Bipolar Disorder

Clara Schild
March 26, 2015
SPED 410

Bipolar disorder can cause unusual shifts in a persons mood, energy and activity levels.
The brain disorder often makes it challenging for those affected to carry out daily tasks such as
decision making, leaving the house, or even just getting out of bed. Symptoms of this debilitating
disorder can range from minor to severe, but most cases are severe. Everyone has times in their
lives where they go through ups and downs, mood swings, and slight depressive states, but these
are escalated and frequent for those suffering from bipolar disorder. Sometimes the person will
experience an overly joyful or excited feeling, which is classified as a manic episode or Bipolar
I. Others may experience extreme sadness or hopelessness called a depressive episode or Bipolar
II. An Individual may experience both manic and depressive episodes at one time.
There are several changes that happen during a manic episode. A person affected could
be easily distracted, impulsive, restless, have unrealistic belief in their abilities, and racing
thoughts. During a depressive episode, a person could feel slowed down, have trouble making
decisions, be irritable, experience changes in habits, or thoughts of death or suicide. These
symptoms are not always extreme. Some people with bipolar disorder experience less extreme
forms of mania or depression. The lessened symptoms are characterized as a hypomanic episode
or Cyclothymia. Hypomanic episodes may be difficult for the person to recognize, and can often
be mistaken for common mood swings. The disorder can affect relationships, work and school
performance, and a persons overall quality of life (Bipolar Disorder).
Four months ago, James found out he has bipolar disorder. He knows it's a serious
illness, but he was relieved when he found out. That's because he had symptoms for years but no
one knew what was wrong. Now he's getting treatment and feeling better.

James often felt really sad. As a kid, he skipped school or stayed in bed when he was down. At
other times, he felt really happy. He talked fast and felt like he could do anything. James lived
like this for a long time, but things changed last year. His job got very stressful. He felt like he
was having more "up" and "down" times. His wife and friends wanted to know what was wrong.
He told them to leave him alone and said everything was fine. A few weeks later, James couldn't
get out of bed. He felt awful, and it went on for days. Then his wife took him to the family
doctor, who sent James to a psychiatrist. He talked to this doctor about how he was feeling. Soon
James could see that his ups and downs were serious. He was diagnosed with bipolar disorder,
and he started treatment soon after (Personal Story).
There have been several population based studies conducted in the past few decades to
monitor the growth of bipolar disorder. Recently the World Mental Health survey initiative
surveyed 61,392 adults in 11 different countries to find the prevalence and severity of the
disorder. The percentage of people on spectrum of bipolar disorder is 2.4% of those studied. Out
of those with bipolar disorder, 75% of the people with depressive episodes and 50% of people
with severe manic episodes experience severe impairments in daily life activities. Also, 75% of
people also met criteria for other mental health disorders. The most prevalent disorder in
conjunction with bipolar disorder is anxiety disorder (Merikangas).
Approximately 1% of the general population meets the criteria for bipolar disorder. The
rates in just the United States are much higher than the world wide average. The prevalence rate
ranges from 1.2% to .1% across the world. In the United States, the prevalence rate is a 3.3%
(Merikangas). Despite the high prevalence of bipolar disorder, little is known of its cause.
Scientists are finding that there could be several different neurochemical and environmental
factors that combine during the onset of the disorder. The most recent thought is that the disorder

is predominantly brought on by biological factors. There is thought to be a malfunction in the

neurotransmitters, the chemical messengers, of the brain. The malfunction is often in the
norepinephrine and serotonin transmitters. Since it is primarily a biological disorder, it may be
dominant for years. Some think it is activated on its own, and others believe that external forces,
like stress, trigger it. Several studies have shown that bipolar disorder is often genetic. A person
is 50% more likely to have bipolar disorder if a close relative has it. One can have it without
genetic factors though. It has been observed that certain health habits, alcohol and drug
problems, and hormonal imbalances can trigger the disorder (Bressert).
After family, friends, or the person themselves notice the behaviors, the first step towards
diagnosis is to go to a doctor. The doctors perform several tests and exams in order to be sure of
the diagnosis. First, a physical exam and lab work is done to rule out any other medical issues
that could cause bipolar-like symptoms. If all the tests are negative, the doctor will either
administer or refer a psychological evaluation. During this evaluation, the doctor or psychologist
will ask several questions. They ask questions about the persons feelings, thoughts, behaviors,
and life. Often, family members and friends provide more information to the doctors to help
determine if the disorder is present. While diagnosing bipolar disorder, the patient often has to do
mood charting. The family, teachers, or individual will keep a track of the different moods
during the day and their frequency, duration, and intensity.
Bipolar disorder is often more difficult to diagnose in younger, school aged children. It is
difficult for teachers, family, and doctors to differentiate between normal mood swings and
behaviors and bipolar disorder. Also, it is common for bipolar disorder to be misdiagnosed for
another mental health disorders like ADHD or others in the younger years. Generally, bipolar
disorder is diagnosed in the teenage years through the twenties. (Tests and Diagnosis)

