what do I do with them now? In fact only three years ago did I truly let go of a lot of feelings of disappointment and bitterness. Because, for all my sister's troubles, she never judged me! I’ve come to realize that she accepted me with all my faults. And now, she does come around when she wants—but on her own terms, I don't need to force her. My parents, who were once so lost about what to do, are now able to look back at good memories they shared with my sister without pain and appreciate them for their beauty. My aunt and grandma helped me get to the point where I was able to let go, really let go, because while I know the past was painful I don't feel the pain anymore.

The one thing I wish people would take out of my life is to not be afraid. And, to be open about any mental health issues! If people didn't gossip and burn a scarlet letter on anyone with any form of mental illness, I firmly believe my sister would be in much better shape than she is today. I liken it often to proper sex education. It helps prevent a world of issues and can prevent deaths. So does proper education on mental illness. The only difference is while there is a lot of misinformation on the former, there is at least some form of dialogue on it. More people need to at least bring up the topic of mental illness.

The writer's sibling was diagnosed with bipolar disorder at the age of 18 but had had severe manic episodes as early as 14 years. Much later the young woman described that she could sense changes even earlier. It took several years of misinformation (arrogance, defiance) and several hidden attempts at suicide before she was formally diagnosed. Therapy and medication followed...with a lot of support from family. The young woman  has periods of stability interspersed with depression and mania. The two siblings do stay connected even thourgh these periods.

My sister has bipolar disorder...

The idea of mental illness scares a lot of people, including me. No one taunts you and says 'you high blood pressured person,' or 'you diabetic' the way they call you psycho and mental. I'm sure they sting but they don't carry the same stigma. My sister has bipolar disorder and she is truly a sweetheart. In her, you will find no jealousy, greed, envy, or judgement. But that doesn't make her an easy person to be with, especially as a teen facing your own demons.
My sister started her first psychotic episode when she was 12, I recently found out. I can't imagine how scared she must have felt, facing it all alone. But looking back, the symptoms were right there, and if we had known what to look for maybe our lives would have been much different, and possibly better.
We left India at a young age to settle abroad and my parents, while they were conservative in some ways, were very open minded in others. Which is what I believe has kept me and my sister sane and dramatic as it sounds, alive. She began acting out at around 14 and she used to have a lot of anger directed at me as well. I used to feel like someone poured acid over my body when she used to rage at me. And then there were my parents, who used to fight amongst themselves, and with her. Some days I went to sleep hearing them scream and woke up to their fights.

When there were moments of calm from my sister's side, I saw my parents struggle to understand what was happening while not knowing where to look. At that time, I used to feel like my sister made everything about her or my parents made everything about her. Looking back I can tell how hard my parents and family tried to make my life as normal as possible. My aunt and uncle tried to surprise me on my birthday, my parents took me to places I always wanted to go, and most of all, my entire family struggled together to give me moments that everyone wished they had in their lives growing up.

When I went to university, my parents made sure I went far away, so that they could spare me some of the difficulties I was accustomed to. The first thing I noticed when I was alone was the quietness. All the fighting and screaming and yelling I had gotten used to was replaced by quietness. And I hated it. I struggled very often to not fall apart. I used to have nightmares for years on end of someone ringing the doorbell. I scared many a roommate by crying in my sleep muttering 'I will open it, I will open it.' When I lived at home, my sister would go out at night without telling anyone where she went. She would ring the doorbell in the wee hours of the morning, and as our doorbell was broken and made a soft buzzing noise instead, no one would hear it except me. I would sneak down to open the door for her, hoping no one will notice she had come back and so everyone would be saved a confrontation.
To be continued...

Guest Posts

Over the years, several people have written to me about their personal experiences. They say that they prefer to write in private rather than comment (even as anonymous writers) on the post itself.

A few have expressed their willingness to share their experiences—as they struggled with their own diagnosis or with that of their loved ones.

These are real people with powerful insight into how they learned to cope. Their message is—you are not alone.

Keep checking for these guest posts.

Ms. S

Please join the line…

That was my mantra last month…travel is supposed to broaden your mind. I really wish it made people wait for their turn!

Some chap moved in front of my friend as we waited at the ticket counter. I directed him to the back of the line in my no nonsense teacher’s voice. My friend burst out laughing—at his audacity and my choice of words. “I would have said, ‘Hey, Can’t you see the line here?’ You were too polite.”

The next incident was when we lined up to board the plane. Another person butted in and the person ahead of us sent him redirected him.  Our neighbor then pointed to a businessman waiting in line“See that person waiting in line? He is a minister in my country…and here we have someone else trying to cut in!”

Then it was time to get off and that set the people in the back alight…while I waited for the passenger in front to get his bags, a couple started to push their way through…I can keep listing these incidents.

