Bipolar Disorder in children involves episodes of mania and depression.
A manic episode is defined as a distinct period of excessively elevated (i.e., inappropriately happy) or irritable (i.e., temper tantrums and rages out of proportion to events) mood. Symptoms may include inflated self-esteem, grandiosity, decreased need for sleep, rapid, loud, or uninterruptible speech, racing thoughts, increased distractibility, increased goal-directed activity/psychomotor agitation, and/or excessive involvement in pleasurable or dangerous activities. Children or adolescents with BP may display intense irritability or rage, or they may show silly, giddy, overexcited, overtalkative behavior coupled with grandiose beliefs (i.e., believe he/she can fly, walk on water, or jump off buildings without being harmed).
An episode of depression is defined as a distinct period of sad or irritable mood or markedly diminished interest/pleasure in most activities and is accompanied by four or more symptoms including: significant appetite change, sleep problems, restlessness or slowed movement, fatigue, feelings of worthlessness or excessive guilt, problems concentrating, and recurrent thoughts of death and/or recurrent suicidal thoughts, plans, or attempts.
In contrast to adults, children diagnosed with Bipolar may exhibit both manic and depressive episodes at the same time or within the same day. Manic and depressive moods in children often are expressed as intense irritability. How does Bipolar Disorder impact classroom performance? At school, students with BP may exhibit the following behaviors: irritability, difficulty concentrating, loss of interest (may take the I dont care attitude), slowness of thought, fatigue, somatic complaints, tardiness, truancy, failure to complete homework, and or school refusal.
As well, since many children with BP are medicated, it is important to consider the side effects of the medication.
What can be done at school?
General suggestions for students with Bipolar Disorder include the following:
- Provide an organized, predictable, and structured classroom with clear expectations and a positive discipline style.
- Plan for down times in the classroom or unstructured settings by assigning tasks for the student to perform. Physical tasks allowing movement may be helpful (i.e., running an errand, erasing boards, etc.).
- Expect and be flexible as symptoms change (i.e., shape expectations regarding amount of work and time frames based on the student’s attention, energy, and motivation.
- Be aware of medication side effects.
- Allow for small breaks during the day.
- Establish a unobtrusive signal for the student to use if he/she needs a break.
- Establish a safe person/place for the student to go to regain control.
- Collaborate with parents, school psychologist, and counselors to determine any events or actions that may trigger a meltdown or explosive outburst.
- Collaborate to determine physical signals to look for which may indicate the student needs a break (i.e., the student may become excessively fidgety).
Other Resources? The following resources may also be helpful:
- The Child and Adolescent Bipolar Foundation
- Raising a Moody Child: How to Cope with Depression and Bipolar Disorder: A Book for Parents By: Fristad & Arnold (2003)
- Understanding and Educating Adolescents with Bipolar Disorder: A Guide for Educators By: Anderson, Kubisack-Boyd, Field, & Vogelstein (2003)