What is Childhood Bipolar Disorder?

Childhood Bipolar Disorder also known as manic depression is a serious brain illness defined as a disorder marked by extreme changes in mood, thinking and behavior.  These extreme mood changes are unlike "normal" childhood moods because the symptoms are more severe and cycle more quickly.  These extremes can have a child extremely happy and more active with little need for sleep to lethargic and self loathing leading to possible self harm or suicide. These changes make getting along with others difficult and learning almost impossible at times because the rapid change in moods causes a chronic irritability with few clear periods between episodes.  Scientists think that childhood bipolar disorder may have to do with genes, abnormal brain structure/function and anxiety though the cause is not always clear. Co existing conditions include but are not limited to substance abuse, Attention Deficit Hyperactivity Disorder and other mental health issues. 

Signs and Symptoms

·         Racing thoughts and speech

·         Risky or dangerous behavior

·         Intense temper tantrums/anger unjust with the event

·         Extreme sadness/lack of interest in play

·         Rapid mood changes lasting hours or a few days

·         Lengthy explosive and destructive rages

·         Separation anxiety

·         Defiance of those in authority

·         Hyperactive agitation and distractibility

·         Little sleep or too much sleep

·         Bed wetting and night terrors

·         Strong and frequent cravings for carbohydrates and sweets

·         Feeling of worthlessness

·         Hyper sexuality, increased sexual thoughts/feelings/behaviors/use of sexual language

·         Impaired judgment

·         Thoughts of hurting self or suicidal

·         Delusions/hallucinations

·         Increased goal directed activity/physical agitation

Some symptoms can show up in infancy with mothers of bipolar children reporting extreme difficulty in settling the child down and erratic sleep patterns plus major clinginess and uncontrollable tantrums triggered by the word no.

Help and Treatment

An experienced doctor will ask many questions about how the child behaves, feels and if there is any mental health issues in the family.  With the family and the doctor(s) working as a team symptoms can be managed and improve over time.  Medication plus therapy are the standard treatments.  Efficacy and symptom changes require changes of medications; these are expected so having a chart of your child's moods and behaviors is vital to knowing when cycles are happening. 

Childhood Bipolar Disorder and Education

This is significant health impairment (like epilepsy) dependent on medications so the child is entitled to accommodations to help them succeed in school. The disorder itself and some medications can cause the child to have sensitivities to lights, noise and stress, making motivation and energy change the child's functioning vary at different times of the day, season and school year.  Any factors that affect the child's education must be identified and addressed in a Individualized Education Plan (IEP) and take into account periods when the child functions well (less intense needs) and illness (more intense needs).  The accommodations need to be backed up via letter and phone call from the treating doctor to the Special Education Coordinator of the child's school. Sometimes a Educational Attorney may be needed to get the child the accommodations that are needed.

Helpful Accommodations:

·         Special education testing and or services in preschool

·         Small or self contained classrooms

·         An aid to help the child in the classroom

·         Notebook or email for communication between home and school

·         Decreased, extended or excused deadlines for school work

·         Later start to school if lethargy is an issue during a cycle

·         Recorded books to help with concentration

·         A safe place in the school for the child to go to when feeling overwhelmed

·         A designated staff member for the child to talk to when stressed

·         Unlimited access to the bathroom and water fountain

·         Art and music therapy

·         Test time extension

·         Calculator for math

·         An extra set of school books at home

·         Keyboard/dictation for writing

·         Regular weekly meeting with Mental Health Therapist or school psychologist

·         Social skills and peer support groups

·         School sponsored annual meetings with the treating doctor(s) for training

·         Engaging curriculum for creativity to reduce boredom

·         Tutoring for extended absences

·         Weekly goals and rewards for achievements

·         When in acute phase a day hospital for treatment

·         Therapeutic day school for extended relapse or after hospitalization before going back to school otherwise placement in a residential treatment center if therapeutic is not near child's home or cannot meet child's needs.

 

Support

Currently there are no support groups for Childhood Bipolar Disorder in the Dayton area.  Feel free to talk to either Kettering Behavioral Medicine Center at (937) 534-4600 or via web at  http://telecomadvisors.biz/www.kmcnetwork.org/kbmc/youth.cfm you may also want to contact National Alliance of Mental Illness Ohio (NAMI Ohio) (937) 299-3667 or www.nami-mc.org to find support groups.