Transcript Bipolar Disorder

Bipolar Disorder
Annabelle Ip, Tim Ma, Jacqueline Simpson, Alison Yau
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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, antipsychotics, 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. 35-36).
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?
Fine Arts & English
WHAT WE THINK!
• 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
- DMX
- Mel Gibson
- Matthew Good
- Macy Gray
- Ernest Hemingway
- Demi Lovato
- Robert Munsch
- Florence Nightingale
- Virginia Woolf
- Winston Churchill
- Robin Williams
- Edgar Allan Poe
- Robert Schumann
- Jean-Claude Van Damme
- Vincent Van Gogh
- Pete Wentz
- Amy Winehouse
- Catherine Zeta Jones
- Ludwig van Beethoven
- Jimi Hendrix
- Mark Twain
- Theodore Roosevelt
- Jim Carey
References.
Angdala, T. (2002). The student with bipolar disorder: An educator's guide. Retrieved
from: http://www.bpchildren.org/files/Download/Educator.pdf.
British Columbia Ministry of Education. (2011, March). Special education services: A
manual of policies, procedures, and guidelines. Retrieved
from: http://www.bced.gov.bc.ca/specialed/special_ed_policy_manual.pdf#page=31.
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: http://www.schoolbehavior.com/Files/tips_mood.pdf.