Parenting Skills for Symptomatic Parents

Parenting Skills for Symptomatic Parents

Episode 23

Helen Sneed: Welcome to Mental Health, Hope and Recovery. I'm Helen Snead.

Valerie Milburn: And I'm Valerie Milburn.

Helen Sneed: We both have fought and overcome severe chronic mental illnesses. Our podcast offers a unique approach to mental health conditions. We use practical skills and inspirational true stories of recovery. Our knowledge is up close and personal.

Valerie Milburn: Helen and I are your peers. We're not doctors, therapists or social workers. We're not professionals. But we are experts. We are experts in our own lived experience with multiple mental health diagnoses and symptoms. Please join us on our journey.

Helen Sneed: We live in recovery.

Valerie Milburn: So can you this podcast does not provide medical advice. The information presented is not intended to be a substitute for or relied upon as medical advice, diagnosis or treatment. The podcast is for informational purposes only. Always seek the advice of your physician or other qualified health providers with any health related questions you may have.

Helen Sneed: Welcome to episode 23 parenting skills for Symptomatic Parents. Well, first off, what is a symptomatic parent? Well, it means a parent who has mental health issues and who can be overcome by symptoms of the illness while parenting. And this can happen even in recovery, you know, symptoms can return. The world of parenting for symptomatic parents is vast, multifaceted, seldom simple, and often overwhelming. Now, Valerie and I want to say up front that we can't possibly cover this entire complex topic, but we'll focus on coping skills and strategies, many based on firsthand knowledge of these challenges. We want to concentrate on how a parent with a mental health condition can get through symptomatic periods. There are three areas we'd like to address basic information on parenting with a mental health condition and Valerie's personal experience skills and strategies for parenting when symptoms are present and skills and strategies for adult children, families and caregivers of symptomatic parents. As I've said, we're talking about a vast universe Boston Children's Hospital's Department of Psychiatry and Behavioral Sciences conducted an in depth study in January of 2022. This is very recent. The results are remarkable. Among US parents, one in five report having a mental health condition in the past year. Of the parents with mental health problems, 68% are women, 57% are men, and 1 in 5 young people live in a family with a parent who has a mental illness. So this affects millions of people in this country. I'm sure by now our audiences are aware of Valerie's battle with severe mental illnesses and substance use disorder and her great triumph of living in recovery for many years up to today. As she tells us her own story of being a symptomatic parent. I just want to say that I am in awe of her courage and desire to share the truth of those difficult years with her family.

Valerie Milburn: Valerie thank you, Helen. I was going to try and get through this without crying, but you already made me cry. Yes, it was hard preparing to share these parenting memories, but it's not something many people talk about and I think it's important to do so. So that's what I'm going to do. And I did become very

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Valerie Milburn: sick in 1994 with my mental health condition. And at that time my kids were 7 and 9. And I had been struggling for many years with alcoholism, drug addiction and severe mood disorders. But I had only started seeing a psychiatrist the year before, and he had sent me to my first outpatient treatment for my substance abuse in 1994, my first breakdown. That breakdown began an 18 month psychiatric crisis and a five year period of intense struggle and treatment. And I struggled those entire five years to get clean and sober. And it took me a couple of years into sobriety to get solidly stable with my mental health. Those five years were indeed a very difficult time for my family and I struggled with parenting my children. My husband lovingly and excellently took over the bulk of the parenting for those first two years of this period, and I slowly stepped back into the best of my ability. The shame and the guilt I carried because of the parenting I couldn't do was just flat out overwhelming. I worried incessantly that I was harming my children, but my psychiatrist, whom I was seeing at that time twice a week for therapy and medication management, assured me that I was not harming them. And as the years have gone by, I've continued to share with that same psychiatrist the lives of my amazing, successful, loving, compassionate children. And he often comments, oh yeah, you really screwed them up. But the struggles of parenting When I was deep in, the symptoms of my psychiatric illness were real. The parenting struggles were stressful and painful and just crushing. I missed one of my son's birthday parties. I had to walk out of one of my daughter's birthday parties. I would spend our Sunday afternoons at family gatherings at the lake house, sleeping in the back bedroom. I missed basketball games and baseball games. I couldn't get out of bed for dinner. Many nights if I was in a manic phase, I would sometimes leave and drive around all night. And then I wouldn't be home for breakfast. I had to take a cocktail with me when we went to the pool. I kept myself altered with alcohol or some drug daily for years. Oh, my gosh, this is hard to remember. I yelled sometimes because there were no napkins on the dinner table or because the kitchen sink wasn't rinsed after someone emptied their plate. I came in and out of psychiatric hospital seven times. I was like a tornado tearing through the lives of our family. And I didn't see it, but I was getting treatment. My husband and my sister would not let me give up. They and my psychiatrist were my lifeline and my love for my kids. I was fighting for my kids and my husband because I didn't have any love for myself at that time in my life. But I reached a turning point, an awakening, when during my seventh psychiatric hospitalization after my suicide attempt, my husband told me I couldn't come home. And this took me to my ultimate bottom, to a place of pain and devastation that was almost unbearable. It was the weekend of my birthday and Mother's Day, and I had a week left in that hospital stay. So I had one week to find a place to live, and I ended up in a sober house. And that was when I began to fight for my recovery. I knew I was about to lose my family and that I had to get better. I had to begin my journey to sobriety. And I did that. And this finally gave me a chance at my mental health recovery, because sobriety is just the bottom line. I mean, nothing was going to get better until I got sober. But getting sober was a long, hard fight for me. Now by this time, my children were 9 and 11, and one of them was very, very angry. And I had to fight to stay connected to my children while I was living in the sober house. And here's one example. The sober house house mother had a dog who had puppies, and I had the kids over to visit the puppies in the backyard. I would meet for lunches with my kids on the Weekends. And then finally, after 30 days, I was allowed to spend one night a week at my home. This was a hard reset, but a good one. Over the next year or so, little by little, my life regained fragments of

