When a person receives a diagnosis of bipolar disorder, their family is changed at the same moment — and usually without any support of their own. As with many health issues, the focal point is the patient.
I have watched this happen scores of times. A diagnosis arrives and it is, in one sense, a relief — finally, a name for what has been happening. But in another sense, it opens a door to a long corridor of questions.
The questions families ask
What does this mean for us? Is this genetic? What do we say to the children? How do we behave during an episode — do we intervene, or give space? What if he refuses medication? What does a good week mean — is she really better, or is this the beginning of a high?
These questions are not clinical questions. They are human questions. And the clinical system, for all its capabilities, does not always have the answers.
The secondary patient
In my practice, I coined a phrase that has stayed with me: the secondary patient. The family member who sits in the background. Who does not present as unwell. Who is, in fact, managing extraordinarily well on the outside. But who is carrying something immense – invariably being asked to carry it alone.
Secondary patients rarely seek help. They are too focused on the person who is 'officially' ill. And there is a stigma — unspoken but real — around admitting that loving someone with a mental illness is also, sometimes, its own kind of suffering.
What I wanted the novel to say
In the Name of the Mother is, in many ways, the story of the secondary patients. It is the story of what happens to a family when the diagnosis is old news — when the drama of the initial episode has passed and the long, ordinary, complicated work of living with it begins.
If you are that family member — exhausted, loving, uncertain — this book was written for you.