A struggle — parenting children with mental illness — is finally shared

I’D SEEK OUT MY FRIEND — standing in the crush at the edges of the P-rade — the one classmate I could talk to each year at Reunions who would understand. We’d turn our backs to the line of marchers and whisper under a tree the latest updates about our young-adult kids. I’d tell him how my daughter, at the mercy of dark moods, periodically would overdose on prescription medications and how my son had suffered an unexplained breakdown at college. Some days my son couldn’t get out of bed, yet he had resisted engaging in treatment. My friend would tell me about hospitalizing his son to pry the young man away from the grip of alcoholism and underlying depression.

We’d been meeting discreetly like this for nearly a decade, since the first hints of our kids’ troubles, whispering our fears, our desperation, our sympathies, and then leaving one another with a big hug and hopes for a better year ahead.

When we’d turn our faces again to the crowd, you would hear my friend say how well his business was doing and, from me, what a grand transition I’d made from a high-profile journalism career to being a dean at one of Harvard’s graduate schools. We had great spouses, great families, great lives! Doesn’t everyone at Reunions?

Marc Rosenthal ’71

I did not expect that my biggest and most painful challenge as a parent would come so late. I thought the hardest years were behind my husband and me: the toddler tantrums; the worries over childhood diseases, school progress, sexual relationships and health; the tamping down of terror as we watched our daughter and then our son drive away in the family car for the first time. 

Measured against the mental illnesses that have struck each of our kids in young adulthood, those earlier tests now seem problems of limited magnitude with straightforward strategies and solutions. Where we are today is a foreign land with no markers or exits, and where we question our own competence.

I know my family’s experience is not an aberration. The major mental illnesses — bipolar disorder, schizophrenia, and depression — typically manifest in the late teens and early 20s. According to the National Institutes of Health, just over 4 percent of all U.S. adults aged 18 to 25 have a serious mental illness. 

It is thought that the biologically based illnesses, which produce a vulnerability in mood regulation and thought processes, are stirred to the surface by external stressors. That young adults may break down in their first year or two of college or graduate school is no accident. Away from the safety and structure of the family, presented with distractions and choices and enormous expectations to succeed, any student with a vulnerability may falter. Many students with incipient mental illness can be propelled by the chaos and pressure into a frightening struggle to maintain their stability. 

Also unsettling, especially to parents, is the fact that our kids are no longer minors, and the health-care system allows them to choose whether to participate in their own treatment and medications. (Try making a 20-something take a pill!) Every developmental instinct these young adults have tells them to push aside authority and go their own way. Only with maturing may young adults be better able to accept responsibility for their own health and act on it.

In the early years of my daughter’s struggle with a mood disorder, I did not talk to others about the turmoil. At the office I became immersed in work and proud of the creativity and effectiveness of the unit I led. I felt competent. But part of me was always on alert, never knowing at what moment a crisis could hit and I’d be summoned to the high school or hospital. Or perhaps it would be my daughter herself calling, crying for me to help her. Whenever I heard a ringtone — anyone’s ringtone — my adrenaline would spike, my heart pound, and my brain freeze. At night I began to have panic attacks, waves of feeling that something terrible was about to happen. 

My husband and I are educated and resourceful people, devoted to our children’s happiness and well-being, and yet we couldn’t protect them. We are financially secure, I was well connected through my job, and we were able to provide my daughter with top doctors and facilities in Boston, this renowned epicenter of medical care. But it didn’t matter. Still she wrestled with her moods and her self-destructive impulses. I began to question my competence and worth as a mother, as a person. I was failing, and I was scared. My daughter’s life was at risk.

A psychiatrist helped me talk about my distress and learn to manage it. Anti-anxiety medication was effective. Strategy sessions allowed me to feel less helpless. After a while I was able to tell my work staff why the boss sometimes had to drop everything and dash out of the office. Even then I couched the situation in euphemisms: “My daughter is having a bad day.” Bit by bit, as the years passed, I allowed myself to explain what was happening to those closest to me — my sister, my cousin, the girlfriends in my book group — especially after the relentless anxiety impaired my very ability to read. 

But there was a time of year when I would not speak of these things, and, I now know, neither would an untold number of our classmates. When mental illness robs your children of their abilities and their prospects, a parent mourns. My husband and I had ambitions for each of them, a specific imagined future particular to our peer group. Was it somehow our fault that this vision was dashed? What paths were open to our children now? Could they be happy? Could we be happy? Could we ever see our lives and theirs as anything but diminished?