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Valerie Milburn: normalcy. I went back to work 18 months after being fired from the ad agency at a part time easy job. I moved home from the Sober House after six months. I went to a 12 step meeting every evening and had dinner with my family right afterward, every night. Or we went to a school or sporting event or whatever family event was on the calendar that night. Because I was mostly sober, I did have several reoccurrences of drinking for a day or two several times in my fight for sobriety. But because I was mostly sober, my psychiatric medications were working and thus my moods were level. I was calmer. I experienced periods of real happiness. I actually laughed occasionally. We began to establish a new family routine, and I was part of that routine. I was there for my kids, physically present for sure, and eventually healthily present, mentally, emotionally, spiritually. But emotionally and spiritually didn't come for a long time. But I began to be the parent I was before I had my psychiatric crisis. My children slowly began to trust me again. By the time I got completely sober in 1999, it had been five years since my psychiatric crisis began. And I had been on the road to recovery for a while. And my children were now 12 and 14. There was still a long road of reconstruction ahead. In fact, my daughter didn't really understand my illness until she took a psychology course as a freshman in college. She called me one day from school and she told me she finally understood that I had been sick, that bipolar disorder is an illness, and, you know, our relationship had been really wonderful for about two years already. But I think my daughter found true forgiveness for me when she found true understanding. And as the years have passed, I've committed myself to lifelong living amends to my family, because it will take the rest of my life to make amends for what we struggled with together. And part of this amends is learning to listen to those who love me when they point out that I'm beginning to struggle. My relationships with my children have become rich and deep and strong, and they're proud of me and support me in sharing my story publicly. And I support them in their busy, successful lives as professionals and parents. And I'm a great grandmother. We all just cherish our family and our love for each other.

Helen Sneed: Oh, Valerie, you tell the most difficult things with such grace. And on behalf of all of us who are listening. I want to thank you for telling us that, for sharing it with us, because it can't have been easy. I know. We know that you've lived in recovery with your mental health conditions for quite a while now. But even in recovery, you mentioned this a little bit. There are times when we become symptomatic again. What was this like when your kids were still living at home, when you would have a setback?

