May 3rd, 2011
07:21 PM ET

How can I make my mom understand my bipolar disorder?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Tuesdays, it's Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University, and an expert in the mind-body connection for health.

Question asked by May from  California

I have bipolar disorder type 2. My mood is almost always influenced by the season and this winter I went through one of the worst depressive episodes I have ever experienced. When I mustered up the courage to tell my mom that I felt trapped and that I was desperate for help, she dismissed my symptoms as "something every teenager goes through" and that things will get better.

She keeps telling me that everyone is depressed once in a while and that's just how life is. I'm better now, but I'm constantly scared about the next depressive episode I'll have to go through. It's been about three years since my diagnosis, and I think my mom has been in denial ever since. I've tried my best to convince her that this isn't normal but she refuses to see the truth. Even when I attempted suicide about a year ago, she lectured me about how selfish I was being and refused to even consider hospitalization or medication.

How do you convince an unsympathetic parent that you need help?

Expert answer

Dear May,

You know, lots of times people send in questions that don't contain enough information for me to make definitive suggestions. Fortunately, you've done a great job of outlining your situation, which is sadly common, and all too often not adequately treated.

Before we talk about your mom, let me tell you a little about your condition. First, many people who fit a diagnosis of bipolar II disorder have exactly the seasonal pattern to their symptoms that you describe. In fact, a major difference between bipolar conditions and what psychiatrists call "unipolar" depression (and which I sometimes refer to in this column as "regular old depression") is that people with bipolar conditions are much more sensitive to the changes wrought by time than are people with unipolar depression, whether these time changes are measured in the cycle of day and night or the longer cycle of the seasons. Most unipolar depressions are caused by psychosocial stress. Many bipolar episodes are caused by the stress of time's changes.

The vast majority of people with a seasonal pattern to their moods, whether they are classified as bipolar II disorder or seasonal affective disorder, suffer depressions in the winter and then either normal moods or abnormally elevated moods in the spring and summer. I don't know whether this would comfort you, but many, many great artists and writers have some degree of seasonal mood change. In fact, a famous researcher named Kay Jamison (who has bipolar disorder herself) found that musicians, writers and artists tend to do all their best work in the spring and summer when their winter depressions have lifted.

I don't know your mom so I can't suggest exactly what the best course of action is. If she is at all reasonable, education can make a big difference. If she understood how much we know about your condition and how greatly it can be helped, she might be more supportive of your efforts to get appropriate care. If she is really dead-set against you getting care, let me make one simple suggestion. People with winter depressions are often helped tremendously by treatment with a bright light.

These lights are widely available on the Internet and don't cost too much. You should get one that is rated as at least 10,000 lux. If you sit in front of it for 30 minutes each morning starting in the fall when you feel the first stirrings of your depression, it is very likely that you can greatly reduce the pain of your depression.

Let me make a couple of final comments. Your mom is right about one thing. Seasonal depressions are much more common in young people than in older folks, and in women than men. You can't change your sex (or at least not easily!) but as you get older it is likely that the seasonal pattern to your moods will diminish. Finally, if you live somewhere with gray winters, you might consider heading south to live when you are old enough to do so. I know a number of people who really improved their winter depressions simply by living someplace sunny.

soundoff (33 Responses)
  1. Brian

    I resent the 'bipolar type 2' diagnosis. 'Bipolar' is a very stigmatizing label and usually is thought to be people who are seriously manic (aka out of control) by most people. With the bipolar type 2 thing, they are basically calling people who have 'variations in depression' or 'agitated' depression Bipolar. Keep in mind, it can merely be ONE variation from the depression, and bam you've got 'bipolar' (and of course, this is solely on a psychiatrist's judgment, when such a person may not know your personal life well). I know that psychiatry has to label every single emotional response as some kind of aberration and so be it, but I do think that 'agitated depression' would be a more reasonable label for it that wouldn't stigmatize people who have little or no mania.

    May 3, 2011 at 21:38 | Report abuse | Reply
    • Laura

      This is completely nonsensical. You're just re-labeling mania as "agitation" and then we're back to "manic depression"- for which major stigma exists all the same. Psychiatry is not stigmatizing anyone... people have and create the stigma.

