bye bye, bipolar disorder!

In Education, General Psychology, Mood Disorders, School Psychology on Tuesday, 19 February 2013 at 06:57

i love this website and the information.  i find it useful in general and in my work in the schools.  if you work with children with behavioral issues or are interested in learning more, i recommend you join dr. mac’s b-list email list.  i always find interesting and useful articles like the one below.  thanks, dr, mac!

Bye-Bye Bi-Polar Disorder

Hello again, fellow B-Lister!  Where are you located right now on the mood spectrum?  Forlorn?  So-So?  Ecstatic?  How’s the energy level right now? Are you sinking into the sofa for the 3rd day in a row, taking a short-lived seat to read this communication, or jumping up and down on it?

We all have ups and downs in mood, energy, or ability to function well in our daily tasks.  Some folks, though,  re-cycle through these ups and downs, reaching the extreme ends of the continuum.

Back-in-the-day, I typically heard the term “Manic Depression” used for the condition under discussion in our newsletter today.  When I first heard the term “Bi-Polar”, I thought it had something to do with the melting of the polar ice caps or penguins moving up to Santa’s domain!

Bipolar disorder: A mental illness that is evidenced by extreme shifts in mood, energy and functioning.

Yes, now Bipolar Disorder is the clinically correct terminology for the dramatic, recycled changes experienced by individuals with this mental health disorder.  However, I must admit that manic-depressive held more meaning for me. It identified the two opposites of the continuum rather than using vague terminology as a label.

There are different variations of Bipolar Disorder listed in the two mental health diagnostic manuals, the DSM-IVtr (soon to become DSM-5) and the International Classification of Diseases (ICD-10).  Once thought to be a rare condition in children and youth, the 1990’s era saw a massive increase in Bipolar diagnoses for kids with severe sadness, irritability, anger, and grumpiness. a rise of 4000% in just 12 years!  As might be expected, the dramatic increase sparked discussion and disagreement about whether children were being misdiagnosed and then prescribed powerful psychotropic mediations with significant negative side effects. (A future topic for a B-List members)

Bipolar disorder is a life-long mental disability, but most research has shown that  kids diagnosed with childhood bipolar disorder (the expansive version) are no more likely to develop classic Bipolar Disorder than their non-diagnosed peers.  Additionally, the prescribed medications didn’t work as well in children as in adults.  Certainly, these youngsters possessed a legitimate mood disorder, one that may very well extend into adulthood. but for most of them, it wasn’t Bipolar Disorder.

One of the graduate students in my teacher preparation program in behavior disorders created a wonderful video regarding authentic Bi-Polar Disorder in children.  Using a case study of a 6 year old boy, Michelle then compares the youngster’s symptoms with the criteria for the condition, before offering strategies and approaches for intervention. (Thanks, Michelle!)

*Health note: Omega 3 oil, lecithin, and vitamins B6 & B12 have been implicated in the condition, with Bi-Polar individuals being deficient in these nutrients.  If you are seeking a natural alternative or supplement to Lithium and/or the other common medications you can find them in their purest form here: http://www.shop.com/healthnutrition-a.xhtml (Your purchases result in discounts & cash-back while supporting a kid’s pre-teen swim team.  My nutrition consultant, Cindy, is also available to assist you at this site)

A rose by any other name.

In response to the great controversy & disagreement as to whether this mental health disability should be diagnosed in kids, DSM-5 (due for distribution in May 2013) makes an effort to reduce the numbers of Bipolar diagnoses… by creating a new diagnosis!…: Distemper.  Oh Wait!!!  That’s my dog.  For our kids, the mental health diagnostic manual it will soon contain a new condition titled “Temper Dysregulation Disorder with Dysphoria” (TDD).

Dysphoria: An emotional state of feeling unwell or unhappy.

TDD displays itself in severe outbursts of anger/temper interchanging with negative mood states.  Unlike Bipolar Disorder, it does not include phases of mania (but neither did the criteria used to diagnose kids as having Bipolar Disorder… Odd, eh?… Labeling kids as being Bipolar when they didn’t have a second pole).  TDD is also not considered to be a life-long disorder.

The American Psychiatric Association states that it hopes that the majority of kids (perhaps 60-70%) who have or might have been diagnosed with Bipolar Disorder will now receive the TDD label.  This re-diagnosis would probably also include many youngsters with Conduct Disorder who were labeled as being Bipolar in order to obtain health insurance coverage for treatment

The symptoms of TDD in the upcoming DSM-5 manual are similar in many ways to the broad type of childhood bipolar disorder (as it was diagnosed). The proposed diagnostic criteria for TDD include:

severe recurrent temper outbursts that are grossly out of

proportion to the intensity of the situation

frequency of at least three temper outbursts per week

temper outbursts ongoing for at least one year

temper outbursts present in at least two settings (for

example, at home and at school)

onset before age 10

There is an excellent 10 minute video on the new disorder in the archives of National Public Radio: http://www.npr.org/player/v2/mediaPlayer.html?action=1&t=1&islist=false&id=123544191&m=123564957


For those of you working with youngsters who have the symptoms mentioned above:

1. Rob Plevin’s 3-part FREE video series on working effectively with disruptive kids is still availabe.  Click here to view effective strategies for quieting noisy classes and kids.

2. Modify the character of the youngster using the Circle of Courage model of intervention.  This comprehensive, intensive and positive program changes lives.

3.  The Behavior Intervention Guide allows you to determine a disruptive youngster’s present level of readiness to change behaviour.  Based on the outcome of the assessment, strategies are provided that move the youngster toward greater levels of willingness to change his/her behavior for the better.

4.  Use “The Behavior Survival Guide for Kids: How to make good choices and stay out of trouble” in your social skills/anger management programs, or place it in the class library.  Stellar reviews by websites, magazines, parents, teachers, and the kids themselves let you know the effectiveness of this self-help book for kids.  It’s written on a 4th grade reading level… just like these weekly newletters!

5. Implement the FREE 100+ lesson plans that accompany The Behavior Survival Guide (or use them in isolation)

For Parents of Defiant & Angry Youngsters

1. Develop a home-school behavior change program based on the monetary system.  When money and priviledges are involved, kids listen!

2. Learn the principles of changing behaviour for the better, and effective strategies for helping your child make better behavior choices.

3.  Leave “The Behavior Survival Guide for Kids: How to make good choices and stay out of trouble” out on the coffee table for your child to pick up.

4. Seek out family counseling.

5. Acquire the comprehensive program designed specifically to help parents of children with Conduct Disorder/highly disobedient behavior change their child’s behavior for the better. (Click on the Total Transformation box below)

NEXT WEEK: Disruptive Behavior (Not otherwise specified)

(When the actions are disruptive, defiant, and/or aggressive,but don’t meet the criteria for ODD or Conduct Disorder)

Dr. Mac

Room 914west,

Department of Special Education, Hunter College,

695 Park Avenue,

New York,

NY 10021


Retrieved from: http://www.behavioradvisor.com


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