Valerie Milburn: Yeah, mainly what I talked about just now is when I barely got into recovery. But yes, living with the mental health condition means there are going to be times when the symptoms of our conditions flare up, even when we've been in recovery for a while. And having that toolbox of skills is important in order to continue to parent as well as possible during these times. And like you just saw, like you just heard, there were times when these parenting skills for symptomatic times that I'm about to share were not accessible to me. Times when I couldn't get out of bed, times when I was sick enough to have to go to the hospital. But as I moved into a life of recovery, I was able to begin implementing these effective parenting strategies and skills. I'm about to share for times when my symptoms did flare up. Many people worry that it's going to be difficult to cope with parenting as they have a mental health problem. I'm not the only one who worries about that or worried about that when they were young and still living at home. And it's natural to be concerned about the impact this is going to have on us and our children. But this is important to remember. With the right support and resources, it's perfectly possible to be a good parent while managing a mental health problem and to care and support for our children in a positive way. I mean, all parents face challenges. And here are some tips gathered from a couple of different resources. Mind.org, bp. Hope and the mental Health association of San Francisco. Here's the first

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Valerie Milburn: first one. Get help and follow through. The first step is to seek treatment. Another one, very important, is to talk to our children about our illness. These are some great steps that we have found about recommendations for talking to a child about mental illness. These come from the American Academy of Child and Adolescent Psychiatry. You can go to their website, American Academy of Child and Adolescent Adolescent Psychiatry, to get these steps because they're wonderful. The first one is communicate in a straightforward manner. Two, communicate at a level that is appropriate to a child's age and developmental level. The third one is to have the discussion when the child feels safe and comfortable. Another one Watch the child's reaction during the discussion. Slow down or back up if the child becomes confused or upset. And this one is really important. Listen to and validate the child's reactions. They're all important. And again, there's that website.

Helen Sneed: I just think this is an extraordinary list and extraordinary advice. I'm so glad that you're giving it to us.

Valerie Milburn: Yes, those are just really, really important tips. Another strategy is to take time to play with your children. I mean, people of all ages need time to play. It's a source of satisfaction in life. And if you can't remember how to play or it feels uncomfortable, just follow your child's lead. The kid knows how to play. Our kids know how to have fun and just get on the floor and play. Involve supportive relatives and friends in your road to recovery. Ask for help. Allow friends and family to help with child care with other activities of daily living such as housework and meal prep and transportation. Also, reach out to others with mental health conditions for support this Seeking support from other parents with the mental health condition can really help us in our recovery and an excellent resource for this. If you're a a regular listener, you've heard this resource before. The national alliance on mental illness NAMI.org will help you find your local affiliate. And one of the resources particularly helpful to those of us living with the mental health condition is their peer to peer class. NAMI.org Helen, you and I have talked about reducing responsibilities in general when we're struggling with our symptoms.

Helen Sneed: Yeah, I was curious. Valerie, everybody's got a roster of responsibilities in life and in daily living. If a person's overwhelmed, how do you deal with that?

Valerie Milburn: Well, I know you and I say often to ourselves, what can we cut back on if we're feeling overwhelmed? And when you're a parent, we, you know, have these periods when we do need to think in advance sometimes about what practical steps we could take to reduce our responsibilities. When we get into these times when we need some help and we can try to organize extra childcare for our children, perhaps ask a family member or friend to help with those arrangements. If we're working and it's possible, we can ask our employer if we can work fewer hours temporarily or work from home sometimes again, we can see if family members can cook occasional meals and we can also, if we usually have to help our kids with homework, see if somebody else can come over and be a step in, tutor people are willing to help. Another thing that's really important for Me, and for many people I know when we're in a difficult time is to follow a schedule. I follow a schedule all the time. And I know people who thrive on a very tight schedule. Time to get up, time to play, time to work, a time to eat, a time for bathing, the kids set bedtime. A schedule provides stability in a family. Another thing is try not to do anything impulsively. I try to step back, take a moment to myself and calm down. This was really important with my kids. Step back, take a moment to myself and calm down. I have a really funny story about my daughter being 14, having a 14 year old outburst. And I just looked at her and said, wait a minute, I've Never had a 14 year old daughter before. I need to think about what to do. And I mean, she looked at me and just went, okay, mom. And