I was puzzled though—no one was going to miss the plane, nor would they catch an earlier one. Everyone had their assigned seats—you can’t get a better seat can you? Why do we not wait for our turn?

Over the next two weeks as I spent time in different classrooms I noticed some teachers were deliberate in teaching their students to wait for their turn.  The teachers were able to spend their time on teaching and guiding as the students took turns without interrupting. And when they did, the students knew the appropriate ways of doing so.  Activities and discussions in these classrooms were very productive.

In other classrooms there was way too much chaos. There was no order as the children called out answers randomly or too many of them got up to run errands. Not surprisingly the teacher had to spend a considerable amount of time on classroom management.

Is this only the teacher’s responsibility? No. Parents too have to teach their children to wait for their turn. How often do we see parents push their children ahead of the line because ‘it is ok?’ Your child will not miss anything by waiting for those few minutes. In fact the reverse holds true—etiquette plays a big role in how well you advance in the workplace.

Ms. S

"I give him English medicine at night...

My son is able to sleep only if he takes that medication. I give him one other pill in the morning—after breakfast. Then when he comes back from school I give him some homeopathy medicine,” the mom paused."  

The child’s teacher jumped in, “Yes, there’s a lot of medication change going around and we don’t always know what’s happening.” 

We were discussing how to help a seven year old diagnosed with ADHD but probably had additional needs. The neuro-psychologist had prescribed several medications for him. The parents were concerned about the ‘English Medicine’ and were looking for alternatives with less side effects. The mother had a general understanding that ‘English Medicines’ (allopath) have side effects but beyond that she really didn’t have much information.

 Here are some things to be aware of if your child is on medication-stimulants or otherwise:

• Medications impact hunger. Some drugs make children over eat and others affect appetite adversely.
• The same medications don’t work for every child with the same diagnosis.
• Medication affects a child’s sleep patterns. Some induce sleep while others (especially if it isn’t right for your child) can keep your child awake.
• Most drugs come in two forms based on how quickly they release the medication into the bloodstream: Slow release (extended release) which releases the compounds into the bloodstream over a period of time. The effects of this form last 8-12 hours. Quick release (instant release) where the medication is released into the bloodstream right away and the effects last 3-5 hours.

Can you see how time release can impact attendance, behaviour and productivity in school?

• Medications for conditions like asthma, epilepsy, and allergies can also impact a student’s ability to attend and follow directions. Steroids can act as stimulants while drugs for epilepsy can make a child look mellow and act with less initiative.
• If your child is prescribed antidepressants inform the psychiatrist if you suspect your child has an eating disorder. Some antidepressants stimulate hunger and others suppress it. If your child has an eating disorder, then the wrong prescription can have serious effects.
• Some medications (anti depressants, antipsychotic drugs) have to reach a certain level in the bloodstream. Depending on the person, it takes 3-4 weeks. This is why you must do a blood test a few weeks after starting a new medication. The full effect of the medication is seen only after this period.
• On the other hand, some medications may not fit your child’s metabolism. In that case you will know that it is not the right medication for him/her. For example, some antidepressants can trigger mania (instead of controlling the symptoms of depression). In that case please don’t wait for the 3-4 week period to change medication.
• Some side effects may seem too weird to us…but be aware that it creates extreme discomfort to the child. They may decide to stop taking medication because of this. Even excessive sunlight can be a deciding factor.
• Just because your child was prescribed a medication two years ago doesn’t mean that it has to work now. Sometimes an increase in dosage may help. But not always! Our bodies can develop resistance to medicines at any time. So review your child’s medications periodically…keep track of his/her progress and look for changes in behaviour and socialization.
• Remember your child is growing…that means medication needs to be reviewed as his/her metabolism changes.
• Keep your child's teachers informed of any medication changes and side effects. This will help them accommodate his/her needs in school.

Nothing is ever static. Nobody knows all the answers. Keep yourself informed about studies on drugs and methods. There is a lot of research in this field which will only serve to improve our lives.

Ms. S

Assessments and Diagnoses-Professionals' Responsibilities in Imparting Information to Parents

I came home to Chennai ruminating over VK’s question on teachers’ knowledge base. A day later I dropped in at a primary school a block away from my parents’ home. This time I observed a few children who needed more supervision, especially in their social interactions and in understanding boundaries. 

What fascinated me was that several of these children had been diagnosed with ADHD but there was no other explanation for their behavior. I talked to the parents and their understanding of their child's needs stopped at "He has ADHD and so he behaves like this."

I had a lot of questions running through my mind—do I ask the parents to talk to the professionals to get more information? Shouldn’t they list the tests they conducted in their report? Shouldn’t the professional write a longer narrative on the behaviours they observed? Did anyone explain to the parents what ADHD is (beyond ‘hyper’), especially in relation to their child’s behavior?

