May is Mental Health Awareness Month, and our goal with MSN Causes is to help you understand the various aspects of mental illness.

We begin our coverage this month with our celebrity hero, Joe Pantoliano, talking about his personal experience with depression and his commitment to helping others through his passion project, No Kidding? Me Too!

Understanding the effects of mental illness on a loved one is very important, and we share stories from several angles.

Mental illnesses are treatable, and we talk about some surprising treatments and share some wise words from two prominent psychotherapists.

We hope you’ll tweet, post and share the stories you like to get the word out. Talking about mental illness is up to all of us.

Preschoolers and tantrums go together like Bert and Ernie. Young kids get spastically silly. They flip out when a friend snatches their toy, or become Mr. Hyde when they’re tired or hungry. They imagine themselves unstoppable superheroes and elegant princesses.

But when does normal childish behavior veer into something different, something more extreme and unsettling?

“There are a lot of children with ‘terrible twos’ and tantrums,” says Muffy Walker. But her youngest son’s fits of kicking and throwing things were not like the outbursts she’d seen in his two brothers. They were scarier.

“He had a lot of rages, a lot of threatening behavior – threatening to hurt himself,” she says. “He was very angry all the time, unprovoked.”

By age 4, Walker’s son was seeing a psychiatrist and taking anti-depressants. But something was still wrong.

After checking into a hotel while on a family ski vacation, the boy – about 5 at the time – began leaping between two beds. When told to stop, he raced to the bathroom, locked the door, filled the bathtub with water and told his parents he would drop a hairdryer into it. They broke down the door to stop him.

By 7, after the boy showed clear signs of manic behavior, a pediatric mental-health expert confirmed what Walker and her husband suspected: Their son was bipolar.

Bipolar disorder is an incurable disease defined by episodes of extreme moods and behavior, swinging between dark depressions and mania. Over recent decades, doctors have grown to accept the idea that younger teens and prepubescent children could have the disorder, but whether preschoolers – kids as young as Walker’s son – could be bipolar remains controversial.

While bipolar adults and children can experience many of the same manic traits – sleeplessness, scattered and restless behavior, irritability, feeling overly joyful, a sense of grandiosity – these symptoms can be harder to recognize in kids.

“Being happy and silly is part of being a kid. The question is where you draw the line,” says Dr. Boris Birmaher, director of the Child and Adolescent Anxiety Program and co-director of Child and Adolescent Bipolar Services, both at the University of Pittsburgh Medical Center.

Medical experts distinguish between normal highs and lows and more serious manic episodes by observing the severity of the symptoms, the presence of multiple traits associated with bipolar disorder, how long the episodes last and if they keep coming back. In the more severe cases of bipolar disorder, episodes of depression, mania or a mix of both will last most of a day for a week or more. Some bipolar kids cycle very quickly between extremes, and sometimes the episodes are milder.

To muddy things further, bipolar disorder can look similar to other mental-health problems such as depression, attention deficit hyperactive disorder (ADHD) and autism. And recently, mental-health experts have added a new category of disease: temper dysregulation disorder with dysphoria, which includes a syndrome that makes kids chronically irritable.

It’s a complicated field of ailments, and a correct diagnosis is critical because the treatments can be radically different. If a child is misdiagnosed, a doctor could prescribe a medication that actually makes his bipolar symptoms worse. Approximately 2 percent of American children have symptoms of the disease.

“Parents really should be looking for someone who has expertise and experience assessing children, particularly children with severe mood disorders and who will take time with them. This is not the sort of thing you sit down very briefly with the child and come out with a diagnosis,” says Dr. Ellen Leibenluft, chief of the Bipolar Spectrum Disorder Section at the National Institute of Mental Health in Maryland.

It takes 10 years on average to travel from the first symptoms of bipolar disorder to diagnosis of the disease and effective treatment, Birmaher says.

Walker says she is certain that her son, now 19, was correctly identified as bipolar as a young child. After his diagnosis, it took another seven years to find the right cocktail of drugs to treat his disease.

Walker, who lives in San Diego, went on to co-found and lead the International Bipolar Foundation, which provides education, resources and support for people living with the disorder.

It’s critical, experts say, that bipolar kids get help as quickly as possible. Without treatment, they are more likely to have problems in school, find it difficult to make and keep friends, abuse drugs and alcohol, engage in risky behavior and become suicidal. The right medication can stabilize their volatile brain chemistry.

“There is help,” Birmaher says. “These kids can have a completely normal life.”

RESOURCES:

Bipolar Spectrum Disorder Section at the National Institute of Mental Health: A program studying kids with bipolar disorder or severe, chronic irritability to better understand the causes and effective treatment of these diseases. To participate, contact the program: bipolarkids@mail.nih.gov

University of Pittsburgh Medical Center Bipolar Institute: An institute providing diagnosis and treatment of bipolar disorder. It also conducts basic science, clinical and mental health services research, and is an international training center for research-based treatments.

International Bipolar Foundation: An organization working to eliminate bipolar disorder that provides referral services, supports research and aims through public education to remove stigmas associated with the disorder.

Depression and Bipolar Support Alliance: An organization facilitating support groups in communities nationwide that also provides up-to-date, scientifically based resources and information about bipolar disorder for the general public.

Ken Duckworth, medical director at the National Alliance on Mental Illness, owes his career to the disease that threatened to tear his family apart.

"There was this overwhelming hurricane that would periodically visit my life. There wasn't the freedom to talk about it. And it would disappear for months. It was confusing," he says. "My father was bipolar, and it was the reason I became a psychiatrist."