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Valerie Milburn: we both took a breath and it turned the whole situation around. I have a few more additional ideas for times when we're symptomatic with our mental health condition. And one is to set an alarm for the morning, morning and the evening. We're familiar with setting an alarm same time every day to get up at the same time because that's very important to help us get out of bed when we're depressed or to stay on a schedule when we could be in a phase of mania. But setting alarm at night, that's really a good tip for me to wind down. Know when it's time to wind down and get to bed, set an alarm. Night and morning routine. Like we said, I make my bed and take a shower, get up, keep my routine, give ourselves timeouts. Parents get overwhelmed, take a time out. It's okay to let the kids watch television for a bit or play a video game for a little while and give ourselves time to close our eyes, regroup before we hit a wall. Another very important tip for me, I take all my meds all the time, on time. Another very important thing for kids and for me and for adults and for the world is to speak kindly. Mean words in an angry tone cut kids to the core and are felt for a long time afterwards. Just using kindness to communicate with my kids meant a lot less damage control down the road. And it's also important to speak kindly to the people my kids care about. And if I can't, I don't speak at all. My sponsor has this great line, she says to me, sometimes you get to say nothing. So one more thing I want to share is how it's important. Couple things important to interact with our children Even when we feel that blankness or numbness that sometimes comes with our medications. Sit down and watch your kids favorite show with them. Go out for a walk. And the last one is read, read with your kids. It's a calm way to connect with our children. And so those are some strategies and skills for parenting during symptomatic times. And one last comment. No parent is perfect. It's okay to struggle. I know this from my experience that it can be easy to blame my difficulties as a parent on mental health problems or to try and overcompensate by trying to be a perfect parent. It's important to remember that all parents have difficult times and there's no such thing as a perfect parent. I give myself a break.

Helen Sneed: Well, I'm fascinated by this because I think everyone puts that I have to be straight out of a magazine parent, which is not necessary. But there's something that you have said to me with great authority that I wanted to ask you about, which is you've said without good self care, good parenting can't follow.

Valerie Milburn: I believe that. I know that I can't, can't give away what I don't have. I can't help somebody else be strong and healthy emotionally, physically, you know, spiritually or in any way if I'm not strong and healthy myself in all those ways. And all the experts agree that caring for ourselves is crucial for sound parenting. And these self care strategies I'm going to go over are basic and well known, but I need to hear them repeatedly. And it's get regular exercise, eat nourishing foods, prioritize sleep, seek community support. Now we just have talked about that at great length. Communicate, ask for help, talk to people about what is happening to us. Meditation and mindfulness. You know me, mindfulness. I meditate every morning and I practice mindfulness throughout my day and pursue creative outlets. Journal, listen to music. If you're creative artistically, as in drawing and even adult coloring books with soothing music in the background can be a very creative outlet. That's soothing for me. So parenting with a mental health condition can indeed leave us feeling frustrated, overwhelmed or out of touch with our needs. But it's important

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Valerie Milburn: So Helen, let's shift our discussion from parenting children while struggling with a mental health condition or symptoms to a discussion of being the adult child or caregiver of someone with mental health symptoms. And you've done some really valuable research about strategies and skills for adult children and spouses and caregivers of symptomatic parents. I learned so much as you shared your research with me. So let's take a look at what you've discovered.

Helen Sneed: Well, I'll tell you, it's been endlessly fascinating and occasionally frightening or frustrating, but I just have learned quite a bit and I think one of the basic questions is what is the role of the adult child of parents with mental health challenges? Well, I think one answer is that there are many possible roles and we're going to look at some of them today. I want to look at these issues from the perspective of adult children, families and caregivers of parents who are symptomatic. Now, there are skills and strategies that can help a person sort through and establish a healthy relationship, or at least one that can be productive and sustainable. However, we must remember that it's not always possible or healthy for some adult children to have any relationship or contact with the parent. As I address some skills and methods, don't lose sight of the fact, please, that these family relationships are as individual as thumbprints, no two or alike, and there is no set remedy. Today I want to first focus on how an adult child can take care of him or herself, and then Some skills and strategies for providing emotional and practical support for an ill parent. Now, in numerous episodes of mental health, hope and recovery, Valerie, you and I have focused on the roles of the family and caregivers because it's so important.

Valerie Milburn: Yes.

Helen Sneed: And although there may be different dynamics for different families, the most essential strategy is for the caregiver to take care of him or herself first and foremost. For only when the individual is in a safe place can caregiving to a parent with a mental health condition become feasible for either party. Now, in her article from Psych Central Helping Adult Children of Mentally Ill Mothers, of course it Could Be Fathers, Caroline Freeman describes the three fallacies that adult children were trained to believe. The first is chaos and crisis are normal. This is what you learn then is that nothing in the world can be trusted. There can be total chaos or disintegration at any moment. The second is the focus is not on me. The focus of care is on my ill parent. In other words, I don't matter for very much low self esteem and very, very low sense of any kind of worthiness in the world. The third is don't speak too much about

