Parental mental disorder and children's functioning: silence and communication, stigma and resilience

In this article I argue that narrative accounts of the effects of parental mental disorder (particularly mood disturbance) on children's functioning may provide unprecedented windows on crucial issues of silence, stigmatization, diagnosis, etiology, and treatment, which can mutually inform empirical research efforts. In publishing a book-length account of the life of my father, The Years of Silence are Past (Hinshaw, 2002b), I departed from my usual academic writings and gave voice to a complex and troubling life history, marked by misdiagnosed bipolar disorder and misguided treatment that lasted 40 years. Herein, I focus on the ramifications of this narrative for scientific and clinical efforts in the field, including the still-prevalent stigmatization and silence surrounding mental disorder, the great need for accurate diagnosis and responsive treatment, the complex and transactional web of biological and environmental risk factors that exist for mental disturbance, the blending of inner experience with social realities regarding symptom content, the resilience and strength that can accompany mental disorder, and the ways in which parents with mental disturbance can promote active communication with their offspring. Narrative accounts may be particularly important in reducing silence and in framing the next generation of empirical research questions; blending qualitative and quantitative methods may help address crucial goals related to child functioning in the presence of parental mental disorder.