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Mourning the Living: Mental Illness and Family Estrangement

A Personal Perspective: A father with bipolar disorder reflects on estrangements

Key points

  • Research indicates that about 25 percent of American adults are living with an active family estrangement.
  • These painful relationships are rarely discussed openly because cultural norms and expectations make estrangement especially stigmatizing.
  • In addition to abuse, toxicity, and bad parenting, mental illness and substance abuse are major contributors to estrangement.
  • Although sometimes appropriate, estrangement is associated with a slew of negative psychological effects.
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Estrangement between parents and their adult children appears to be on the rise. Research indicates that about 25 percent of American adults are living with an active family estrangement that either they or another family member initiated. Some experts believe that at least part of the context for this trend is increased political and cultural polarization coupled with growing mental health awareness and recognition of the effects of toxic or abusive family relationships on well-being.

In spite of their prevalence, these painful relationships are rarely discussed openly because cultural norms and expectations make estrangement especially stigmatizing. That has led to widespread misconceptions about estrangement, including that estrangement is rare, that it happens suddenly, that there’s a clear reason people become estranged, and that estrangement happens on a whim.

In addition to abuse, toxicity, and bad parenting, mental illness and substance abuse are major contributors to estrangement. And although sometimes estrangement is a happy ending, it is also associated with a slew of negative psychological effects, including grief, anxiety, depression, ongoing trust issues in other relationships, a decreased ability to self-regulate, and a tendency to ruminate about problems in all relationships rather than enjoying their positive, nurturing aspects.

I was diagnosed with bipolar I disorder at the beginning of 2019 after I had been kicked into a severe manic episode from multiple stresses, including the collapse of my 20-year marriage, estrangement from my daughters, and alcoholism. I then swung into an intractable depression that left me unemployed, uninsured, filing for bankruptcy, and collecting Social Security Disability.

With medicine and therapy, I've been able to manage my bipolar disorder well enough to start working again while also becoming a mental health advocate and educator. One of the things I've enjoyed most about getting involved in mental health advocacy has been getting to know and work with other mental health advocates.

One of those advocates is Major General Gregg F. Martin, Ph.D., U.S. Army (Retired), who shared a writing exercise with me in which he’d been challenged to write a “love letter” of sorts to bipolar disorder. While we both agreed the idea sounded a little hokey, he had found it to be a valuable experience. So I gave it a try.

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An open letter to my bipolar disorder

Dear Bipolar Disorder,

One of the intrusive thoughts that haunts me is of my oldest daughter crying and screaming, “I wish I had a normal dad!” That was back before she cut all ties with me.

You're to blame for that.

I hate you. You've taken my girls from me, and I f---ing hate you for that more than I've ever hated anything in my life. Because I've never loved anyone or anything in my life more than them. It’s still incredibly difficult for me to discuss. I’ve only recently been able to start discussing it with my therapist.

I’ve had to mourn their loss, even though they are still very much alive and don’t want a relationship with me. I’ve had to watch them graduate high school and start college through my youngest’s Instagram account. (My oldest blocked me from hers.)

I’m reminded of them dozens of times a day—whether scrolling past a show on Netflix that used to be “our show” with my younger daughter, or knowing that for the rest of my life if I eat something with coconut in it, I will immediately think about how my older daughter absolutely hates coconut.

Their ghosts are present in everything I do and see and hear and feel and think. I can’t throw out six-pack rings without cutting them up because my older daughter loves sea turtles, and she did a report about them once. At least I assume she still loves sea turtles.

I miss them so much it sometimes paralyzes me in both thought and action, and the triggers come from everywhere, constantly. The source of that pain can be traced directly back to you.

You're why I've been fired from three law firms. You're why I see colleagues who started along with me who are doing so amazingly well financially, while in the couple of years leading up to my 50th birthday, I had a house in foreclosure, two cars repossessed, no money or assets, and several hundred thousand dollars owed in taxes and unsecured debts.

