|Bipolar disorder (also known as manic-depression) is a serious
but treatable medical illness. It is a disorder of the brain marked
by extreme changes in mood, energy, thinking and behavior.
Symptoms may be present since infancy or early childhood,
or may suddenly emerge in adolescence or adulthood. Until
recently, a diagnosis of the disorder was rarely made in child-
hood. Doctors can now recognize and treat bipolar disorder in
Children and adolescents with bipolar disorder and their
families need to work closely with their doctor and other
treatment professionals. Having the entire family involved in
the child's treatment plan can usually reduce the frequency,
duration, and severity of episodes. It can also help improve the
child's ability to function successfully at home, in school, and in
Parents should learn all they can about bipolar disorder. Read,
join support groups, and network with other parents. Early
intervention and treatment can often stabilize mood and restore
wellness. You can best manage relapses by prompt intervention
at the first re-occurrence of symptoms.
Your child can reduce the minor mood swings and stresses
that sometimes lead to more severe episodes by adhering
to the following:
· Maintain a stable sleep pattern. Go to bed around the same
time each night and get up about the same time each morning.
Disrupted sleep patterns appear to cause chemical changes in
your body that can trigger mood episodes. If your child has
trouble sleeping, or is sleeping too much, be sure to tell the
· Maintain a regular pattern of activity. It is common for teens
to drive themselves impossibly hard and be involved in too many
· Do not use alcohol or illicit drugs. These chemicals cause an
imbalance in how the brain works. This can, and often does,
trigger mood episodes and interferes with medications. If your
child has a problem with substances, ask your doctor for help,
consider self-help groups such as Marijuana Anonymous, or
admit your child to a treatment center or residential program.
· Be very careful about "everyday" use of small amounts of
caffeine, and some over-the-counter medications for colds,
allergies, or pain. Even small amounts of these substances can
interfere with sleep, mood, or medicine. Also, some of these
seemingly harmless medications are abused, such as Coricidin.
· Support from family and friends can help a lot. Even the
"calmest" family will sometimes need outside help in dealing with
the stress of a loved one who has continued symptoms. Ask
your doctor or therapist to help educate both your child and
your family about bipolar disorder. Family therapy or joining a
support group can be very helpful.
Regardless of scheduled appointments or blood tests,
call your doctor if your teen exhibits the following:
· Suicidal or violent feelings
· Changes in mood, sleep, or energy
· Changes in medication side effects
· A need to use over-the-counter medications such as cold
medicine or pain medicine
It is very important to learn the warning signs of suicide. Take
any threats your child makes very seriously. Call 911 or a
hospital emergency room if the situation becomes desperate.
Encourage your child to realize that suicidal thinking is a
symptom of the illness. Tell your child that you love him and
that you would be devastated if anything tragic happened.
Examples of school-related accommodations helpful to
children and adolescents with bipolar disorder include:
· preschool special education testing and services
· small class size (with children of similar intelligence) or
self-contained classroom with other emotionally fragile
(not "behavior disorder") children for part or all of the day
· one-on-one or shared special education aide to assist child in
· back-and-forth notebook between home and school to assist
· homework reduced or excused and deadlines extended when
energy is low
· late start to school day if fatigued in morning
· recorded books as alternative to self-reading when
concentration is low
· designation of a "safe place" at school where child can retreat
· designation of a staff member to whom the child can go as
· unlimited access to bathroom
· unlimited access to drinking water
· art therapy and music therapy
· extended time on tests
· use of calculator for math
· extra set of books at home
· use of keyboard or dictation for writing assignments
· regular sessions with a social worker or school psychologist
· social skills groups and peer support groups
· annual in-service training for teachers by child's treatment
professionals (sponsored by school)
· enriched art, music, or other areas of particular strength
· curriculum that engages creativity and reduces boredom (for
highly creative children)
· tutoring during extended absences
· goals set each week with rewards for achievement
· summer services such as day camps and special education
· placement in a day hospital treatment program for periods
of acute illness that can be managed without inpatient
· placement in a therapeutic day school during extended relapses
or to provide a period of extra support after hospitalization and
before returning to regular school
· placement in a residential treatment center during extended
periods of illness if a therapeutic day school near the family's
home is not available or is unable to meet the child's needs
A Turning Point--
Learning that one's child has bipolar
disorder can be traumatic. Diagnosis
usually follows months or years of the
child's mood instability, school difficulties,
and damaged relationships with family and friends. However,
diagnosis can and should be a turning point for everyone
concerned. Once the illness is identified, energies can be directed
towards treatment, education, and developing coping strategies.
Click==> Educational Issues of Students with Bipolar Disorder
|Dealing with a
Ask The Parent Coach—
I’ve been following your program. It has been a
Godsend. I do have one question though. I’m a
bipolar mom. The daughter I’m having trouble
with is also bipolar. Do you have any tips on how
I can make this work even with my disability?
Let me start by sharing Katrina’s story (one of
my recent bipolar clients):
Most teens spend their time discussing their
latest crush with friends, studying for college
admission tests, and taking driver's education.