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Helen Sneed: about what goes on at home. People don't like it. It's too much for them. That of course, makes a person that just brings out all the stigma that we all have to fight anyway. It enhances a sense of shame and a real fear of being truthful about what's going on. Now, it can be extremely difficult to put these beliefs behind us. Some of the challenges of having a parent suffering from mental illness may cause a person to struggle into adulthood in key areas. Emotional instability, social interactions, feeling guilty, low self esteem, finding and keeping a job, personal relationships, and even parenting their own children. Now this is what we want to start with is what I said, which is how to deal with having a mentally ill parent. This is how to take care of yourself, which, you know, Valerie and I just keep stressing this again and again. And these suggestions are from the Mentari Behavioral Health how to Deal with having a Mentally Ill Parent. Okay, first off, go to therapy. Evaluating and making sense of childhood experiences can be invaluable to creating a healthy life for yourself. Practice meditation and mindfulness. We've talked about this quite a lot, but there's so many thoughts of self blame and anger at the sick parent and worry that you too may end up suffering from the same mental illness. I think a really important one is mourning. Mourning the lost relationship. Then there's acceptance. Okay, your parent has a mental illness. Now this does not Mean accepting the way they treat their children, but acceptance of the parents condition and to not feel responsible for parents actions or feelings. These are the symptoms of an illness. Okay, boundaries. Be clear to your parent that the boundaries you're setting up are for your mental health. Setting boundaries can break the cycle of mental illness about as effectively as anything that I studied in all of this. Educate yourself. It's very empowering to understand causes, triggers and best treatment. And again also to look for what to look for in yourself in case you become concerned. Believe in yourself. You are not damaged goods and not to blame. Be gentle with yourself as you work through the trauma. It's not easy. Find supportive people, a strong support network, including safe people that you can be honest with about your past and current situation and feelings. Valerie's mentioned it already, but this is where it can be really helpful to be in group therapy because you're with people in the same boat and they get it. Practice prevention. Know what to look for in yourself. Provide for your adult self, what was missing in childhood and practice good self care. We, you know, we always are going over this, but it's exercise, diet, therapy, meds, relationship journal, music, whatever it is that you need to take care of yourself. All right, so now that we've looked at these suggestions for how you can keep yourself safe and strong, let's look at how to maintain healthy relationships with the parent. This is from the national alliance on Mental Illness Anami and we know how smart they are.

Valerie Milburn: We do.

Helen Sneed: We do. The first thing is don't buy into stigma. And that means don't be silenced and shamed by the fact that this has been going on and you're an adult now and it's still ongoing. Understand confusing behavior. Remember again, these are symptoms of the illness. You are not the cause. See opportunities for improvement, however small. Try to find things you can fasten on and you can point out that create hope and optimism. Get support from other people, other family members, professionals, your social network. This will strengthen you, especially if it's a parent who used to fill a major supportive role in your life before getting sick. Just because you stopped getting it as a child doesn't mean you can't find it as an adult. This is one of the great things about being grown up. Expect decent behavior. This one's very important. Tell the person what you expect. This is something that also is very important, which is have a safe place and a plan for what to do if safety becomes threatened. Now, regardless of the relationship, age, time, communication

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Helen Sneed: is key. The adult child can benefit from learning to talk about feelings and getting supportive feedback. Because one of the great difficulties that I kept coming across in my research is that that the adult child feels an overwhelming need to take care of the parent emotionally, even as an adult. And despite the mental toll it can take, this is trying to communicate and to dispense with beliefs such as that one. Communicate effectively. We've talked about this in other episodes. Use I statements. Tell things through your perspective. Because that's the only thing is just say, well, to me it looks like et cetera, et cetera, not theirs, because only they can express theirs. Listen attentively, be respectful. And I think I can say that respect is something that is so important for people who are suffering from a mental health condition. Because your self esteem is so low and life looks so bad and you feel like such an inferior person. And it is wonderful to be treated with respect. All right, try to see it from their perspective. This can be hard at the first when it gets so emotional. But try to learn to empathize with your parent. What is it like for them? Get curious about it. Focus on your larger goals to keep on track. Don't let little things trip you up. The minute there's a problem, start a conversation about it with your parent. Just as soon as something upsets you. Just try to get it out in the open while it's still relatively small. And don't let it fester and turn into some kind of giant. Use simple, direct and clear language. Again, another communication skill. Try to cover just one topic at a time. Share small amounts of information at one time and say exactly what you mean rather than hinting at it. This is a time in life and in this relationship where you need to talk turkey. Because this is the best they've discovered and learned through all this research. Being direct is the most effective way. And describe what you want and why. This promotes a growing understanding between you. If there is a problem, ask your parent for suggestions for a solution. I mean, if they're engaged in helping to find a solution, there's a better chance for a positive outcome. Now, when boundaries and communication are established, then the adult child can begin to determine and define areas where he or she can provide support for their parent and where they can't. This is another place where every individual may have a different response or strategy. These are some suggested areas where emotional and practical support are invaluable.

