Bipolar Disorder - Supporting Children
In this article, GP Principal Dr Gwyndaf Williams presents an overview of bipolar disorder to assist school staff to gain an understanding of the condition together with some practical tips for planned support.
What is Bipolar Disorder?
Bipolar disorder (formerly known as manic depressive disorder) is a mental health condition that affects a person’s moods, which can swing from one extreme to another.
People with the disorder have episodes of:
- feeling very low and lethargic, losing interest in or the pleasure of most activities;
- feeling very high, overactive and unusually irritable.
The high and low phases of the disorder are often so extreme that they interfere with everyday life such as sleep, energy, judgement and behaviour.
What are the signs and symptoms of Bipolar Disorder in children?
Bipolar disorder is most often diagnosed in older children and teenagers, but can occur in children of any age. Signs and symptoms of bipolar disorder in children include:
- Insomnia or significantly decreased need for sleep and night terrors;
- Cravings, especially for sweets and carbohydrates;
- Severe mood swings that are different from usual mood swings, explosive, lengthy and sometimes destructive rages;
- A depressed or extreme irritable mood for most of the day, nearly every day during a depressive episode;
- Crying without any apparent reason;
- Hyperactive, impulsive, aggressive or socially inappropriate behaviour;
- Impaired judgement;
- Being impulsive;
- Risky and reckless behaviours that are out of character, such as alcohol or drug abuse, spending sprees or sexual promiscuity;
- An inflated / unrealistic view of own capabilities e.g. they truly believe that they know more than their teacher, that they have the ability to fly;
- Defiance of authority;
- Separation anxiety;
- Delusions and hallucinations;
- Suicidal thoughts or behaviours, mainly in older children and teens.
A number of childhood disorders cause symptoms similar to those of bipolar disorder, so diagnosis can be challenging and difficult to determine. Children with the disorder experience symptoms in distinct episodes. Between these episodes, they return to their usual behaviour and mood. It is a lifelong condition, but mood swings and other symptoms can be managed by following a treatment plan.
Effects of Biploar on a child's learning
Bipolar disorder affects learning in a number of ways impinging on attendance, concentration, executive function and cognition. The side effects from medications can also affect the child's ability to learn and their energy levels. Even when their mood is stable, the disorder still often causes cognitive deficits, such as the ability to:
- Pay attention;
- Remember and recall instructions and information;
- Think critically, categorise and organise information;
- Employ problem-solving skills;
- Rapidly coordinate eye-hand movements.
Practical Support for children with Bipolar Disorder
As you can see from the list above, the cognitive deficits that children with bipolar disorder experience will undoubtedly have a negative effect on their readiness and ability to learn and form relationships with their peers. Focusing on the following core skills will help facilitate learning and the development of a successful and secure relationship with a child diagnosed with bipolar disorder. This includes practical steps such as:
- Seating the child where there are less distractions;
- Taking a flexible approach by adapting curriculum content, assignments and how topics are presented so they are accessible. This includes shortening assigned work, including homework, to focus on quality not quantity;
- Scheduling the most challenging tasks for times when the pupil is best able to perform them;
- Staying calm and modelling desired behaviour;
- Being patient;
- Ignoring minor negative behaviours;
- Providing behavioural choices which focus on encouraging positive behaviours;
- Resolving conflict in non-confrontational ways;
- Being receptive to change, taking on board strategies recommended by other professionals;
- Working with parents to identify patterns in behaviour that may help to identify successful ways of handling specific situations;
- Ensuring changes in the pupil's home life or medication are known in order to work around them constructively at school;
- Carefully planning support, especially during times of transitional change e.g. changes to the daily schedule of events, educational visits, as school holidays approach and transitions such as changing class, teachers or school.
Ensuring that the above strategies are built into the child’s support plan will greatly improve their experience of school life and enable them to achieve their full potential.
Want to know more about supporting mental health? Check out our Supporting Mental Health and Wellbeing training.
Dr Gwyn Williams