When I was in my early twenties I already knew I didn't want to have children. I just didn't have that "maternal instinct" as it is called. I kept this revelation to myself; as the women around me at work and in the Advertising Co-Ed Softball League, in which I was playing at the time, were planning their weddings and their future families.
      If I had disclosed my feelings at that time, I would have been told that I'm too young to make such an absolute decision, that I will inevitably change my mind — when I meet the man I will marry, or that maternal drive will kick in as my biological clock ticks down.
      None of those things happened — what occurred is that within several years of acknowledging that feeling, I was diagnosed with a serious and persistent mental illness. Spending the next twenty-five years cycling in and out of psychiatric hospitals, the choice whether or not to bear children faded into the background.
      Now that I have passed my childbearing years and the decision is no longer mine, I do not regret that I am childfree. With the exception of my four year old niece who I absolutely adore, I am uncomfortable around children and adolescents. Finding myself feeling awkward, not knowing what to say, how to communicate — whether to try to make myself known in the language with which I am familiar, or to try to be "hip" and risk making a fool of myself.
      Had I chosen to have children, I fear I would have passed the propensity for depression, for an eating disorder, for addiction down to them — as my parents did to me. My mother was bulimic and my father is a recovering alcoholic, but he continues to suffer from depression. I would venture a guess that my parents didn't mean to create an invalidating environment in raising me and my brother, but they were just two people who shouldn't have married each other and perhaps who should have thought twice about having children.
      I look at my patients' relationships with their children, grown or still relatively young, and most of the time there are difficulties. The problems run the gamut — from enmeshment to estrangement, there is intermittent contact, manipulation and game-playing by either party. It's sad and disheartening to see animosity between parents and children of all ages, to hear words of aversion, of disrespect hurled at the other — especially when the other is not there to defend himself or herself.
      I suggest, recommend family sessions, but most of the time they never happen. Either the parent or the child is not willing, often too fearful of what secrets will be revealed, what family dynamics will be exposed. "I am here to be a mediator, this office is a safe space," I tell them, but that is not enough assurance.
      What I hear a great deal of the time is, "I love my daughter/son, but I don't like her/him very much." Where does that leave the parent? And the child? My patients who say those words are suffering; they long for an amicable relationship with their children, to be able to have a friendly conversation, to be able to chat with each other about the little goings-on in their lives — the stuff that fills the gaps between the silences.
      I'm not saying by any means, that people who suffer from mental illness should not have children. I'm proposing that whatever the diagnosis, mental illness adds an extra dimension to the challenge of parenting. Being a parent is an individual choice for any person -— more so for a person who is diagnosed with depression or bipolar disorder or an eating disorder. Every person who I know who has had a child says that once that child comes into their life, nothing is ever the same again, that child comes first in every respect.
      I consistently tell my patients who do have children that I believe that parenting is the hardest job in the world and that it doesn't come with a manual. I admire the men and women who made the decision to become parents and make the commitment that for all intensive purposes does not have an age limit to it.
      I am one of the lucky ones. I knew from early on in my life, even before I was diagnosed that I didn't want children. I was spared from wrestling with this decision as the severity of my illness waxed and waned in an unpredictable pattern. I didn't have to continually ask myself the question, "Is now the time? Is the beast of my illness gone for good?"
      The answer had to be "There are no guarantees." So for some unknown reason, the instinct that I was imparted with almost thirty years ago was what I'll call a great gift. Thank you to whatever forces were at work which were able to protect me from the distress of agonizing over this life-changing decision.

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