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BIPOLAR DISORDER:
Epidemiology, Educational
Implications, and
Interventions
Shelley Hart
shelley_hart@charter.net
DIAGNOSIS
DSM-IV-TR
Five types of
episodes
Four subtypes
Four severity levels
Three course
specifiers
Differences =
Length of time
Impairment not as severe
Major Depressive Episode
Symptoms:
1. Depressed mood (in children can be irritable)
2. Diminished interest in activities
3. Significant weight loss or gain
4. Insomnia or hypersomnia
5. Psychomotor agitation or retardation
6. Fatigue/loss of energy
7. Feelings of worthlessness/inappropriate guilt
8. Diminished ability to think or
concentrate/indecisiveness
9. Suicidal ideation or suicide attempt
Mixed Episode
Substance Abuse
40-50%
Anxiety Disorders
35-40%
Suicidal Behaviors
Prevalence of suicide attempts
40-45%
Executive Functions
Attention
Memory
Sensory-Motor Integration
Nonverbal Problem-Solving
Academic Deficits
Mathematics
Psychosocial Deficits
Relationships
Peers
Family members
Recognition and Regulation of Emotion
Social Problem-Solving
Self-Esteem
Impulse Control
TREATMENT
APPROACHES
Psychopharmacological
DEPRESSION MANIA
Mood Stabilizers Mood Stabilizers
Lamictal Lithium, Depakote,
Anti-Obsessional Depacon, Tegretol
Paxil Atypical Antipsychotics
Anti-Depressant Zyprexa, Seroquel,
Risperdal, Geodon, Abilify
Wellbutrin
Anti-Anxiety
Atypical Antipsychotics
Benzodiazepines
Zyprexa
Klonopin, Ativan
Therapy
Psycho-education
Family Interventions
Cognitive-Behavioral Therapy
RAINBOW Program
Interpersonal and Social Rhythm Therapy
Schema-focused Therapy
EDUCATIONAL
IMPLICATIONS
IDEA Classification
Emotional Disturbance (ED) vs. Other
Health Impaired (OHI)
Considerations
Rapidly changing moods of depression,
irritability, grandiosity, pressured speech, racing
thoughts, etc.
Need for movement
Poor relationships
Difficulties with concentration and focus
Difficulties with task completion
Impaired judgment and impulsivity
Disorganization
Becoming overwhelmed with stressful situations
Possible Accommodations/Modifications
Provide student with a safe place and person to
go to when feeling overwhelmed or stressed
Shortened day (permit late start as needed)
Prior notice of transitions
Consistent schedule
Scheduling the student’s most challenging tasks
at a time of day when the child is best able to
perform
Modified or shortened assignments
Plan for unstructured times of the day
Adjust for medication needs, dispensing, as well
as plans for addressing side effects (e.g.,
sedation)
Other Considerations
Educating staff
Communication
Hospitalization
RESOURCES
BOOKS/BOOKLETS:
Mondimore, F. (1999). Bipolar disorder: A guide for
patients and families. City: Johns Hopkins Press.
Geller, B., & DelBello, M. P. (Eds.). (2003). Bipolar
disorder in childhood and early adolescence. New
York: Guilford Press.
Educating the child with bipolar disorder. Available
from: www.bpkids.org
Anderson, M., Kubisak, J.B., Field, R., & Vogelstein,
S. (2003). Understanding and educating children and
adolescents with bipolar disorder: A guide for
educators.
RESOURCES
WEBSITES:
The Child and Adolescent Bipolar Foundation
www.bpkids.org
Depression and Bipolar Support Alliance
www.dbsalliance.org
The Bipolar Child
www.bipolarchild.com
Parents of Bipolar Children
www.bpparent.org
The Gray Center for Social Learning and
Understanding
www.thegraycenter.org/Social_Stories.htm
National Institute of Mental Health (NIMH)
www.nimh.org