prefrontal cortex controls the abilities to differentiate among conflicting thoughts, determine good and bad, better and best, same and different, future consequences of current activities, working toward a defined goal, prediction of outcomes, expectation based on actions, and social "control" (the ability to suppress urges that, if not suppressed, could lead to socially-unacceptable outcomes)
In order for chemical messages to be transmitted properly from one neuron (nerve cell) to another, neurotransmitters--molecules carrying the chemical message--must be generated, sent from, and delivered to the right destination cells. A complex balance of brain chemicals allows the efficient passage of these messages within the system to produce organized thought, movement, emotion, and behavior. Scientists have pinpointed four primary brain chemicals that are affected by bipolar disorder, which disturbs the normal flow of information between neurons and thus interfering with normal activity, feelings, and thought.
Bipolar 2 hypomania/racing thoughts
Kids and teens usually exhibit the mixed Bipolar
Grandiose 3 year old putting on cape and jumping through a window
Weight gain both the mood stabilizers i.e. Depakote, trliptal, and tegretol can cause weight gain, but so can zyprexia. Seroquel, ablify also can cause weight gain often theses meds out of both theses categories are needed to control the s/x of Bipolar d/o
Dealing with Bipolar Teens in School Presented by Mark Livingston LPC CPCS
What is Bipolar Disorder? DIAGNOSISBipolar disorder is a hereditary illness believed to occur in at least 1 - 2 % of the adolescent and adult population, with bipolar spectrum disorders believed to occur in 5 - 7 %. The lifetime mortality rate (from suicide) is higher than some forms of cancer.
Decreases in the number and density of glial cells in the prefrontal cortex.
Decreases in the number of neurons in part of the hippocampus.
Increases in the levels of some neuropeptides in the hypothalamus.
White matter hyperintensities: small abnormal areas in the white matter of the brain (especially in the frontal lobe) as seen using magnetic resonance imaging. These abnormalities may be caused by the loss of myelin or axons.
Bipolar Disorder and Children The number of children diagnosed with bipolar disorder is rising as doctors begin to recognize signs of the disorder in children. Children with bipolar disorder are at risk for school failure, substance abuse and suicide.
Types of Bipolar Disorder Bipolar I A person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood, accompanied by abnormal behavior that disrupts life. Bipolar II is similar to bipolar I disorder, with moods cycling between high and low over time. However, in bipolar II disorder, the "up" moods never reach full-on mania.
Types of Bipolar Disorder Continued Rapid Cycling In rapid cycling, a person with bipolar disorder experiences four or more episodes of mania or depression in one year. About 10% to 20% of people with bipolar disorder have rapid cycling. Mixed Bipolar In most forms of bipolar disorder, moods alternate between elevated and depressed over time. But with mixed bipolar disorder, a person experiences both mania and depression simultaneously or in rapid sequence. Cyclothymia (cyclothymic disorder) is a relatively mild mood disorder. People with cyclothymic disorder have milder symptoms than in full-blown bipolar disorder.
Symptoms of bipolar disorder in children and adolescents
Symptoms of bipolar disorder in children and adolescents
Behavioral Symptoms Until recently, doctors rarely diagnosed bipolar disorder in childhood because they were unaware that its symptoms in children can differ from the more widely recognized adult form. Symptoms may be present since early childhood, or may suddenly emerge in adolescence or adulthood. This are beyond the normal mood fluctuations, temper outbursts, fantasies, etc. associated with normal child development.
Behavioral Symptoms Bipolar disorder influences mood, energy, thinking and behavior. Unlike adults, who experience episodes of distinct "highs" and "lows," many children with the disorder suffer from an ongoing, continuous mood disturbance that is a mix of mania and depression. This produces chronic irritability and few periods of wellness or clearly discernible episodes. Moreover, since many children with bipolar disorder have other psychiatric disorders such as ADHD, ODD, OCD, and RAD it is difficult for parents and clinicians to clearly see distinct episodes of mania or depression. It is important for clinicians to look at the cardinal symptoms of the disorder such as the elevated/expansive mood, grandiosity, decreased need for sleep, racing thoughts and increases in goal directed activities as identifiers of the episodicity of mania to distinguish between the two disorders. Although not all children with severe tantrums have bipolar disorder, many children with bipolar disorder often had uncontrollable, severe tantrums or rages out of proportion to any event. Some children with this disorder exhaust their self-control during the school day and therefore exhibit more severe symptoms in the relative safety and privacy of the home.
Individual Management Plan Simple, clear and positively phrased expectations Give only one direction at a time Reward the student for desired behaviors Expect the best from the student, while clearly understanding their ability Ignore minor issues – not everything has the be a battle Create many opportunities for success socially and academically
Establish a Safe Spot A safe spot should be established in the school. A safe spot is where a teen with bipolar disorder is allowed to go into a meltdown; also, efforts should be made to calm the teen down. The teen should be given the option of calling parents to talk and/or talk with a trusted adult in the building. Once the teen is calmed down, he or she should be given the option of returning to class. When returning to class, it should be at a time when the least amount attention be brought to the teen. Having a meltdown or episode in class is one of the hardest and embarrassing things that can happen to a teen. Every measure should be taken so that he/she don't have an episode during class, but rather can leave the room in time without undue attention. However, if they do lose control of emotions during class time, they should quietly leave. If the student is questioned by other students, they can just say that they didn’t feel good and leave it at that. Students should not feel obligated to tell details of what happened, as most others simply would not understand.