A Caregiver's Lament

As my client sat on the couch opposite me, her tone became tighter the more she spoke. As if in a trance, she talked about her years growing up and the relationship she had with her mother, now a point well-beyond her 40 years of dealing with a parent who was diagnosed bipolar for as long as my client could remember. Though her mother had good and bad days coping with approaching dementia, my client was cautious about discussing any of the past with her mother. She knew it could be dangerous emotionally.

Some things don’t change, and her mother’s clouded picture of the past caused her to attribute truth and certainty to events that bewildered my client, who saw them much differently. Her difficulty was due to a long period of chaos and tumult when dealing with her bipolar mom.

All is going well now, but she still remembers when her mother was delusional, and sees the past as part of her mother’s normalness, not allowing her daughter to let go of it, always a little on edge. Her mom sees her life as a “flatline,” all episodes in her life equal and part of a continuum with no insight. The daughter sees the bumps in the road and doesn’t want to go there, knowing that at some point the good times will end and my client will be forced to deal with dysfunction. As a caregiver, she has her mom well for now and enjoys being a daughter, going out to lunch or shopping together.


Lack of insight is dictated by the rule that all behavior is measured the same. To normal people, they see the extreme highs and lows and have to deal with them. On a good day, my client talks about memories with her mom, but all too often, there were bad days when her mother’s view was inflexible, seen through a prism of need and dysfunction, death by brain cell atrophy.

Now an adult child of a parent with bipolar disorder, what she goes through as her mother ages, adds to the already significant pile of lost episodes and tainted experiences. Her mother is now at the gateway to further dysfunction, senior onset dementia. When did it become so complicated my client laments? She has become a conservator of her mother’s dwindling financial resources and is making plans for how best to care for her as she ages.

We talk from a period of upswing for my client and her mother. Mom is having a period of lucidity during which they are able to connect with one another. For a sliver of their lifetime together, they can laugh and remember good times. My client’s children are also able to be a source of pleasure for their grandmother. “Don’t count the days too long, but enjoy the present,” is my client’s outlook.