Valerie Milburn: That's some amazing information you just gave. So concrete and helpful and I know that.

Helen Sneed: Thank you.

Valerie Milburn: Yeah, just wonderful. And you just mentioned emotional and practical Support being invaluable. And I know those are two types of support we can give others. And you have some excellent examples of those two types of support. Emotional and practical.

Helen Sneed: Yeah, it's really nice because to me, this gives. If you're an adult child, it gives you some options of being terribly helpful. Regardless of which path you choose, if one of them is going to work for you to begin with, there's emotional support. Here's some tips. Listen. Giving a parent space to talk. You can help just by listening. If they're finding it difficult, let them know that you're there for them when they're ready so that it doesn't, you know, there's no finality to it. You're leaving the door open. Offer reassurance. Let you know that you are there for them and they are not alone. And in this context and in many others, try to express hope for their future. Stay calm. Even if it's upsetting to listen, try to stay calm. It may help them stay calmer and realize that they can talk to you freely and that you won't freak out. That will make people, I think, feel more inclined to want to be truthful and to confide in you. Be patient. Don't rush things. It can be so hard to be patient, especially when you want more information or you want to think. You can see a way that they can get help immediately. Be patient. Let them set the pace for seeking support. Try not to

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Helen Sneed: make assumptions. Your perspective may be very valuable and useful and dead on. But don't assume that you know what caused their condition or what will help. That's up to them. Keep social contact. When possible. Try to keep things as normal as you can as a situation can bear. Can the parent attend a social event or a religious activity or fair or just a concert? See a friend at home. They're not able to get out or talk on the phone. If they can, phone calls can be great. Just help them dial the number. Or you could try talking with them about other parts of both your lives, other interests that you have, maybe to talk about things that you both love and have done together. Okay, so these are the kind of emotional things you see how it goes. It's being there for someone and helping them with their feelings and with getting to the truth of the matter. But here is another thing that some people might be more able to do that is amazingly helpful and that is practical support. Here are some ideas for that. Look for information that might be helpful. Making treatment choices can be overwhelming and just create total paralysis and Your research can really, really help, especially when the parent is incapable of doing the research and other actions that require attention and concentration. Which again goes with these. Those are symptoms. It's a problem. Help your parents make a list of questions for the professionals they're seeing and put the questions into a cohesive order. This is really important because this is where they're getting their information and advice. Go to appointments with them if they want you to. Even being in the waiting room can be reassuring. Here's a big one. Help to organize paperwork and fill out forms such as notes, prescriptions and records of appointments, insurance. Mental illness is just the most bureaucratic thing a person can come across in life. And anyone who can help with these things is doing a phenomenal, immeasurable service to the parent. Make a list of responsibilities, kind of a layout of things, practical tasks, a daily living schedule for the parent. Then review it together. Just look at, this is how things are looking these days. Now, it is not up to the adult child to find solutions for everything. Please don't take on that responsibility. But it can be a great help just to know what needs to be done for the maintenance of the parent and have it in writing so you can all check on it and the parent can check on it. My final suggestion is be self aware. Bear in mind that you, as the son or daughter of a mentally ill parent, can feel guilt, anger, resentment, grief, helplessness, despair and fear that the illness may strike you someday. And so these suggestions of support are not an implication that the adult child must do them. That is entirely up to the individual. The first priority is boundaries and safety and the ability to live and cope with the complexities of having the legacy of a symptomatic parent.

Valerie Milburn: I love those suggestions and ideas and I love the breakdown between emotional support and practical support. I know my siblings and I each had different strengths in that area when we were taking care of. Of my mom. Some of us were good at the practical, some of us were good at the emotional. And knowing which one of us could do which task really was important. So I love that you broke it down that way. Very helpful.

