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BIPOLAR DISORDER Designed by Debra Caywood-Rukas 7/02 Bipolar Disorder What is Bipolar Disorder? “Manic-Depression” • • • • • • • A brain disorder affecting moods and energy that effects over 2 million in the U.S.A.* Emotions, thoughts and moods are distorted resulting in mood swings that are overly “high” to extremely sad and hopeless Defined as having one or more manic or mixed episodes and depression episodes lasting most of the day, every day for 2 weeks or more A long-term illness that typically develops in adolescence or early adulthood but symptoms often seen in childhood Often misdiagnosed as ADHD, OCD, OD, CD and depression and sometimes schizophrenia Often leads to suicidal thoughts Can be treated and lead full productive lives Signs and Symptoms MANIC • Feelings of grandiosity or very • • • • high self-esteem, euphoric Extreme talkativeness, racing thoughts Decreased need for sleep Highly distractible Engaged excessively with pleasurable activities, often recklessly SIGNS IN YOUNGER CHILDREN Poor sleep and night terrors • High activity level • Easily startled • Bedwetting • Oppositional behavior • • • • • • DEPRESSION Ongoing sad, anxious or empty mood Lack of energy and ability to concentrate Sleeping too much or too little Lacks interest in others and activities, irritable, feeling hopeless and worthless Thoughts of death or suicide Range of Mood and Emotion severe mania mild to moderate mania (hypomania) normal-balanced mood mild to moderate depression severe depression Treatment • Just like long-term illnesses such as diabetes and • • • • • heart disease, bipolar disorder is an illness that requires medication to improve quality of life Not all medications work for every person Severity of moods and side effects must be weighed Medical management by a psychiatrist is best A combination of medication and talk therapy is most effective, specifically cognitive behavior and family therapy Long-term management of symptoms reduces risk of suicide ** suicide rate 10-15%, NIMH Medication “Mood-stabilizers” Medicine combinations Lithium reduces manic episodes and aggression. Eskalith, Lithobid, Lithonate • Side effects: upset stomach, tremors, headache, weight gain, tiredness and difficulty with memory. Anticonvulsants/Antiepileptics reduce seizures, mania, aggression. Side effects include upset stomach and drowsiness. • Tegretol Carbamazepine: nausea, irritability and agitation • Depakene &, Depakote Valproic: hand tremors and loss of hair • Neurontin/Gabapentin, Lamictal/lamotrigine, Topamax/topiramate and Gabitril tiagabine are the newest medications. Side effects are similar with the addition of rash, nausea & dry mouth School Accommodations • Inform teacher how disorder is manifested and alert to side • • • • • • • • • • effects of medication Is there an IEP? If so, accommodations, modifications and interventions are written along with goals Counseling with school psychologist or social worker Reduced work load due to level of concentration and fatigue Provide clear instructions to alleviate/prevent frustration Offer instruction, corrections and feedback in a calm, positive manner Prearrange an area in and/or outside the classroom for the student to retreat to when needed and a discrete cue Allow extra time to complete assignments Mutually choose a peer mentor to assist when needed Consult with the school psychologist for additional information Employ effective classroom management programs Family Issues and Interventions • Attend to behavior such as rage with therapeutic hold, quiet retreat area and pick your battles, behavior modification does not work well • Siblings relationships and marriages often become strained • Get family therapy • Don’t ignore signs of suicide ideation or extreme hopelessness • Educate family on disorder and how to deal with mood swings • Seek support groups and parent resources Resources WEBSITES National Institute of Mental Health (NIMH) http://www.bipolarbrain.com/SoWhatsBipolarIllness.html http://www.nimh.nih.gov/publicat/bipolarmenu.cfm http://www.nimh.nih.gov/publicat/manic.cfm Excellent brochure and other pertinent information National research of mental health , booklet. Articles Northern County Psychiatric Association (Maryland) http://www.ncpamd.com/Bipolar.htm articles, links on disorder, meds, suicide, etc Pediatric Psychiatry Pamphlets http://www.klis.com/chandler/pamphlet/bipolar/bipolarpamphlet.htm definition, case studies, treatment, side effects Child and Adolescent Bipolar Foundation (CABF): Wilmette, IL Phone: (847) 256-8525 http://www.bpkids.org/ National Mental Health Associatopn (NMHA) http://www.nmha.org/infoctr/factsheets/76.cfm Pediatrician Guide to Health and Safety http://www.keepkidshealthy.com/ ASSOCIATIONS National Institute of Mental Health (NIMH) Bethesda, MD 20892-9663 Phone: (301) 443-4513 Depression and Related Affective Disorders Association (DRADA) Johns Hopkins Hospital Baltimore, MD 21287-7381 Phone: (410) 955-4647 or (202) 955-5800 National Alliance for the Mentally Ill (NAMI) Arlington, VA 22201 Toll-Free: 1-800-950-NAMI (6264) Web site: http://www.nami.org National Depressive and Manic-Depressive Association (NDMDA) 730 North Franklin Street, Suite 501 Chicago, IL 60610 Toll-Free: 1-800-826-3632 : http://www.ndmda.org National Mental Health Association (NMHA) Alexandria, VA 22314-2971 Toll-Free: 1-800-969-NMHA (6642) E-mail: [email protected]; Web site: http://www.nmha.org BOOKS: SCHOOL: Illinois State Board of Education (ISBE) http://www.isbe.state.il.us/; Special education information, IEP MEDICAL TERMS AND MEDICATION INFORMATION Dictionary: http://www.medicinenet.com/script/main/AlphaIdx.asp?li=MNI&p=A_ DICT RX Drugs: http://www.nlm.nih.gov/medlineplus/druginfo/drug_Aa.html http://www.healthsqr.com/aindex.htm The Bipolar Child by Demitri F. Papolos M.D. The Explosive Child by Ross W. Green Ph.D. http://www.bipolarworld.net/job_school.html http://www.schoolbehavior.com/conditions_bipolar.htm http://www.nami.org/youth/schoolprog.html SUPPORT GROUPS and DISCUSSIONS: http://www.soc.support.depression.manic http://www.families-first.com/whc/depression3.htm http://www.bipolarparents.vitualave.net/ *National Institute of Mental Health (NIMH) ** Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) Thank You The End