You're why, for years, I led a secret life of affairs, prostitutes, and Craigslist/AdultFriendFinder hook-ups. Until I would feel so guilty that I would stop, only to resume a few years later. Why I eventually deluded myself into believing that my ex-wife had to know what was going on, and so she was giving her tacit approval. Why I discovered instead that it was not a "don't ask, don't tell" situation; it was an "I'm asking, and tell me right now" situation. At the time she discovered what had been going on, I was seeing four women and chatting up a fifth. You are why I actually said to my ex-wife, "Can't I just keep one?"

There are so many examples I could list. You’re the reason I’ve been handcuffed in the back of a police car twice, and why, in a separate unrelated incident, I was able to punch the windshield of a parked minivan and shatter the glass without breaking or even bruising my hand. Let's just agree that before I knew you were to blame, I had just about resigned myself to the fact that maybe I'm just not a very good person. And I guess the jury's still out on that, but at least now that I know you're involved, the story is more nuanced.

You are the source of my greatest pain and weakness. But, goddamn it, you're the joy and the strength too. And the creativity. And intelligence. And drive.

You're how a painfully shy kid from a blue-collar background not only went to college but earned a Ph.D. and a law degree. You're how I got that music scholarship from Wake Forest University and that predoctoral fellowship from the NIMH. You're how, when my graduate school advisor went M.I.A. from alcoholism, I was able to roll up my sleeves and manage the lab so I could wrap up my dissertation. The lab that was part of the neurosurgery department and where I learned to perform sterile neurosurgical procedures on non-human primates. You're how I got those offers for postdoctoral fellowships at Yale and UCSF, and also how I had the strength to turn them down and go to law school.

You're how, even though they highly advise against working during your first year of law school, I worked about 20 hours a week for a law firm getting on-the-job experience. How, when working too much impacted my second semester grades so that I didn't make law review, I proceeded to create my own by lobbying the administration to allow me to lead the creation of Wake Forest Law's first law journal besides the law review.

You’re how I was able to juggle my third year of law school with the birth of my oldest daughter. How I was able to get through the oceans of cortisol generated from studying for and taking a bar exam when my new job, new home, and new baby all depended on the result.

You're how I became a ghostwriter for Senator Bob Dole when he joined my law firm. How I had the guts to insert a joke (that I made up) into the first speech I ever wrote for him, one he loved so much he used it over and over.

You're how I became the golden boy at that law firm. How, in addition to working with Senator Dole, I chaired panel presentations for five years at meetings of the Biotechnology Industry Organization which included members of Congress. One of them was chosen for a special "second run" on Capitol Hill for members of Congress and their staff, and an equity partner asked if he could get in by carrying my bag. I was a first-year associate.

You're how I was able to do such sophisticated legal work at such a high level, like managing the worldwide patent portfolio for Prevnar-13, the world's best-selling vaccine before COVID-19. I get a sense of accomplishment looking at the list of clients from over the years: Johns Hopkins University, Syngenta, Illumina, Duke University, Wyeth (now Pfizer), to name a few.

You're also the source of my creativity—or at least you're the bellows that stoke the fire. I write, I draw, I paint, and I cook because of you or your help.

My personality can change so very much. At times it's been hard to tell where I end and you begin. Is there a core "me" who lies somewhere between the alcoholic serial adulterer prone to explosive anger and the catatonic shell whose big accomplishment for the day is moving from the bed to the couch?

I've desperately wished that I could disclaim my extremes. That I could excise the tail ends of the distribution. But, actually, I don't think that's the appropriate metaphor.

Getting rid of you would be more like a redaction of my life—one that would leave a document that is so marked up that it's hard to make any sense of it.

I'm the "core me," and I'm the extremes. I'm all of it. You aren't just an add-on—you’re baked into me.

I used to think that if I had the power to change things, I would choose to have never known you—to be "normal." But more recently I've been thinking that maybe I would choose to go back and hand my younger self a bottle of lithium and a custom-drafted owner’s manual for the care and feeding of us.




Scharp KM. “You’re Not Welcome Here”: A Grounded Theory of Family Distancing. Communication Research. 2019;46(4):427-455. doi:10.1177/0093650217715542.

Pillemer, K. A. (2020). Fault lines: fractured families and how to mend them. New York: Avery, Penguin Random House LLC.

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