1. BIPOLAR DISORDER Designed by Debra Caywood-Rukas 7/02

2. Bipolar Disorder

3. 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

4. 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 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 SIGNS IN YOUNGER CHILDREN  Poor sleep and night terrors  High activity level  Easily startled  Bedwetting  Oppositional behavior

5. Range of Mood and Emotion severe mania mild to moderate mania (hypomania) normal-balanced mood mild to moderate depression severe depression

6. 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

7. Medication 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 “Mood-stabilizers”Medicine combinations

8. 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

9. 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

10. 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/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/ Illinois State Board of Education (ISBE) http://www.isbe.state.il.us/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.nlm.nih.gov/medlineplus/druginfo/drug_Aa.html http://www.healthsqr.com/aindex.htm 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: infoctr@nmha.org; Web site: http://www.nmha.orghttp://www.nmha.org BOOKS: The Bipolar Child by Demitri F. Papolos M.D. The Explosive Child by Ross W. Green Ph.D. SCHOOL: http://www.bipolarworld.net/job_school.htmlhttp://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)

11. Thank You The End