Not Katrina. When the 26-year-old Texas native
was 17, she was busy trying to talk car dealers
into selling her a new ride -- even though she
didn't have a dime to her name -- and staging
a two-week walkout from her high school
chemistry class because she wasn't "happy
with the level of the teaching."
But what seemed like normally high levels of
energy and ambition were just the beginning of
the full-blown mania that quickly followed.
"I wanted to have sex with anything, I didn't care
who or what," she recalls. "I felt like my mom
was trying to hurt me, and I had feelings of being
"I would go from moments of being totally happy,
bubbly, and having fun to moments when pain
from every point in life would come exploding out
and I would lose control," she says.
As a result of these symptoms and the horrific
depression that followed, Katrina was eventually
diagnosed with bipolar disorder.
Just about everyone has ups and downs from
time to time, but for people like Katrina, these
changes can be severe. Moods range from
ecstatic or irritable to sad and hopeless -- often
with extended periods of normalcy in between.
Manic episodes may mean increased energy,
euphoria, and an unrealistic belief in one's
abilities. People with bipolar disorder may go
on lavish spending sprees. They may also have
hallucinations (such as hearing voices) and
delusional thoughts, as Katrina did about her
Onset typically occurs in late adolescence, as it
did with Katrina, or early adulthood. But some
people develop symptoms later in life and still
others start showing them during childhood. The
illness affects children and teens differently from
the way it affects adults, according to results
from the Course and Outcome of Bipolar Illness
in Youth (COBY) research program. The very
young develop symptoms that last longer and
swing more swiftly from hyperactivity and
recklessness to lethargy and depression, the
While the exact cause of bipolar disorder is not
known, most researchers say that it is the result
of a chemical imbalance in certain parts of the
brain. And some evidence suggests that
individuals may have a genetic predisposition
to the illness.
More than two-thirds of people with bipolar
disorder have at least one close relative with
the disorder or with unipolar major depression.
True to form, Katrina has two uncles and a
grandfather with the disorder.
Bipolar disorder can't be cured but is typically
treated with medication, psychotherapy, and
lifestyle changes. Doctors often treat the mania
symptoms with one set of drugs, and use other
drugs to treat the depression.
Maintenance treatment with a mood stabilizer
such as lithium or an anticonvulsant drug can
substantially reduce the number and severity of
episodes for most people, but this can be a
tough pill to swallow.
When people with bipolar disorder are
depressed, they almost always know that
something is wrong. Nobody likes feeling that
But it's different for people who are hypomanic
or manic. Often, they don't think anything is
wrong. Or if they notice a difference in their mood
and personality, they think it's an improvement.
Mania and hypomania can be seductive. You
might feel more energized, creative, and
interesting. You might be able to get extra-
ordinary amounts of work done. So what's the
The fact is that manic phases often turn
destructive. Some consequences of a manic
episode can't be undone. You can wipe out your
savings account. You can have affairs that ruin
your marriage. You can lose your job. Most
dangerous of all, mania can make you do things
that risk your life or the lives of others.
Although hypomania or mania can feel good at
the moment, in the long run, you'll be happier,
healthier, more productive, and more successful
if you can keep a stable mood.
The mood swings of bipolar disorder can be
profoundly destructive. Depression can make
you isolate yourself from your friends and loved
ones. You may find it impossible to get out of
bed, let alone keep your job. During manic
periods, you be may be reckless and volatile.
Picking up the pieces after mood swings can
be hard. The people whom you need most --
especially your friends and family -- may be
angry with you or reluctant to help.
The best way to avoid these mood swings is to
get treatment for your bipolar. But unfortunately,
periods of hypomania, mania, or depression
aren't completely preventable. Even people who
always take their medication and are careful with
their health can still have mood swings from
time to time.
So that's why it's important to catch changes in
your mood early before they develop into
At first, mood swings may take you by surprise.
But over time, you might start to see patterns or
signs that you're entering a period of mania or
depression. Aside from a shift in your mood, look
for changes in your:
· Alcohol or drug use
· Energy level
· Sex drive
· Sleep patterns
You may also discover particular "triggers" --
situations or events that can provoke a period of
mania or depression. Some people find they're
more likely to become depressed or manic
during stressful times at work or during holidays.
Many people see seasonal patterns to their
mood changes. Of course, not everyone can
identify triggers. Also, some triggers can't be
anticipated or avoided, like a serious illness or
a traumatic event.
One good way to see patterns or triggers is
to keep a journal. Make note of big events,
stresses, your medication dosage, and the
amount of sleep you're getting. Over time, you
might see some patterns emerge.
If you know what your triggers are, you can
prepare for times when you might be most
vulnerable. Ask for more help from coworkers.
Have your family and friends check in more
often so you get extra support.
If you see the signs of potential trouble, get help.
Don't wait for the mood swing to pass on its own.
With quick intervention, you might be able to stop
a very minor mood swing from becoming a
Good luck. You can do this.