After a while I realized that my priorities had to be reorganized:) My limited observations told me that the students' needs were a little more complex than just impulsive behaviors. (Just impulsive behaviors?) A couple of the children seemed to have severe pragmatic difficulties, repetitive behaviours…do I tell the parents to get a speech language evaluation? As the administrators and I talked, I decided it would be unethical for me to say anything about the current evaluation or the report. I'd be more productive giving them strategies to follow in their respective environments.

I spent a few hours with the staff going over why these kids behaved the way they did…Fortunately the administrators got it but the teachers insisted that “if he can follow the direction in one instance, he better follow them in every situation.” I don’t think I succeeded in making the teachers understand that the students’ behaviours were a function of their brain and not their intent. I have to spend more energy there.

The question which lingered in my mind was “what about the clinical professionals and their knowledge base?” Are ADHD and LD the diagnoses of the moment? Do the professionals even look beyond these two conditions and try to understand the child better? And if they did, would the diagnosis still be the same? One child was recommended to a speech therapist for his stammering…what about his social language needs? Why didn't they explain to the parents how the social and learning behaviours impact learning? If the evaluating professionals gave a comprehensive report instead of just the terminology , maybe the teachers will be more open to learning about the child's needs? 

Right now these parents wait to be told that the school can no longer handle or help their child. They will admit him into any school which will accept him and start the waiting game again. They don't know how to breakdown the skills he needs or the accommodations which will support him in school. If the parents knew how their child's behavior reflects the diagnosis, would they be less afraid to seek help?

But then I make the assumption that all professionals have a strong foundation in their field. That is not true is it? 

Personally, such meetings serve a very important purpose…they remind me that I don't know everything in my field and I need to update my skills regularly. 

Ms. S

"How can the teacher teach a topic when she herself doesn't know much about it?"

VK has accompanied us on all our school visits and been part of our meetings with different NGOs as we explore our options for the community school in this rural area. A few trips ago, VK and I spent a three hour long ride from the airport to the hotel discussing the needs of this area-the schools, economy, politics...I liked her calm analysis of the facts and her ability to understand different perspectives without veering to either extreme.

My friend and I particularly like how VK joins us in our meetings. She pulls up a chair and takes in all the information-especially our talks on what we look for in our teachers, our methodology and of course our philosophy. 

Last week VK wanted us to visit her children's school and okay-ed it with the school officials. My friend and I were very impressed with the staff and students. The teachers were working under constraints because the management didn't really understand that schools have other necessities beyond textbooks and blackboards.. But they took pride in their work and obviously enjoyed it.

On our drive back VK and I fell into a discussion. "But Madam, I am not too sure about how well the teachers are prepared to teach. My older child's homework was to write the names of five vegetables in English. The teacher taught them four names but she herself didn't know the fifth. So she has taught the students to write dhoodhi (bottle gourd) in English. My child's learning is affected by the teacher's limited knowledge base. 


I am not that well educated and I want my children to have better opportunities. I eat less to be able to save money for their school fees and extras. But if we don't have access to proper training, our teachers can't really do their job properly. Even if my children go to an "English Medium" school they don't learn to read, speak and write fluently in English. I practice my English on the tourists who come here and then go home and speak in English. At least then they'll get used to hearing and understanding the language!"

How many of us realize that English as a medium of instruction doesn't necessarily improve the child's fluency in that language? Except for a very small percentage of our population, all of us start as English Language Learners. Are our teachers aware of this? Are they equipped to handle this aspect of their job? Do the educational departments in our states understand the concept of building up on English Language Skills by connecting it to the child's dominant language?

Ms. S

Autism Speaks: Top Ten Research...

Autism Speaks came out with its list of autism related top ten research achievements in 2011 a little while ago. I was unable to  post this earlier as I am travelling around in India. Yes, it's that time of the year again:)

So here it is...


I will continue my posts on food and eating habits after I get back home.


Ms. S

Healthy Attitude Towards Mealtimes

"Oh no, I am missing all the delicious pulau!” My sister complained as she went into labor. She had asked my mom to make her favorite, vegetable pulau, for the following day’s lunch. That evening she went for a long walk with my brother in law and subsequently went into labor.

 We tease my sister that her cries were heard by my niece at birth—that girl loves a good meal. It is fun to cook for my niece because her love of food is so obvious. She enjoys variety and eats healthy portions. Her descriptions of a good meal are eloquent and fun to listen to. Needless to say my sister takes great joy in cooking for her daughter. They feed into each other’s behavior.

Make meal planning fun. Include your child in preparing meals. Even very young children like to participate. Give reasonable choices...otherwise the child will want the same item over and over again.

Do you include all the food groups in your meal? A plate of rice or several rotis alone don’t make a full meal.

