Category — 2.9 Children with Mental Illness: Mood disorders – Bipolar Disorder

Children with bipolar disorder suffer from extreme mood swings. Sometimes the child suffers from depression. Other times, the child suffers from what the psychology community calls “manic episodes. ” This is an episode lasting a week or more and is when  a person experiences mania, an abnormally cheerful or joyful mood. A depressed or manic state can last several hours or several days. A child can swing between these two extreme moods several times per day or only a few times per year.

When the child is depressed, he or she could show the following symptoms:

• Feeling very sad;
• Have little or no energy;
• Having little or no appetite, or over-eating;
• Not sleeping enough or oversleeping;
• Feeling worthless and having very low self-esteem;
• Thinking about committing suicide;
• Feeling hopeless and helpless;
• Finding it hard to concentrate and carry on typical daily activities (such as taking a shower);
• Experiencing little or no pleasure in any activity, including things that used to provide the child with great pleasure (Fig. 1);
• Experiencing physical pain even though there is nothing medically wrong with him or her.

Figure 1. Experiencing little or no pleasure

When the child is in a manic state, he or she could exhibit the following symptoms:

• Feeling very important (grandiosity);
• Feeling that one can do anything (omnipotence);
• Feeling very happy for no apparent reason (euphoric);
• Feeling as if one has a lot of energy and sometimes going days without sleeping;
• Having an unusually high self-esteem;
• Having a lot of self-confidence;
• Speaking very fast;
• Exercising poor judgment because one feels very confident;
• Engaging in risky behavior (some people have jumped off the roofs of their houses during a manic episodes because they felt that they could fly);
• Being easily distracted;
• Having trouble concentrating on a specific task because one is thinking about a lot of different things at the same time;
• Getting lower grades at school because one feels that there is no need to study because one is so smart.

Children with bipolar disorder need help. They need psychotherapy from experienced clinical psychologists or psychiatrists with experience working with children.

The most common type of psycho-therapy for children who have bipolar disorder is cognitive behavioral therapy (see ECI Glossary) (CBT). For information about other types of therapy, please visit the birth to six section of this course, and scroll down to the bottom of the page. Children who have bipolar disorder can also be placed on medication (Fig. 2). The child’s parents, along with his or her psychiatrist can decide on what the best medical options would be.

Figure 2. Medication

In the classroom, the bipolar child can be helped in the following ways:

• For depressive episodes:
  • Letting the child know that he or she is welcome and safe in the classroom;
  • Making sure the child eats enough (if under-eating);
  • Allowing the child to go to the nurse’s station and take a nap if he or she is not sleeping enough at home;
  • Allowing the child to take extra time to do assignments and homework;
  • Giving the child extra time to complete tests (Fig. 3);
  • Giving the child lesson outlines to make it easier for him or her to follow what is happening in the classroom;
  • Giving the child frequent but sincere compliments;
  • Knowing the side effects of any medication the child may be taking;
  • Collaborating with the school counselor.
  • For manic episodes:
    • Letting the child know that he or she is welcome and safe in the classroom;
    • Encouraging the child to be calm when having a manic episode;
    • Watching the child very carefully when having a manic episode;
    • Giving the child frequent physical breaks so he or she can release all the extra energy that he or she has;
    • Giving the child extra work or activities to engage in if he or she finishes class work quickly;
    • Helping the child to pace him or herself  to make it easier for him or her to concentrate;
    • Knowing the side effects of any medication the child may be taking;
    • Collaborating with the school counselor.

Bipolar disorder is a lifelong condition for which there is no cure. Children who receive appropriate and effective therapy (psychological, medical or both), grow up to be healthy and happy adults.

Figure 3. Taking a test

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