BIPOLAR DISORDER typically develops in late adolescence or early adulthood. But experts say there is no exact time frame for the onset, as some people can have their first symptoms during childhood, while others, later in life. Often it is not recognized as an illness, and it is likely for a manic depressive to go untreated for years before his or her problem is correctly diagnosed. According to Balderama, bipolar patients on average are diagnosed properly only on the seventh or eighth year of their illness.

As children, Ruby and her siblings probably thought their mother somewhat strange, but still wonderful and, on most days, a delight to be around with. Sometimes, their mother would wake them up at four in the morning, just so they could gaze at the stars. They even had a chant. "I don't remember it exactly now but I remember we clapped our hands and did a little dance," Ruby says. "Mama told us that by doing that, we would absorb the powers of the stars."

But then there were also incidents like one that occurred during the late '70s. In the middle of the night, their mother woke them up, not to gaze at stars, but to accompany her to Malacañang. They were then just four children in the family; Ruby, the second child, was only seven years old. The country was under the dictatorship and there was a curfew. But Ruby's mother was adamant that they had to go to the Palace because she had to talk to the president.

The police stopped their vehicle at the Palace gates, and trained their armalites at the insistent woman, her four frightened children, and the family driver. "It was scary," recounts Ruby. "I remember we all started crying, begging her to go home. And that was what convinced her to turn back."

Ruby was already 11 when her mother was finally diagnosed with bipolar disorder. Her father had taken her mother to specialists in the States and Japan before she was pronounced to have the illness. Her father then sat down with the two eldest children, which happened to be Ruby and her ate. He told them, "Mama is ill, we all have to help out."

"Papa was also at the end of his rope," says Ruby. "He did not know what had happened. It was not the woman he loved and married. She was different."

She says she knew her father needed help, but at first she resented being asked to help take care of her mother. It was only later that she realized how "wrong" it was to feel that way. "It was only fair that we would help Papa," she says. "No one will ever be able to understand, no one will be able to help Mama and the family, more than ourselves."

Ruby's eldest sister took over the role of the mother in the family. She was not even 15 at the time, but she went to market, planned and cooked the meals, made sure all of the children kept strict bedtime hours and were awake on time, ready for school. Ruby's ate also managed the family's finances. Ruby was the younger set's babysitter, a task she enjoyed. She says even now, "I had it easy. Take them to the playground, tell them stories. What was so difficult with that?"

But the younger ones (four boys after Ruby and then another girl, the family baby) soon took on responsibilities at home, too. Even the boys were not spared, though the three sisters would grumble they had the more difficult tasks to accomplish. Ruby, however, reasons that maybe this was because the girls were indeed innately more responsible. Besides, all seven of them had to band together not only to protect their mother, but to help each other out.

THE WAY Ruby's family "reversed" their roles as soon as the mother fell ill is a coping mechanism common among those who have a member suffering from bipolar disorder, says Balderama. "The family will adjust so they can all help to manage the illness," she explains. Usually, she says, the pattern of caregiving will follow whatever structures already exist within the family. In Ruby's family, however, it was the primary caregiver that now needed care, and so the older girls stepped up.

Experts say that the combination of medication — to stabilize the chemical imbalances in the brain — as well as psychiatric counseling, is the best strategy for managing bipolar disorder. Indeed, it's a prescription that Ruby's family has been following for more than two decades now. "Patients need to strictly comply with the regimen," says Balderama. Otherwise, she says, the episodes will come more often and there will be less hope for functioning properly.

Balderama thinks Ruby's mother "could still have been a mom. Her bipolar disorder didn't mean she was incapacitated." Whatever role reversal must be done — such as young children assuming the roles of a parent — is, ideally, a temporary arrangement, she says. "You can change that," says the psychiatrist. "It doesn't have to be that way, so that the burden becomes less and the patient can also try to function normally."

Ruby herself now admits her mother could have helped herself more, instead of relying on them. Yet she says she and her siblings probably turned out better because of their mother's illness, which made them mature faster.

"We took on responsibilities at an early age, and we had to rely on ourselves and stand up for ourselves," Ruby says. "Also, we learned early on what was right and wrong, by ourselves, without others telling us — least of all our mother, from whom we should have been taking our cues, but who was not equipped to provide them."

"We channeled ourselves to being better people," she continues. "Or at least, to not being victims. That is what I refuse to be. I will never be a victim. I may be pained, but I will not be a victim of my mother's illness."

Today it seems that no one among them (the eldest is 38, Ruby is 35, the youngest in her late 20s) is such a "victim." Ruby's psychiatrist told her, in fact, that compared to other families with a similar situation, theirs has survived with minimal scars. "All of my sisters and brothers turned out to be good people," says Ruby. "Growing up in an atmosphere that was so unstable, we could have easily turned out badly but we did not."

As for their father, Ruby says their Papa is the one who is consistently the kindest, and most understanding, toward their mother. "I do not know how he does it," she says. "Sometimes I rib him, 'You're not related to her anyway. Why are you so good to her?' Love? Damn love."