By Margarita Tartakovsky, M.S. 

Parenting is a difficult job and a juggling act no matter what. It requires balancing your own needs with those of your child. It involves managing your time, having adequate resources and supporting your child.

For parents coping with a mental illness, “these issues are amplified,” said Ryan Howes, Ph.D, psychologist, writer and professor in Pasadena, Calif.

“When you’re living with any kind of chronic or severe illness, like mental illness, diabetes or cancer, there are times when your functioning will be compromised by that illness,” said Joanne Nicholson, Ph.D, a psychologist who directs the Child and Family Research Core of the University of Massachusetts Medical School Center for Mental Health Services Research.

But that doesn’t mean that you can’t have a healthy family. Here are some pointers to help you overcome common challenges.

Parenting with a Mental Illness Challenges

Depending on the particular condition, parents with mental illness have the added challenges of decreased energy, irregular sleep, trouble concentrating, sustaining attention, irritability and moodiness — all of which can contribute to a less available parent, said Nicholson, who also coauthored Parenting Well When You’re Depressed: A Complete Resource for Maintaining a Healthy Family.

According to Nicholson, research has shown that mothers with depression are less likely to interact with their children in active ways. And this has an “impact on your relationship with your child and capacity to parent,” she said. With a lack of stimulation, young kids tend to lag behind in language development, emotional behavior and maturity.

Consistency is key for kids, but with the ebbs and flows of mental illness, this also can be compromised. Kids can feel lonely, become confused and blame themselves, according to Michelle D. Sherman, Ph.D, clinical psychologist and director of the Family Mental Health Program at the Oklahoma City Veterans Affairs Medical Center.

“The biggest challenge is stigma,” Nicholson said. Because our society tends to hold negative attitudes and beliefs about mental illness, it can be difficult to acknowledge that you’re struggling and to seek treatment. Stigma also adds more pressure on parents to be the perfect caregiver. “Parents feel as if others are watching them a little more closely and may have negative assumptions,” she said.Another challenge is insurance coverage. Nicholson gave the example of a mother who was breastfeeding and wanted to take a different antidepressant that was better for her. Her insurance company wouldn’t cover it, so she had to stop breastfeeding.

Tips for Parents with a Mental Illness

There are many things you can do to parent well while coping with mental illness. Here are tips to help.

1. Focus on the whole family. “From my perspective, mental health is family health,” which means paying attention to each other’s wellbeing, Nicholson said. Watching for red flags in kids becomes especially important because “research has shown that kids with parents with serious mental illness are at risk for developing mental illness themselves, both due to genetic and environmental issues,” said Sherman, who’s also a professor at the University of Oklahoma Health Sciences Center. She cited research that found that 30 to 50 percent of kids with parents with mental illness develop mental illness compared to 20 percent of kids in the general population. Longitudinal research has shown that increased risk for mental health problems still persists at 10-year followup.

• Engage in treatment. “The best predictor of kid functioning is parent functioning,” said Sherman, also co-author of Finding My Way: A Teen’s Guide to Living with a Parent Who Has Experienced Trauma and I’m Not Alone: A Teen’s Guide to Living with a Parent Who Has a Mental Illness. Even if you don’t want to seek help or get better for yourself, do it for your kids. Model healthy choices. Remember that acknowledging that you need help and seeking help are signs of strength.
• Connect with others. Mental illness can be isolating. But isolation is detrimental to both parents and kids. All the experts emphasized the importance of surrounding yourself with supportive individuals, whether that’s family, a spiritual leader, school counselor, mental health professional or parents with similar experiences. Find people “who understand your circumstance and respect who you are and your goals for your family,” Nicholson said.Sherman stressed the value of “having other people in your world that your kid can count on.” These people help to provide consistency, too.
• Troubleshoot. “Think through the way your illness makes you think, feel and act,” said Nicholson. This helps to anticipate the times when you’re not thinking clearly and to be ready in the moment to keep your child safe, she said.
• Create a crisis plan. During a calm time, sit down with your therapist or doctor and establish a plan of action for emergencies, such as being admitted to a hospital. Consider concerns like where your kids will stay and how they’ll get to school.
• Enroll kids in activities. While it can be tough keeping up with everyone’s schedule, especially when you’re running to your own appointments, getting kids involved in extracurricular activities can be beneficial, Sherman said. This gives kids another opportunity to connect with healthy peers and adults.
• Attend to your needs. When Nicholson’s kids got sick, she’d rush them to the pediatrician. “When I’m sick, I come to the office,” she said. Most parents can relate to this scenario. But this can be devastating to your mental health — and your family. “I often see problems occur when parents deny their symptoms and extend themselves beyond their limits. If you’re too depressed to go to the ball game, accept this limitation and stay home to take care of yourself,” Howes said.
• Give the best time to your kids. “If vacations cause anxiety, plan more ‘staycations.’ If weeknights are depressing but weekends are brighter, make quality family time on Saturdays,” he said.Learn to understand your illness, its triggers and cycles, and apply this knowledge to your schedule, he said.
• Recognize your strengths. When you’re struggling with a mental illness, your strengths are the last thing on your mind. Especially if you suffer from depression, your thought patterns probably sound more like this, according to Nicholson: “I can’t do anything right, this day isn’t going to go well, I’m never going to be a good mom.” But try to celebrate your strengths (e.g., list three things you like about yourself). “You can build on strengths, but you can’t build on failure,” she said. Plus, this is a positive activity to model to your children.
• Practice your passions. Both parenting and mental illness can be all-consuming, leading individuals to “lose touch with the unique, vital, passionate parts of themselves,” Howes said. Engage in activities that go “beyond the roles of parent and patient,” whether that’s “exercise, creativity, travel, learning, bungee jumping — whatever reinforces the unique parts of your identity.”Howes also said that it can be beneficial to involve your kids. “They’ll be thrilled to see dad enjoying himself and expressing parts of his personality he really enjoys.”

Single Parenting

Being a single parent can add another challenge. “The extra responsibility that comes with being the only provider, the only nurturer and the only disciplinarian results in additional stress, and stress can exacerbate the impact of mental illness,” Howes said.

Don’t hesitate to ask for help and continue connecting with others. Howes suggested “teaming up with other parents for play dates and exchanging babysitting duties.” Also, “having time to vent is not just a luxury, but a necessity.”

Prioritizing is key. Maybe you don’t fix fancy meals every night or have a spotless house, but your and your kids’ mental health needs are taken care of, Nicholson said. Focus your energy on what’s important to your family, and “let some of the other stuff fly.”

In general, remember that mental illness is nothing to be ashamed of and that taking good care of yourself is a great gift to your kids. “I speak with adult children of mentally ill parents who tell me ‘My mom had bipolar disorder and she tackled it head-on. She always let us know she loved us and faced her illness with courage,’” Howes said.

Margarita Tartakovsky, M.S. is an Associate Editor at Psych Central.

Last reviewed: By John M. Grohol, Psy.D. on 17 Jul 2016 
Originally published on PsychCentral.com on 17 May 2016. All rights reserved.

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