      May 3, 2011 at 23:04 | Report abuse |
    • Sanders Kaufman

      A lot of severely mentally ill people are jumping on the "no labels" bandwagon.
      They think that by refusing to give a name to their illness, it will go away; or that the only reason they're sick is because somebody stuck a label on them.
      This is particularly true in the Evangelical community with people who honestly think that their god is talking to them and ordering them to carry out all manner of tasks – from obsessively collecting newspaper clippings and web site printouts, to going out and hurting people.

      May 4, 2011 at 02:59 | Report abuse |
    • jen

      It could be worse– you could have BPD. Talk about stigmas.

      May 17, 2011 at 15:28 | Report abuse |
  2. Jing Hu

    Personally, i think a persons mental health is JUST as important as there physical health. It is unfortunate this indivisual has no one to seek help or support from when he/she is going through this unfortunate state.

    I recomend this indivisual to seek help from his/her school counsler or a psychologist.

    May 4, 2011 at 01:48 | Report abuse | Reply
  3. Brian

    Some people are being ridiculous, not applying a stigmatizing label doesn't make the problem go away....though it does help with the stigma and hence make a person a bit less stressed in some situations. I'm sure some people deny it altogether- that is a problem within itself. It's also a problem that people have to put some 'medical label' on a severe emotional condition in order to take it seriously, which signifies a problem in society itself. A psychological/emotional problem can be extremely crippling, regardless of whether you call it 'major depression', 'the throes of life', or 'bereavement' or WHATEVER,

    Actually, Laura, if you knew anything about this, bipolar 2 requires ONE 'HYPOMANIC' EPISODE and thats why it is so easy to slap this label on someone. A 'hypomanic episode' can range from a huge number of things that can easily be misinterpreted. It is a gap from depression and can encompass 'irritable' states, agitation, et cetera. As has been stated, a person with 'bipolar 2' or hypomanic episodes can be very normal and functional, which is why the stigmatizing label in this case is a problem and should be removed in favor of something like 'agitated depression'. 'Mania' normally refers to the extreme highs and lows that come with the 'real' bipolar, which is the 'crazy' behavior commonly associated with the label.

    And yes, psychiatry has been stigmatizing people for a very long time with its excessive labeling and lack of empathy...as well as failing to examine social and environmental factors adequately. They've been doing it for over 100 years. It's not worthless, but it does cause a lot of harm to sensitive people. If you don't care to read up on both sides of the story, then it's not my problem.

    May 4, 2011 at 04:39 | Report abuse | Reply
    • education please

      Brian, you need to do some reading. "Agitated depression" is actually called a "mixed state" which is mostly depression with a few features of hypomania or mania. Mania is a very high energy state that may or may not involve a good mood and it is severe enough to interfere with job or personal life. Mania is only associated with a bipolar 1 diagnosis. No matter which way you slice it, sick people are sick and they sometimes need help. Let's all be open to the fact everyone is different and sick or not, sometimes we all need some help. I prefer "manic depression" because it is slightly less stigmatizing than "bipolar illness" but I also keep myself in the mental health closet because the one thing you got correct is the stigma associated with any of these labels. Most people don't know much and worse, some people know a little and think they know it all when they really have only stereotypes. Get educated people. Google is waiting for you.

      May 4, 2011 at 20:10 | Report abuse |
    • Bocaburger

      @Education please-Dont act like you just typed all that info in like you knew it, you had a second tab opened and was reading and typing at the same time from wikipeda so dnt be degrading others comments like you no more or are better than others peoples comments you D-bag!

      May 5, 2011 at 12:47 | Report abuse |
  4. eeg of brain

    Thanks for writing this. I really feel as though I know so much more about this than I did before. Your blog really brought some things to light that I never would have thought about before reading it. You should continue this, I’m sure most people would agree you’ve got a gift. Thanks for sharing…


    May 4, 2011 at 05:59 | Report abuse | Reply
  5. mzdaxx

    Sadly, my mom didn't take my mental health issues seriously until my daughter was also diagnosed with similar ones. She still doesn't take them as seriously as I'd like but maybe with time...

