Bipolar Disorder Annabelle Ip, Tim Ma, Jacqueline Simpson, Alison Yau :):

What is Bipolar Disorder? Cycling between 2 "poles" (high and low episodes) Historically known as manic-depressive disorder Mood disorder; the presence of one or more "manic" episodes with or without one or more depressive episodes (usually separated by "normal" moods) Bipolar spectrum: can be divided into bipolar I, bipolar II, cyclothymia, and bipolar NOS (not otherwise specified) Genetics have been shown to be a major contributor (coupled with environment)

The Bipolar Spectrum Bipolar I: (manic end of spectrum) One or more manic episodes. May include depression, but not necessarily. May included psychosis. Bipolar II: (depressive end of spectrum) No manic episodes, but one or more hypomanic episodes and one or more major depressive episodes Cyclothymia: (not as extreme edges of bipolar) Hypomanic and depressive episodes. Bipolar NOS: aka Not otherwise specified. All other types of Bipolar that do not fall under the first three categories.

What are the symptoms? Mania: Full of energy (needs little sleep or food), feeling high Feeling more important than usual More talkative, social, easily annoyed Impulsive behaviour, racing thoughts (sexual, spending, adrenaline) Impaired judgement, doing things uncharacteristically Highly distractible, unable to concentrate Delusions and hallucinations (only for extreme cases) Unrealistic grandiose belief of one's ability or power Racing thoughts, jumping from ideas to another

What are the symptoms? Depression: Increased need for sleep, unable to sleep, or oversleeping Loss of interest or pleasure, apathy, indecisiveness Feelings of uselessness, inadequacy, or guilt Increased restlessness, agitation, isolation Thoughts about death or suicide Concentration and memory problems Physical and mental sluggishness Fatigue, loss of energy

What are the symptoms? (continued) Symptoms can range, depending on the patient, making it difficult to diagnose (these symptoms are ongoing) Experience abnormally elevated paired with depressive states which can interfere with normal functioning

What causes it? Genetics: BP tends to run in families. 2/3 of people with BP have a close relative with the illness or one who suffers from depression. Physiology: Bipolar begins during adolescence or early adulthood and may continue to be a problem throughout life. Men and women are equally likely to develop BP regardless of race, education, occupation, or income. Environment: life events (death, stress, traumatic/abusive childhood, interpersonal relationships) all correlate (NOT a cause on its own)

How is this treated? DRUGS: since BP is an imbalance in bio-chemistry of brain, drugs are the main form of treatment: mood stabilizers, anti-depressants, anti- psychotics, anti-anxiety, anti-convulsants, sleep medication, as well as medication to treat the side effects associated with the other meds Hospitalization: used to control severe symptoms of BP to cope with any self-destructive, reckless, aggressive behavior Cognitive therapy: combat distorted thoughts and beliefs Interpersonal therapy: reducing strain that BP places on relationships Occupational Therapy: Teaching life skills and social skills to people with BP eg. afraid of riding the bus or resume building (in extreme cases) Alternative Therapies – for example, light therapy to treat co-existing SAD (Seasonal Affective Disorder)

Coping Mechanisms? Lifestyle: prevention of episodes and management of BP Requires proactive attitude as opposed to reactive attitude Maintain regular sleep pattern Regular exercise, being in nature Reduce stress, learn how to manage it, relaxation Careful of consumption of alcohol, caffeine, or drugs Lifestyle choice: stability and equanimity Channel creativity into positive outlets Be self aware: mood/food diary, educate yourself on BP Family and friends: encouragement, support system, people who understand and aware of the condition

Accommodating students who are taking medication (Packer, 2002) Lithium: allow students to keep a water bottle with them at all times (dry mouth) Mood Stablizers: may cause diarrhea, students may need a permanent pass to leave the room at their discretion, as needed All medications: cognitive dulling is a potential side effect, as is visual blurring. This may make the completion of work frustrating for the students Some medications will have fatigue or sleepiness as a side effect and the student may have trouble staying awake in school. If the student is newly diagnosed, frequent changes in meds may mean changes in side effects Parents and physician may need frequent behavioral or medication-monitoring reports as part of the school's plan

As a teacher, what could we do if we suspect or know that a student is bipolar? The disorder may express itself differently in each student affected; these students may have very different needs Talk to the parents about your observations Keep a journal of observations Consult the school nurse or SEAs Talk to the student Be empathetic and take the illness into account when discipline issues arise Keep in contact with family, counselors, etc.

How should teachers respond? For students who are unable to attend school due to hospitalization, the BC Ministry (2011) states that: "Depending on their health, hospitalized students should continue with an educational program as similar as possible to the program they would receive in school. In most instances hospital teachers employed by school districts provide classroom assignments and instructional support for students confined to hospital. Classroom teachers maintain ongoing responsibility for coordinating the student's educational program with the hospital teacher acting as liaison” (pp.35-36). Students with BP are often very sensitive to their environment. Do not try to manage the student, but instead change the environment. This, in turn, will impact the student.

How should schools/districts respond? Districts should establish procedures to ensure that: all appropriate school assignments are provided to the student; the hospital teacher provides reports on student progress; regular contact is established among the hospital teacher, the regular classroom teacher and the parent; the hospital teacher has access to available school district resources (e.g. equipment, materials and curriculum guides); facilities appropriate to good learning conditions within the hospital setting are secured through agreement between the school district and the hospital administration; and records of referrals received and educational services rendered to hospitalized students are maintained and available at the district level. School districts are encouraged to co-operate with each other to ensure that instruction is provided to students who must be temporarily hospitalized outside their home school district" (BC Ministry, 2011, pp ).

Classroom techniques/modifications? "The ideal teacher would be consistent in classroom routine and rules yet flexible to accommodate for the cyclical nature of this illness" (Anglada, 2002) Allow for inclusiveness without isolating the student Be flexible when it comes to time deadlines Know what medications students are on and be cognizant of their side-effects

WHAT DO YOU THINK?!?!?!! With this knowledge, how would you accommodate students with Bipolar Disorder in your subject area?

WHAT WE THINK! Fine Arts & English Provide an outlet for their creative energy through journals writings, reflections, composition, and performance drawing from their personal experiences Sciences & Math Provide structure but be flexible in your approach and allow students to come up with different ways to satisfy requirements Phys. Ed. urge students to participate, with the emphasis of the student having the physical activity vs. the performance (happy hormones - endorphines) *** be sensitive in your approaches subject matter discussed

The Positives! There is a correlation between "giftedness" and BP Many people with BP are often creatively gifted Sensitive to changes in environment (positive?)

Famous people who are Bipolar: - Kurt Cobain - Edgar Allan Poe - DMX - Robert Schumann - Mel Gibson - Jean-Claude Van Damme - Matthew Good - Vincent Van Gogh - Macy Gray - Pete Wentz - Ernest Hemingway - Amy Winehouse - Demi Lovato - Catherine Zeta Jones - Robert Munsch - Ludwig van Beethoven - Florence Nightingale - Jimi Hendrix - Virginia Woolf - Mark Twain - Winston Churchill - Theodore Roosevelt - Robin Williams - Jim Carey

References. Angdala, T. (2002). The student with bipolar disorder: An educator's guide. Retrieved from: British Columbia Ministry of Education. (2011, March). Special education services: A manual of policies, procedures, and guidelines. Retrieved from: Kasper, S. (n.d.). Treating and managing bipolar disorder: a guide for patients. Bipolar Education Awareness Materials. Packer, L.E. (2002). Accomodating students with mood lability: Depression and bipolar disorder. Retrieved from: