Bipolar disorder is a chronic brain disorder marked by bouts of extreme and impairing changes in mood, energy, thinking and behavior. The most apparent symptoms are behavioral. Bipolar disorder does not affect every child in the same way. The frequency, intensity, and duration of a child’s symptoms and the child’s response to treatment very dramatically.
Kids with bipolar experience intense mood states that don’t cycle in clear cut patterns. Children are more likely to have mixed mood states (symptoms of depression and mania present at the same time) and rapid cycling (switching between mania and depressions very fast) many times a day. Most typical pattern of cycling is low arousal states in the morning followed by increases in energy towards late afternoon or evening.
(Behaviors and symptoms in bold are common in Jada)
Common seem behaviors:
• Defiance of authority
• Difficulty making changes
• High levels of anxiety
• Easily frustrated
• Difficulty controlling anger
• Hyperactivity, agitation, and distractibility
Symptoms of mania:
• Euphoria (elevated mood)—silliness or elation that is inappropriate and impairing
• Racing thoughts
• Talkative—pressure to keep talking
• Impulsiveness (difficulty waiting one’s turn, interrupting others)
• Irritability or hostility when demands are not met
• Excessive distractibility
• Poor judgment
Symptoms of depression:
• Lack of joy and pleasure in life
• Withdrawal from activities formally enjoyed
• Agitation and irritability
• Pervasive sadness
• Sleeping to much or the inability to sleep
• Inability to concentrate
• Loss of energy
• Feelings of worthlessness
• Change in appetite
Depressed children may not appear to be sad. Instead they may withdraw, not want to play, need more sleep than usual, display chronic irritability or cry for no obvious reason.
Irritability is a common symptom of both depression and mania.
• Mania: irritability erupts into severe rages, which can include destructive, violent, or other dangerous behaviors.
• Depression: whiney and exceedingly difficult to please, snippy, snappy, grouchy, and downright nasty. It is severe, intense, and disruptive
Defiance and aggression are the most challenging moods to manage.
• It is important not to take it personally, keep you composure, and do not get involved in power struggles.
• An ultimatum or threat can easily force the child to make poor choices.
• Although they may appear to be trying to manipulate you, there are reasons for their behavior. They may be manic or just be trying to cover up their confusion over why they are saying and doing things that they know are inappropriate or why they can not get themselves to do what they are supposed to do.
Many kids are able to suppress their symptoms in certain situations. They can keep it together during school and fall apart as soon as they get home. They do this because they are exhausted from the effort to be “normal” at school and home is a safe place where their friends won’t see them being this way.
How Bipolar Disorder can affect learning
Bipolar disorder affects learning in a number of ways, ranging from difficulties with sleep, energy, school attendance, concentration, executive function, and cognition.
Even when moods are stable, the disorder often causes cognitive deficits, including the ability to:
o Pay attention
o Remember and recall information
o Think critically, categorize, and organize information
o Use problem-solving skills
o Quickly coordinate eye-hand movements
In addition, bipolar disorder can cause a child to be impulsive, talkative, distractible, withdrawn, unmotivated, or difficult to engage.
Despite all these challenges, a student with bipolar disorder CAN succeed in the classroom with the right supports and accommodations.
o Most important factor in these children’s success is the way adults respond to and work with them.
o Praise, encouragement, and key words elicit positive behaviors, while negativity helps the child spin out of control.
Teaching skills that make a teacher successful with typical students are essential when working with children who have bipolar disorder.
o Flexibility—adapt assignments, curriculum, and presentation style as needed.
o Patience—ignore minor negative behaviors and encourage positive behaviors. Most important is the ability to stay calm and be a model of desired behavior.
o Good conflict management skills—resolve conflicts in a non confrontational, positive manner.
o Receptivity—working collaboratively with the child’s parents, doctors, and other professionals to best meet the needs of the child.
In a manic mood
o Help them direct all that energy productively with hands-on projects and increased activity
o Send the child on errands
o Assign tasks involving motor activity
In a depressed mood
o Shorten assignment tasks
o Check in frequently to help them stay on task
o Ask what is wrong and how you can help will sometimes get the student back on task.
Adjusting your expectations doesn’t mean you’re giving in. It means you are meeting the child where she is—accepting what she is capable of right now, and the moment—and moving on from there.
Us
Before Jada started on medication, every day was a complete challenge. She could be in a completely happy mood and in an instant turn into such an angry child that she would rage for thirty minutes or more. Most days, she would come home and have complete meltdowns while trying to transition to being at home for the evening. Every command was met with a battle.
There have been and continue to be many challenges raising a child with bipolar disorder. There is no easy day and every day is completely different from the last.
The only thing you can count on with a bipolar child is that you can't count on anything.
For more information on bipolar disorder check out the following websites:
