Because bipolar disorder so often first manifests in the late teens and twenties, it’s common for a first major mood episode to occur while at college. Many have speculated that the added stresses and freedoms of college, easy access to drugs and alcohol, late hours, changes in diet, academic demands, etc., may precipitate a first episode in a vulnerable person.
As with any first episode, it can be a scary and confusing time. Depending on the nature of the episode, depressed, manic, or mixed, the interventions will vary. Ultimately, what’s needed is quick access to treatment; an accurate diagnosis, and a strategy that can help get the person feeling better and stable.
There are a few broad issues to be addressed here. For parents, if their child is now eighteen or older, the rules have changed. This can be frustrating and scary when you’re listening on the phone to your son or daughter, who is clearly manic, refusing treatment and enraged that you even mentioned there is something wrong with them.
Necessary strategies may include contacting the university’s counseling or mental health clinic. If you’re concerned that things have reached an emergent level, your son or daughter is manic, suicidal, or psychotic, you’ll need to contact the emergency services (typically 911) in the town or city where your child is in school. It’s at this point that many parents will pack a bag, book a flight, or get in their car to see first-hand what is happening with their adult child, and to be there for him.
If hospitalization seems likely, or necessary, it’s a good idea to have someone advocate for your son or daughter. Attempt to have your child sign releases for all providers, but even if they don’t or won’t, you are able to talk with various doctors and counselors without written permission, if you have information to give them. They, being bound by the rules of confidentiality, cannot divulge information. This can be a frustrating form of communication, but at least you are able to give you child’s treators important information. Maintaining contact with the treatment team also lets them know that you are concerned and involved. As your child’s condition improves, he or she will be more likely to sign a release and you will be able to communicate in more of a give-and-take fashion.
Emotions of all involved will be running high, and it’s easy to give in to catastrophic thinking: “My son will never finish college,” “He’s going to lose his scholarship,” “He’s going to kill himself.” People with bipolar disorder and their parents will experience a mixture of strong emotions: loss, anger, and fear. Denial of the illness is frequently seen, not just with the person who has bipolar disorder, but with her parents as well: “This can’t be happening,” “It’s just the drugs she was doing,” etc. These responses are natural and normal and it’s critically important to get beyond them, especially the denial.