Reprinted from "Parenting" issue of Visions Journal, 2004, 2 (2), p. 6
Background Issues for Consideration
Parenting is an important life role that is valued highly by most people in our society, and people with mental illness are no exception. Not surprisingly, they are also highly motivated to become parents, and as shown by one re cent study done at the University of Massachusetts, people with mental illness do parent at the same rate as the general population. Having a serious mental illness – as with any other serious illness – impacts the ability to parent, but does not prevent a person from doing so. With the right kind of support, people with mental illness can be good parents. The following article provides some background as to the kinds of issues that should be addressed when considering the support needs of a parent with mental illness
The socioeconomic context of parenting with mental illness
When we think of the kinds of issues faced by parents with mental illness, many of them relate not to the illness, but to the fact that many of these parents are dealing with struggles related to poverty, isolation, and in some cases, gender.
Many parents with mental illness are single mothers who live on limited incomes. And because they are poor, they face difficulties with meeting basic needs such as decent, affordable housing, adequate transportation, proper nutrition for their family, finding child care that they can afford, and paying for recreational activities that support the healthy development of their children (outings, lessons, etc.).
Since mental illness often causes conflict within a person’s social network, parents may become isolated from family and other potential sources of emotional and practical support that most people access through their informal networks.
A final point relates to gender: more women with mental illness than men are parents. For people with schizophrenia, for example, this is partly because the illness often strikes later in women, after they have had children. One issue that may be relevant is protecting themselves and their families from domestic abuse
The impact of parenting on mental illness
The relationship between mental illness itself and the parenting role goes both ways. That is, having an illness impacts on the ability to parent, and being a parent can have an impact on the way an individual experiences her or his illness.
First of all, for some people, the birth of a child can actually trigger the onset of the illness. For others with a vulnerability, the stress of child-rearing may be what triggers the illness. For a person with a pre-existing illness, the day-to-day demands of parenting, on top of the demands of managing the illness – keeping appointments, taking regular medications, etc. – can be a major stressor that can worsen the course of the illness. Parents might also feel guilt or resentment related to the sometime conflicting demands of parenting and managing their own illness.
There may also be added stress since people with mental illness feel pressure to ‘measure up’ or prove themselves as parents, sometimes to unrealistic standards. For example, they may lose sight of the fact that some of their struggles are typical for all parents, and judge themselves negatively.
It’s important to remember that being a parent is not just a source of stress. It can also become a major contributor to a person’s recovery, by providing:
- a source of motivation to manage one’s illness (some people will say that they didn’t follow through on their treatment in the past, but that they decided that it was important to take responsibility for their health so they could be there for another person.
- a source of structure that helps them be organized enough to ‘make it through the day’
- a sense of identity and status apart from being ‘only’ a person with a mental illness.
The impact of mental illness on parenting
The other side of the two sided relationship between parenting and mental illness is the impact that the illness has on the parenting role. First of all to consider are the effects that symptoms related to certain illnesses can have: for example, depression – either in and of itself, or co-occurring in other illnesses such as schizophrenia – can have negative effects, as it can reduce an individual’s motivation and energy level to parent. For people with schizophrenia, negative symptoms (i.e., lethargy, emotional ‘flatness’) can have similar effects, especially if their medications are not adjusted properly. Positive symptoms of schizophrenia (i.e., delusions) that are not properly managed can also have an impact if they distract the parent from attending to real-world concerns and if their children are drawn into a delusional worldview – especially if the offspring have not been given any education about the illness.
The illness may also have an impact on the parent’s ability to form relationships and attachments. One consequence is to reinforce the tendency for the parent – and therefore the family – to be socially isolated. The other relates to the difficulties that the individual may have with forming healthy attachments with their small children. Research shows that they may either be overly detached or overly involved. This may translate, for example, into having difficulty understanding how to play or interact. The impact of this may be that the parent may be either overly directive and brusque, or on the other hand, mayappear not to show any interest at all in what the child is doing, or in the needs that the child is indicating. As time goes on, these difficulties in knowing how to parent may be compounded if the individual’s own parent had a mental illness and was not a positive role model that can be drawn upon for strength.
A final point for consideration is how the issues of familial mental illness cause concerns for the parent in relation to the healthy development of their children. These can cause further negative impacts on the parent’s own mental health. Mothers with mental illness tend to have more difficult pregnancies and their offspring tend to have more physical health complications over time. Chronologically,the next issue that comes up is the concern over attachment and style of interaction with their children and the impacts this can have on the healthy socialization and mental health of the offspring. As the children get older, the parent may then have to cope with mental health problems or behavioral difficulties in the children themselves. And as the offspring approach the age of risk for major mental illness, the parents face the worry over whether their child will develop the same illness they have. As the adolescent approaches adulthood, parents often have difficulties in fostering a healthy degree of separation as the adolescent moves into adulthood. Often, the offspring is the parent’s primary source of self-esteem, so the eventuality of the child moving on represents a threat to the parent. Both the parent and the offspring may need support to negotiate this transition