This is not the story of every adolescent– just the story of too many. It is dedicated to John who I met when he was 16. He described to me what it was like to be bipolar for him. Basically torture. He had tried medication. He had tried therapy. He had tried drugs and alcohol. He liked them best. He said, “Its the only time I can stand the way I feel…” He told me once, “I will be in prison by the time I was 21.” He was a couple of days late. 3 days after his 21st birthday he was picked up for breaking into cars. He is now in prison.
Adolescence is a difficult time given the best of circumstances. For adolescents with bipolar disorder it is way past difficult. Too many of them seem to play out the same tragedy, a seemingly eternal tragedy that few seem to escape.
For 35 years I have worked with kids in the mental health field. Time after time I have seen the same scenario play out:
They don’t do well with the world around them. Because of the cyclical nature of their problems they are often labeled as the bad kid whom either doesn’t try hard enough or who just simply doesn’t care.
At an early age frequently between the 5 th and 7 th grade they have their first drug experience. Two things happen. They find a way to medicate moods that they can’t stand. They also find a group that accepts them, when it seems like they are accepted or understood by anyone else.
By the time they are between the 7 th and 9 th grades they have begun a series of school expulsions and other legal problems. By the 10 th grade many of them are so far behind in school because of disciplinary issues resulting in missed credits and missed instruction that they have given up.
Between the 8 th and 10 th grade their involvement with the legal system gets more intense. They are arrested and put on probation and arrested and put on probation ad nauseam. The idea of “getting in trouble” no longer intimidates them and they become convinced they can “work the system.”
Between the 8 th and 10 th grade they have their first experience with “drug treatment.” They typically don’t see they have a drug problem. For them using drugs is a normal way to live. They may become compliant to get people off their backs, but as soon as they think others have reduced their vigilance they go back to using.
When you talk to them and really listen one of the things they will tell you is not that although drugs may cause some problems in their life, drugs solve the problem of “them.” Without drugs they feel either so manic that they are out of control or so numb they feel dead.
Eventually the drugs begin to affect their cognitive and emotional capacities. They don’t read as well. They don’t remember as well. They don’t think as well. They are not motivated by things that used to motivate them and life continues to go downhill.
Many of them progress in the juvenile justice system to the point where they have spent time in juvenile correctional facilities.
By the time they are 18 they are prepared to be one of the many people with mental health problems who are set to spend a lifetime in and out of jail.
The mental health and correctional systems do not do well with kids with bipolar disorder or other mood disorders. Many of them are simply “lost” in the system. We mark them off as unmotivated or resistant. We comfort ourselves by saying it is their failure and not ours. They could do better if they wanted to and they just don’t want to. When you talk to adults who can’t hold a job or maintain a relationship and who are in and out of jail and never learn their lesson and ask them to describe their adolescence what you have just read is what they describe.
I hope it is a pattern that we can find a way to break. One of the keys is to help more people understand that it is the unrecognized and untreated mood disorders that supply the fuel that drives this bus. Mental health systems need to get much more sophisticated. They are much more comfortable when a client only has one thing wrong: when he is “just this…. Or just that…” For all their talk about dual diagnoses they neither identify them well or when they do offer very effective treatment.
Too often when all else fails, as it seems to do too frequently, they just blame the client. Every person with bipolar disorder knows what it feels like to be told that their problem is that they don’t try hard enough. The stigma attached to the diagnosis is bad enough, but when you know you are going to be blamed for your life being hard who is likely to buy into that system and continue trying to get the help they need.
At Hopeworks we get calls all the time from parents of kids anywhere from 7 to 17 who feel like their children are being ravaged by something they can neither understand or explain. They ask desperately for help. Too often there is not much there. There are not many support groups. They are left to live with what seems to be the unmistakable conclusion that they have let their kids down right when they needed them most.