Dear Therapist:

Our 26-year-old daughter recently went through a time where she was down. We didn’t think much of it and she appeared to get better but then showed some troubling behaviors. On the advice of our rov, we brought her to a psychiatrist. We are also still on a waiting list to see a therapist. The psychiatrist believes that she has bipolar disorder and is giving her medication for that. Our question is, does it make a difference to tell her this diagnosis or is it not necessary? Somehow bipolar sounds less common and more serious than anxiety, depression, and ADD that people understand is pretty prevalent. Plus, she is already having a difficult time with shidduchim and when she hears this diagnosis, she will be fearful of how much harder it will be. Who knows if this could make her bipolar worse? She might be less scared off just calling it depression (which is what she thinks she has) than bipolar, which sounds much worse. Is it harmful if we just called it depression? If you do think it is important to discuss the bipolar how do you suggest that we have that conversation with her? 

Response:

Naturally, any conversation that you have with your daughter would take into account your relationship with her and your understanding of how she responds emotionally. I cannot advise you as to the way in which you might broach the subject with her.

I often speak to the somewhat arbitrary nature of diagnostic labelling. Would a bipolar diagnosis give your daughter any more information as to her issues? From an educational perspective, she would have access to more information about causes, triggers, and treatment. But why should she feel differently toward herself? She already knows what her issues are. Would the bipolar label suddenly make her recognize that her issues are worse than she had thought?

Of course, many people do have negative reactions to the assignation of certain diagnoses. However, this is largely due to feelings, associations, and preconceived notions relating to the particular label. However, I believe that this concern is more than offset by the danger of withholding information. As mentioned, understanding her diagnosis can help your daughter to better wrap her head around her issues, their causes, and ways of better dealing with them. In fact, research may help your daughter to normalize her mood problems. Recognizing that a vast number of people deal with similar issues can help people to feel less isolated and abnormal.

Additionally, hiding your daughter’s diagnosis from her can easily backfire. She may be more intuitive than you give her credit for. She may already have a sense that her issues lean in the direction of a bipolar diagnosis. Even if she doesn’t at this point have this sense, she will likely find out at some point. The fact that you withheld her bipolar diagnosis could feed directly into the feeling that it is something to be ashamed of.

If your daughter knew that she was diagnosed with bipolar disorder, would this make her feel worse about herself? Or are you projecting your feelings of shame and embarrassment onto her? Today, younger people are often more open and open-minded about mental health diagnoses than we give them credit for. If you separate your own feelings and projections from your objective understanding of your daughter’s feelings and needs, you may recognize that many of your concerns are your own, and may not be shared by her.

-Yehuda Lieberman, LCSW

 psychotherapist in private practice

 Brooklyn, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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