Helen Sneed: Yeah, well, and hearing that, you know, you know firsthand that it works, because it really, it really does. Now, I'm sorry to do this, Valerie, but we're. It's time for. We're going to have to bring this to a close. This complex episode. I think I can speak for both of us when I say that it has generated many strong feelings and possibly generated the same feelings in our listeners as well. Yes, now, as always, there is hope for those who are symptomatic parents and those who are their children, adult children, and caregivers. Dr. Patricia Ibiziaco of Boston Children's Hospital said, many children who grow up with a parent's mental illness learn empathy, kindness, and the ability to deal with difficult circumstances. And if they have children, it even can benefit the way they relate to their own kids.

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Helen Sneed: As Valerie taught us about symptomatic parenting, today, the road to recovery can strengthen a family even in the face of a severe mental health condition. And now we are going to turn to Valerie for a mindfulness exercise.

Valerie Milburn: Thank you, Helen. Today we are going to be mindful about entering the autumn season. In a recent article in the New York Times, Eric Vance summed it up Whether you like it or not, fall is here. The following is adapted from Vance's article It's fall. Soon the weather will get colder, the leaves will die, and the nights will stretch longer than the days. Another year is dying. That's just how it goes. But it's not all bad. Fall also brings with it bright, brisk days and cozy sweaters. Somewhere in the crunching leaves, the crackling fires and the chilly air, you might locate a few Feeling of possibility. There are those, though, who struggle with seasonal depression in the winter months, and the fall can be the beginning of their symptoms. A few small studies even suggest that if you are ruminative or deeply preoccupied with your thoughts in the autumn, you may be at more risk for depression in the winter. Psychologists say that the feelings that often crop up in autumn stem from our discomfort with change. All of these things make autumn the ideal season to build resistance, resilience, and practice mindfulness. Since we can have these unsettled feelings as we face the changes in our lives as the seasons change, it's a great time to use mindfulness to work on our acceptance of our uncertainty. To embrace these unsettled feelings, we can work on what's called our intolerance of uncertainty, a tendency identified by psychologists as a risk factor for poor mental health. And this will be our mindfulness exercise today. Leaning into Uncertainty Using mindfulness as a way to build exposure to a tolerance toward, and perhaps even an appreciation of times when you don't know what's ahead and could feel a bit out of control. So let's get mindful. What is mindfulness? I always begin with the definition. Mindfulness is purposefully attending to the present moment without judgment. Let's begin by closing your eyes. If you can settle in and breathe as always, let's Begin with a few diaphragmatic breaths. Whether your eyes are opened or closed, let's steady our breathing with two diaphragmatic breaths. When you do this on your own, take as many breaths as you need to to become calm and centered. I usually take about 10 diaphragmatic breaths to start my mindfulness and meditation practices. Let's breathe. Inhale through your nose, expanding that imaginary balloon in your stomach as you inhale. Exhale through your mouth, pulling in your stomach as you do. Forcefully exhaling again. Inhale through your nose, expanding that imaginary balloon in your stomach as you inhale. Exhale through your mouth, pulling in your stomach. Exhaling forcefully. Pull your stomach all the way in. Keep this slow, steady breath going. Now imagine yourself in an upcoming situation that has uncertainty attached to it. A situation where you don't know what is going to happen and are maybe anxious about. Could be a past situation like this that you would like to have handled differently. Imagine where you are. Keep your slow, steady breath going. What do your surroundings look like? Who is in the room with you? Keep your slow, steady breath going, focusing on your breath. Look around the room and accept

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Valerie Milburn: that some things are uncertain. Lean into the uncertainty. What could be good about the uncertainty? Keep your slow, steady breath going. Let the following thought enter your mind in this uncertain moment. I am alive and that's enough. Hold that thought as you look around the room you are imagining. With this thought in mind, lean into the uncertainty of the situation with grace. Now, please gently bring yourself back to the present moment. Thank you for doing this mindfulness exercise with me.

Helen Sneed: Thank you, Valerie. I guess I want to thank you. I do, every. Every time we talk. But I'm so grateful for everything that you have given to us today. It's been rather extraordinary generosity and many thanks to you, our listeners, for giving us your precious time and attention. We're honored to have you here today and hope you'll join us for our next episode examining bipolar disorder. The highs and lows and in between. Until then, I leave you with our favorite word. Onward.

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