When diagnosing bipolar disorder in adolescence, doctors us a manual called the

Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as a reference. Some children
fit the definition perfectly, but most are challenging to diagnose. Teachers and family members
often notice severe depression, rage, anxiety, hostility, compulsive behaviors, and sleep
disturbances in children with bipolar disorder. Generally, the school is minimally involved in the
diagnosis process since doctors and psychologists administer the tests. It is important for teachers
and school personal to monitor and record the childs behavior and moods to help the doctors.
Children with bipolar disorder will often struggle in school. Students with bipolar
disorder often qualify for some form of special education. The medications used to help treat
bipolar disorder often make children tired and can cause fluctuations in the students behavior
throughout the course of a day. Studies show the there are clear biological differences in people
with bipolar disorder. There are several ways that the disorder affects learning. Students often
have a hard time sleeping, energy issues, trouble with normal functions, and cognition issues.
The disorder also affects attendance and concentration. Students usually have sensitivity to light
and sound, react negatively to stress, and have trouble with motivation and transitioning. It is not
uncommon for the student to have trouble recalling information, thinking critically, organizing,
hand eye coordination, and problem solving. Despite all the troubles that may impact a student
with bipolar disorder, it is still possible for them to excel in the classroom.
It is common to see learning disabilities along with bipolar disorder. This may be due to
the students inability to focus and the inconsistent energy levels that go along with the disorder.
Individuals with bipolar disorder often have communication disorders too, the most common
being with non-verbal, and receptive language. Non-verbal language helps people understand
social situations, norms, and skills. Receptive language disorders affect the way an individual

interprets information. Students with bipolar disorder who exhibit signs of communication
disorders may need extra time to process information and work on assignments. It is also
common to see reduced executive function skills in student with bipolar disorder. These skills
are needed in organization, planning, motor skills, and other learning activities. The reduced
executive function can impact memory, planning, and analysis. It can also make it challenging
for the student to complete homework, gather materials, and answer questions of different
formats (The Balanced Mind).
If the disorder is adversely affecting the students education, it is the job of the school to
test the student to see if they qualify for services. If the student does qualify, the teachers and
parents will meet and create and Individual Education Program (IEP) for the student. A very
important part of an IEP for student with bipolar disorder is the accommodations section. The
school needs to have a plan in place for when the student has an episode. Its extremely
important for the educators to be flexible with the student. The teachers need to be able to adapt
assignments to suit the students needs and be flexible when the student is having an episode.
There are several accommodations that will help when teaching students with bipolar
disorder. It is important for the teachers to limit distractions in the classroom, have a consistent
schedule, shorten assignments, and notify the student and parents of any future transitions. When
a teacher is working with the student, it is important to be positive, praise the students good
behaviors and work, and encourage them to continue working. It is recommended by experts to
praise students once every 5 minutes to help keep positive behavior (Educating the Child).
Often, students with bipolar disorder are put on medications to help with hyperactivity,
depression, anger, and sleeping difficulties. One of the most common medications is Lithium.

This medication is usually used to treat people with frequent manic episodes, although it helps
with depression as well. The medication helps to stabilize mood swings and makes the manic or
depressive episodes less severe. Anticonvulsants are also fairly common for individuals with
bipolar disorder. Usually, anticonvulsants are used to treat epilepsy, but they have been known to
minimize the durations of manic-depressive episodes. Instead of the episodes lasting weeks or
months, they last mere hours or days. Doctors often prescribe antipsychotics and antidepressants
along with the other medications to help specifically control the manic and depressive symptoms
(Silver).
The bad news for people with Bipolar disorder is that there is no complete cure, but the
effects can be minimized with medications and monitoring of moods. There is also not a
completely clear cause of bipolar disorder, but scientists are researching different biological and
environmental factors that may cause the disorder. Although bipolar disorder may cause some
learning difficulties, with the help of teachers and family the individual can overcome and
achieve in an academic setting.
It is important for educators to not only know how to teach a student with bipolar
disorder but also the specifics about the disorder. A teacher who knows the signs and symptoms
may be able to spot a student with the disorder and start a plan sooner. The earlier the disorder is
caught, the more doctors and teachers can do to help combat it. Knowing how to work with a
student with bipolar disorder is also critical for teachers. It may be challenging to keep the
student on task and motivated, but if the educator knows what tasks to avoid and how to modify
work it becomes much more manageable. Teachers need to keep a close relationship with the
parents of the student to stay on top of any growing episodes, behaviors, or triggers. Overall, the

more educators know about disorders, such as bipolar disorder, the better equipped they will be
to help the student reach their potential.

Citations
"Bipolar Disorder." NIMH RSS. Web. 21 Mar. 2015.
<http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml>.
"Bipolar Disorder." Tests and Diagnosis. Web. 22 Mar. 2015.
<http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/basics/tests-diagnosis/con20027544>.
Bressert, Steve. "The Causes of Bipolar Disorder (Manic Depression)." Psych Central.com.
Web. 21 Mar. 2015. <http://psychcentral.com/lib/the-causes-of-bipolar-disorder-manicdepression/000912>.
"Educating the Child with Bipolar Disorder." The Balanced Mind. Web. 22 Mar. 2015.
<http://www.thebalancedmind.org/sites/default/files/edbrochure.pdf>.
"Personal Story." NIMH RSS. Web. 21 Mar. 2015.
<http://www.nimh.nih.gov/health/publications/bipolar-disorder-easy-to-read/index.shtml>.
Merikangas, Kathleen, Robert Jin, and Jian-Ping He. "Prevalence and Correlates of Bipolar
Spectrum Disorder in the World Mental Health Survey Initiative." Archives of General
Psychiatry. U.S. National Library of Medicine, 1 Jan. 2012. Web. 21 Mar. 2015.
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3486639/>.
"The Balanced Mind Parent Network." Bipolar Disorder and Learning. Web. 22 Mar. 2015.
<http://www.thebalancedmind.org/learn/library/bipolar-disorder-and-learning>.
Silver, Harry. "Medications for Mania and Bipolar Disorder." EverydayHealth.com. Web. 22
Mar. 2015. <http://www.everydayhealth.com/bipolar-disorder/bipolar-disorder-drugs.aspx>.