For children with parents who suffer from mental illness, life can be anything but predictable. Bipolar is a disorder of the brain that that causes severe or unusual shifts in mood, energy level, thinking and behavior.

"For my father, he felt it was normal to change his appearance, use drugs and alcohol, sleep very little, engage in grandiose ideas and projects, spend money profusely, and dissociate with his friends and family," says Zak Boone, 38, whose father was diagnosed when Boone was 21. "In each of these episodes, the family finally had to intervene as he became a danger to himself and others."

In Boone's case, his father's manic episodes would occur, almost like clockwork, every three years in the spring, and would persist through the summer.

The cyclical nature of bipolar disorder, as well as other mental illnesses, can make them particularly challenging for family members who are trying to help — and cope, says Patrick Hendry, senior director of consumer advocacy at Mental Health America, a Virginia-based nonprofit. The parent/child dynamic can also make role reversal a sensitive issue.

"When you have a parent who is used to taking care of things in life, then have a child come in and begin taking care of it, that can put a wedge in between them," says Hendry, who himself is bipolar, and has a parent and a son who both have the disorder.

His advice? Listen to the person who is afflicted.

"For the most part, people with mental illness have learned what works for them and what doesn't. Historically we've forgotten to simply listen to them. It's a quagmire a child can get in," Hendry says.

Of course, it's easier to listen to loved ones if they acknowledge their condition and are willing to get treatment. With bipolar as well as other types of mental illness such as schizophrenia, severe depression or Post-Traumatic Stress Disorder, it can be difficult to give broad-stroke advice, says NAMI's Duckworth, because every situation is different.

However, there are some basic suggestions worth keeping in mind from those who've been there.

"When someone has a serious mental illness in the family, it affects everyone in the family," says Duckworth. "Get treatment. It might be helpful to seek therapy for yourself to talk about your experience."

"If you don't take care of yourself, you can't take care of anybody else," agrees Hendry. "That's probably the most important lesson we've learned."

Lily Tollefsen, 33, whose father was diagnosed as bipolar when she was 29, says it's critical to find a support system. "Find a support group of your peers. … Talk openly about your fears, hopes and concerns. This is not a shameful thing and you will be blown away by how many people share your experiences."

Another vital skill is knowing when to let go.

"As a child of a person with mental illness, you most often have to be the adult in the relationship," Tollefsen says. "I've learned that I cannot fix him, but I can help him while living my own life. I notice that he is happiest when I am free rather than fretting over his health. It's a balancing act."

According to Hendry, studies have shown that the most important thing that moves people with mental illness toward recognition and ultimately the ability to live with the disease is having someone who believes in them.

"Love them," agrees Duckworth. "You don't have to provide a cure. It's a win if you have a loving relationship with them."

He adds that it's important to continue to celebrate the person's strengths, not just focus on the illness. "Increasingly, mental illness is thought of as more of a marathon than a sprint, a lifelong condition you have to learn how to master."

For years, veteran actor Joe Pantoliano thrilled audiences in films such as “The Fugitive” and “The Matrix,” but he could never quite get a grip on his own emotional happiness, engaging in destructive behavior to mask the dark feelings that had plagued him since childhood.

But that all changed when he was working on a film in 2006 called “Canvas,” which explored how mental illness affected an entire family. Pantoliano later went to see his doctor, who diagnosed him with clinical depression, or what he calls “brain dis-ease.”

“I was euphoric,” he says. “I felt like I had found a box of golden coins. I came to understand that I was treating my depression with depression-producing drugs, like sugar, wine and bad behavior.”

Pantoliano also discovered that when he discussed “Canvas” or his struggles with mental illness with his fans, they would respond in a surprising way. “They’d say, ‘No kidding, me too!’ or, ‘No kidding, so does my friend or family member!’” he says. “Everyone had someone in their life who was dealing with this. That’s when we decided to start the organization.”

No Kidding? Me Too! is Pantoliano’s passion project, a public charity whose mission is to remove the stigma and societal barriers attached to mental illness through education and by empowering sufferers to acknowledge their illness, seek treatment and become greater members of society.

“We want to make it cool and trendy and sexy to talk about your emotional life,” Pantoliano says.

With a star-studded advisory board that includes Robert Downey Jr., Samuel L. Jackson and Harrison Ford, Pantoliano has used his celebrity to bring the issue to the forefront, writing a memoir titled “Asylum: Hollywood Tales From My Great Depression” and directing a documentary titled “No Kidding, Me 2!” to shed more light on mental illness.

“Why is it that I can talk to you about my flu and there’s no stigma or shame in that discussion, but when you talk about your emotional life, people shut down?” Pantoliano says. “The reason why I wrote the book was to explain what it was to be me at this time in my life. It was, unquestionably, the best thing that ever happened to me.”

Directing the documentary also opened the actor’s eyes to the depth and breadth of the mental-illness issue around the world and how, once people were able to discover and discuss their issues, answers could be found.

“People would tell their stories and I’d hear amazing examples of recovery from a cross-section of America,” he says. “I thought, ‘Why isn’t their story being told?’ My depression doesn’t get the credit it deserves. It tells me something is wrong.”

Pantoliano hopes that his work with No Kidding? Me Too! will help to make the first step on the road to recovery an easy one – by getting those with depression-like symptoms to talk openly to people who will listen.

“I had a very nice woman I know come up to me with tears in her eyes and said, ‘When I was a teenager, you saved my life,’” Pantoliano says. “I didn’t know. But all I did was listen. That’s what people need to understand. You just need to listen.”