    May 4, 2011 at 07:19 | Report abuse | Reply
  6. aeh4543

    I'm in my mid-30s and my mom continues to gripe at me about my bipolar I; she blames all of my marital and parenting problems on me rather than on the disease. She still tells me to "get over it," even though I'm receiving treatment and have been for years. I've had to purposely distance myself from her in order to keep my sanity.

    May 4, 2011 at 11:53 | Report abuse | Reply
    • BenThere

      There is nothing you can do to change your Mom. It is better for you to keep your distance. Stay on your meds, and find comfort in your good days and let go of your bad days. Do not give your negative thought any power. I have had depression most of my life, over fifty years. Most people will not understand your thinking patterns so don't bother telling them. Just try to be in control of your life and not let the depression be in control. And remember there is always a new day and be thankful for it. Good luck to you on your journey.

      May 4, 2011 at 12:16 | Report abuse |
    • Wow

      OMG... You do realize that its not acceptable to blame bad behavior on an illness. Sick or not, YOU are still responsible for your actions, not your illness. You may not like your mom's message but its infinately more healthy than to simply blame all your problems on an illness.

      May 4, 2011 at 19:19 | Report abuse |
  7. no suicide necessary

    There's an important warning sign that Dr. Ralston and the commenters up until now seem to have completely missed - the fact that your mom refused to allow you to seek hospitalization or medication *after* a suicide attempt. I don't know where you live, but if you're under 18, IMO that translates to child neglect.

    You need to think hard about what *you* need to help you cope with your depression and bipolar diagnosis, and then find an adult in authority to help you get it. Your mom can't live your life for you and make all your decisions indefinitely. There are medical professionals and social services people out there who can make the call of whether you are in need of further help, medication, or possibly time away from your mom so you can get the treatment you need.

    Good luck! Depression is never easy.

    May 4, 2011 at 14:21 | Report abuse | Reply
  8. nina786

    i still don't understand about this Bipolar.....:(


    May 5, 2011 at 07:32 | Report abuse | Reply
  9. Brian

    Education please:

    "Bipolar II disorder is a bipolar spectrum disorder characterized by at least one hypomanic episode and at least one major depressive episode; with this disorder, depressive episodes are more frequent and more intense than manic episodes. It is believed to be under-diagnosed because hypomanic behavior often presents as high-functioning behavior...Hypomania in Bipolar II may manifest itself in disorganized racing thoughts, irritability, anxiety, insomnia, or all of the above combined. Because these agitated symptoms are negative, it may be difficult to distinguish a Bipolar II manic state from depression. Hypomania is often regarded as an elation of mood, however, mood may be negative in Bipolar II hypomania. "

    Supports what I said entirely...you don't need manic behavior to be diagnosed bipolar 2 and because the 'hypomania' is so indistinguishable from depression its too easy to hit someone with the label.

    Either way, our society is toxic and until that problem is solved, mental illness will continue to get more and more frequent. People don't realize it because there isn't so much 'outright' oppression, but even if its subtle it still hurts. I guarantee you that if society's atmosphere were better and people were more supportive, there would be far fewer 'mentally ill' people because they wouldn't go so far down the same path in the first place.

    May 7, 2011 at 14:27 | Report abuse | Reply
  10. jen

    Mental illness isn't only caused by a toxic society. In fact, to blame society for a seeming increase in mental illness is not a fair conclusion. Over the years – humans have made so many advancements in medicine and health. We are all living longer and in general, healthier than in generations past. People are more likely to survive their mental illnesses. Imagine being a hunter and gatherer and having severe depression– you can't get food because of the symptoms of depression and you would end up dead. Now that people are living through their mental illnesses, that means that the genetic predispositions are inherited by subsequent generations.

    May 17, 2011 at 15:33 | Report abuse | Reply
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    This is usually a awesome and great learn. Your blog is created in such a way that it's so easily readable and understand. I'm a fan of your web site. Thank you for sharing this data.

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