At Reunions, in the company of our high-achieving Princeton alumni community, the story of my family’s distress stayed locked up tight. I’d never read about my kind of struggle in Class Notes. There were entries about families facing a loved one’s cancer or recovering from a heart attack. But no one mentioned this.

I was as guilty of Class Notes silence as anyone. Amid the crowings of my classmates about their children’s Ivy League acceptances, I kept quiet about my daughter’s disastrous first semester at an obscure college and sent word to PAW only when she transferred to a prestigious art school — neglecting to follow up with news of her quick emotional descent there. 

Similarly, I let everyone know that my son won early acceptance at a highly competitive college based on his poetry, but not that he ended his freshman year with an inexplicable nervous breakdown and spent the following year mostly in our house before having a similar experience at another college. A hospitalization followed, and we learned that he was suffering from bipolar illness, a thought disorder that impairs cognition and the processing of external information. The door to his academic life seemed to close with a slam.

We now had two kids with mental illness. What were the chances? Our children are not related genetically: We’d adopted our daughter as an infant, and our son had been a surprise pregnancy.

In the midst of his suffering, my son turned a sympathetic gaze on his parents. “I guess you wish that you had other kids instead of us,” he said. My heart fell. I told him no, that there were no imaginary, ideal other kids out there whom I preferred. What I wanted was for my kids to feel better.

And it was true. I had let go of vicarious ambition and trivial matters. When your kid is coping with mental illness, you get to the bottom line fast: He’s alive. If you have that, you can start feeling ambition for the child to be healthy and then happy. That’s all that counts.

My selective silences ended abruptly at my 40th reunion. I sat down at a table under the tent to catch up with a classmate I hadn’t seen for many years. He told me eagerly about his two sons — one finishing at an Ivy college, the other in a terrific job in New York. Then he asked me about my family. I was about to fudge things, but then, with an unexpected feeling of freedom, I plunged ahead and told him that my daughter was stable now after years of hospitalizations and that we’d just learned my son had bipolar disorder. Sadly, neither kid had been able to finish college. 

Then the most shocking thing happened. 

A look of chagrin came over my classmate’s face. He hesitated for a moment, then bent toward me. Actually, he said, his young adult daughter was still living with them at home. She, too, was mentally ill.

Had I not been forthright about my own situation, my classmate would have kept the very existence of his child a secret. I decided then and there that this silence had to end — for everyone who comes to Reunions.

So it was that last May, with the help of the University, I organized a Reunions panel: “Parenting Young Adult Children With Mental Illness.” It drew a standing-room-only crowd of 70 people, many leaning against walls and sitting on the floor in a McCosh Hall classroom. The audience participation was fervent and heartfelt. The overall emotion was relief. Many parents told wrenching stories, asked for help, and were given advice and resources from those in attendance and from the panelists — psychologist Calvin R. Chin, director of counseling and psychological services at Princeton; and my friend and classmate, Laurie Watson Raymond ’73, psychiatrist and former director of advising resources at Harvard Medical School.

READ MORE: Q&A with Dr. Laurie Watson Raymond ’73 on parenting young adults with mental illness

Attendees spoke of having avoided Reunions in past years. One alumnus’ story of long self-exile from campus for fear of being asked about his ill daughter brought the room to tears. Others had made peace with their change in life expectations for both themselves and their kids. One couple spoke movingly of how much their son added to the home life of the family, now that they’d decided he was better off living permanently with them. One mother could not get her ill daughter to speak with her and didn’t even know for sure where she was. Another family could not control their son’s outbursts. Many people stayed long afterward for additional discussions in small clusters. It was, in some sense, a mini-reunion of people who hadn’t known until then that they had this in common with such a large group of fellow Princetonians.

I can tell you that lately my daughter is relatively stable. She has an apartment, a job, a fiancé, a dog, and a vision for the future. My son has not had a hospitalization in quite a while and is living at home. While he still is depressed, he is participating (albeit reluctantly) in treatment. My Princeton friend’s son is much better, lives independently, and runs his own company. He continues to attend AA meetings.

My husband and I still feel on alert, not sure when the next kid crisis might come or whether we can plan our own future, sell the house, and live on the downsized scale that we’d prefer and would help secure our retirement. The probability of having to support our kids indefinitely is real. There’s a lot we don’t know and a lot we only dare to hope for. But I’m through with whispering under the trees, and that sure feels good.

Bill Golden

Robin Herman ’73 is retired from the Harvard School of Public Health, where she was assistant dean for research communications.

READ MORE: A Q&A with Dr. Laurie Watson Raymond ’73 and more resources on parenting young adults with mental illness