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“The Storm in my Brain:” A Teacher’s Guide to Pediatric Bipolar Disorder.
Pediatric Bipolar Disorder (PBPD) is a neurologically based mood disorder found in children 12 years and under. A serious, but treatable mental illness, it causes rapid shifts of mood that commonly cycle many times within a single day.PBPD affects all aspects of a child’s life:
The Child & Adolescent Bipolar Foundation (CABF) estimatesthat at least three quarters of a million American children and teenagers, mostly undiagnosed, may currently suffer from this illness.
Children as young as three-years-old have been diagnosed with PBPD;
preschool students may talk of wanting to
”make myself dead.”
Explosive, lengthy rages
Defiance of authority
Sleeping too little or too much & night terrors
Excessive involvement in multiple projects
Impaired judgment, impulsivity, racing thoughts
Inappropriate sexual behavior
Strong, frequent cravings for carbs & sweets
Also known as “manic-depression,” this disorder manifests itself differently in kids; abrupt swings of mood and energy occur much more frequently than they do in bipolar adults.Characteristics of PBPD include:
The illness has a strong genetic component, although it can
skip a generation; the risk of a parent with bipolar disorder
passing it on to a child is 13%.
A family history of BPD is found in 95% of PBPD patients.
A family history of alcohol abuse is often related to PBPD.
Attention Deficit Hyperactivity Disorder (ADHD).
Over 80% of children with early-onset BPD will meet the full
criteria of ADHD.
Treatment with a stimulant typically prescribed for ADHD can
aggravate symptoms in children with bipolar disorder or trigger
mania in a child with a family history of the illness.
1.) are much more irritable;
2.) have more violent, destructive and lengthy outbursts;
3.) are more grandiose
(“I am the best”);
4.) have more frequent and intense mood changes (i.e. “rapid cycling”)
5.) exhibit an early interest in sexual activity.
about medication: No single
medication works in all
children. Since symptoms
wax and wane, and children’s
bodies change as they grow,
managing medication to
ensure continued stability is
an ongoing challenge. Also,
controlled long-term studies
of the effects of lithium and
other mood stabilizers in
bipolar children is nearly non-
Mood stabilizers (Lithium, Depakote, Tegratol)
Antipsychotic medications (Risperdal, Zyprexa)
Benzodiazepines for sleep disturbances
Close monitoring of symptoms
Education for child and family about the symptoms, course and treatment of the disorder
Psychotherapy for the child and family
Good nutrition, regular sleep and exercise
Participation in a network of support
Accommodations at schoolTreatment for PBPD includes:
symptoms & course of the illness, changes in medication, etc.
flexible, calm, patient, firm, loving and consistent.
overwhelmed and a safe place to regain composure
2) Assign one-on-one adult supervision if needed outside the classroom
during times of transition, lunch, recess, etc.
stress of testing
Listen to National Public Radio programs on PBPD