Bi-Polar Disorder

Another disorder that is becoming more common in the special education classroom is Bi-Polar Disorder. As cases of childhood depression increase, there is a possibility that childhood bi-polar disorder will increase proportionately. According to recent studies, nearly 30% of children with major depression will go on to develop a bi-polar course.

It is not yet known what causes this illness. Biology and genetics seem to play a major role, but environmental stress and individual personality traits may also play a part in bringing on an acute episode. Bi-polar disorder is an episodic illness in that the child may function normally for the periods of time in between the manic episodes. Because so many of the possible symptoms of bi-polar disorder overlap with those of other childhood disruptive disorders, diagnosis can be rather difficult. Some of the overlapping symptoms include aggression, poor school performance, distractibility, restless sleep, and sexually inappropriate behavior.

Bi-polar disorder in adults and children is characterized by the individual experiencing episodes of mania, or elation, followed by low mood, or depression. The specific symptoms of these two primary states associated with the disorder are, as might be imagined, at opposite ends of the spectrum. During the manic state, the child may feel total euphoria. In the early stages, the child may, however, simply appear more sociable, active, talkative, self-confident, perceptive, and/or creative that usual. The child’s mood may elevate to the point where he/she may experience some or all of the following: increased strength and energy; decreased sleep; extreme irritability; rapid, unpredictable emotional changes; racing thoughts or "flight of ideas;" increased interest in activities; grandiosity, or inflated self-esteem; and poor judgment. During the depressive state that follows, the child begins to enter a sad mood that can be accompanied by : a lack of energy; sleep problems (too much or too little); loss of interest in school, family, and/or friends; a change in eating habits; a preoccupation with failures or inadequacies; a loss of self-esteem; feelings of guilt; excessive concern about physical complaints; and crying easily and possibly having suicidal and occasional homocidal thoughts.

No matter which of the above symptoms present themselves in the classroom, the child suffering from bi-polar disorder is a special challenge to the teacher. These children are usually highly creative, sensitive people who are high achievers, sometimes to the point of being perfectionists. It is important to remember that the child has as much difficulty dealing with the effects of the illness as the people around the child do.

Treatment of bi-polar disorder depends on several factors. Since there is no cure for the disorder, it is important to select the best therapeutic approach(es) possible for the child’s well-being. In many cases, monitored medication programs have proven beneficial in smoothing out and reducing the frequency of the highs and lows. Counseling and therapy for the child, and possibly the family, can also be a source of great benefit to the situation. When considering medication as a treatment alternative for the child suffering bi-polar disorder, care should be taken to examine all options and to monitor the child’s progress carefully. At this time, most of the studies that have been conducted on the effect of prescription medication on bi-polar patients has been conducted on adults. Since children are still in the process of maturing, it is possible that they may not respond to medications in the same fashion as an adult.

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