One of the best things about mealtimes in my family was that the two year old sat with the sixty year old. The young ones sat in between the adults so they could learn to eat with others. Ever watched a two year old eat out of a banana leaf? It says something about finger dexterityJ Children who sit down to eat with everyone else enjoy the social time and learn good etiquette.

Don’t force feed your child. Children learn to use food as a control tool very easily. Don’t let mealtimes become power struggles. A teenage neighbor of ours disliked white pumpkin. Once when his mom had cooked it in a dish, he turned it down. His father asked his mother to cook nothing but white pumpkin for the entire week! While the father proudly narrated how he shaped his child’s personality, I had to agree with him—only our views on the personality differed!

Relax and be sociable. Set aside any disputes there maybe with other family members...who wants to eat when they are sad or anxious? Who enjoys eating with someone who is sad or anxious?

Ms. S

Start at the Beginning...Mealtimes

“Eat, eat,” the young mom forced food into her child’s mouth. The child started to gag, but the mom was relentless. She wasn’t giving up until her child finished all the food in front of him. In her mind, not feeding the entire quantity was tantamount to neglecting her child’s health.

Sound familiar? I bet you’ve all come across this situation. Some people would have it that it is a control issue. I don’t think so. Culturally we believe that three full meals are important and that food served on a plate should be eaten. It starts there and gradually moves on to the weight issue. Every child has to be a certain weight…your child should weigh the same as your neighbors’…forget the correlation between height and activity or just general health.

Young children listen to their body. They pick up on the signals that their brain sends when their stomach is full. Trust your child’s instincts. When she (or he) says she is full, accept that she is full. Overeating is a learned habit.

Different children need different calorific intake. So where an active child eats a certain number of idlis or rotis, another child may eat less. It is absolutely normal.

Children should learn to chew and eat slowly. If your daily routine comes with time constraints then work out a menu which doesn’t include several courses. How often do you rush your child at mealtimes?

Make mealtimes interesting. Did you know that our taste buds change as we grow older? That means your child will have a more varied diet as she grows older. So don’t worry if she doesn’t eat some dish or vegetable right from the time you start on solids. After the Human Body unit one of my kindergarteners commented, “Ms. S, I think I’ll like tomatoes when I grow up. But right now my taste buds say no, thank you!” Be patient and your child will try new foods in time.

If you are concerned that your child is not getting nutrients from a particular food group or item then find suitable substitutes. Parents are more willing to adapt to food allergies. If their child is allergic to lactose, they are ok with soy milk or other products. But if the child says no to milk because she dislikes it, that becomes a huge issue. Give your child reasonable choices.

More to follow...

Ms. S

Body Image Anyone?

Last month I met with former co-workers at a friend’s wedding . We caught up with our news and views, sharing information about our new ventures. One woman, a social worker by profession worked with adolescents who had eating disorders.

I know several young people who struggle with multiple diagnoses, one of which was an eating disorder. As a teacher I wasn’t involved in the therapeutic counseling sessions—but I often wondered if the eating disorder didn’t have an equal or greater role than the co morbid conditions (PTSD, BPD). We often hear of the high risk for girls but I knew a couple of young men as well who struggled with anorexia.

My friend said, “Yes, I do have male clients and the occurrence is not restricted to teenage girls. In fact a few took longer to seek help because eating disorders is a ‘girl thingy.’ We continue to work with them on eliminating that stigma.” That was a new one for me!

No society or culture is free of the concept of a perfect look—color, shape, size, weight, height, everything is tallied and marked in terms of preference. Depending on where you live and whom you talk to either their vision is perfect or the other person is wrong. But a few values are specific to specific cultures. We have our own conundrums in India…color is just one of those (I’ve never understood why tanning salons are considered cool and not part of the color craze but that’s for another day).

A few years back I was watching an Indian movie and there was this absolutely crazy song which translates to “I like a round fat figure (in a woman).” I translated this to my husband and his jaw dropped! “That is one thing you won’t find in any western song…you may hear someone lament about not being allowed to be fat but no mainstream song will carry that message.”

Since then there have been all the size zero fantasies (maybe publicity, who knows). All these shapeless women are now the role models for our youngsters. Do the men fare any better? I wish they would put all their effort to develop their non existent acting skills. It maybe true that looking at thin people doesn't case an eating disorder. it certainly reinforces the stereotype that thin is beautiful.

As parents and educators, let us help our children develop positive body image.

To be continued…

Ms. S

Happy New Year...

Hope everyone had a blast...I know I had, with the entire street taken over by youngsters blasting fireworks all night long. Well all night long may be an exxageration but it certainly felt like it:)

I will be in India again over the next two weeks. My posts maybe a bit irregular but keep checking in. There is so much happening there and I enjoy meeting the parents and children.

In the meantime here's the next of the series on living with mental illness.

Click Here

Ms. S