Child mental illness impacts the entire family. Research has consistently found that parenting children with mental health disorders is psychologically distressing. With a former student, Camille Mickle, I recently published a research paper in the Journal of Child and Family Studies (Mazur & Mickle, 2017) on what mothers (mostly) and fathers discuss and question about parenting children with mental health disorders.
We studied 174 posts on four open Internet forums sponsored by organizations in the US that support parents of children ages 5-18 years diagnosed with ADHD, depression, anxiety, and bipolar disorder (BD). We found that most stressors were shared among parents of children with different diagnoses, gender, and ages, with the exception of parent-child verbal and physical conflict. Parents of children with BD, with both ADHD and Oppositional Defiant Disorder, and both ADHD and BD posted more often about verbal and physical conflict than parents of children with only ADHD diagnoses. This result is consistent with an earlier study (Theule, Wiener, Tannock, & Jenkins, 2012) that found that co-occurring conduct problems in children with ADHD increased parenting stress as compared to ADHD alone. Children with BD commonly experience intense and dramatic, seemingly uncontrollable, rage.
So, what were the most frequently expressed concerns of parents? Almost 12% of parents complained about feeling helpless about their children’s illness and symptoms, followed by a stated need for advice on how to cope. Parents often described how difficult it is to cope when children are mentally ill and their behaviors unpredictable; parents have little or no control over the symptoms or severity of the condition, although the expectation of both themselves and others is often that they should. Unfortunately, while most people realize that physical illnesses often are unremitting and erratic, few extend that understanding to parents of children with emotional disorders. Parents are often told that all their child needs is firm discipline, another common concern among the parents in our study.
Parents also expressed numerous concerns and questions about their children’s medication, in particular, its effectiveness, side effects, and children’s refusal to take it. This should come as no surprise considering that one of the most hotly debated topics in the U.S. centers on the use of medication in treating childhood psychiatric disorders. Also, in the frequent instances of children with more than one mental illness and overlapping symptoms, the condition that is diagnosed first is typically treated first, leading to the potential for serious harmful effects of stimulants and antidepressants in children and adolescents (Papolos, 2003).
The take-away for professionals working with patients and their families is that it is important to address the diagnostic heterogeneity that characterizes many children with mental illness. Also, practitioners must address not only the children’s difficulties but also their families’ challenges as well. Psychiatrists and pediatricians prescribing medication need to ensure that both parents and children understand the benefits and drawbacks of that treatment.
The take-away for parents of children with mental illness is that they may benefit from discussion groups that provide online support. Certainly, parents, are often psychologically, if not geographically, isolated from understanding peers. They are dealing with chronic emotionally distressing situations that, as our study shows, typically involve many different stressors. Current active Internet forums that parents of children with mental illness might find helpful are the “Attitude forums” (ADHD) at https://www.additudemag.com/forums/, WebMD message boards that include ones for ADHD and for mental health at https://messageboards.webmd.com/, and NAMI discussion groups for parents and caregivers, https://www.nami.org/Logon?returnurl=%2fFind-Support%2fDiscussion-Groups.
Mazur, E., & Mickle, C. (2017). Online discourse of the stressors of parenting children with mental health disorders. Journal of Child and Family Studies. Online first at https://doi.org/10.1007/s10826-017-0912-4
Papolos, D. F. (2003). Bipolar disorder and comorbid disorders: The case for a dimensional nosology. In B. Geller & M. P. DelBello (Eds.), Bipolar disorder in childhood and early adolescence (pp. 76-106). New York: Guilford Press.
Theule, J., Wiener, J., Tannock, R., & Jenkins, J. M. (2012). Parenting stress in families of children with ADHD: A meta-analysis. Journal of Emotional and Behavioral Disorders, 21, 3-17.