Bipolar disorder affects a person's moods, causing fluctuations between periods of mania and depressed thinking. Children with bipolar disorder commonly exhibit symptoms of rapidly cycling moods and ideas, rambling communication, decreased need for sleep, and hypersexuality. Bipolar disorder in children can be difficult to diagnose since normal children often struggle with staying still and controlling impulses, and also since the Diagnostic and Statistical Manual IV (DSM-IV) still requires that adult-specific criteria must be met for a proper diagnosis. Finding effective ways to discipline a child who has been professionally diagnosed, or who exhibits bipolar-like symptoms, requires parents to think outside the box.
Teaching Responsibility
Since bipolar disorder is an illness, it causes a child to exhibit behaviors that are direct symptoms of that illness. Parents of a bipolar child should take special care to separate the child from the disorder and its symptoms, instilling in the child that she isn't to blame for having those symptoms. On the other hand, parents should expect that child to have some responsibility for the illness. Just as a diabetic child or asthmatic child would be expected to monitor behaviors and medication to some degree, a bipolar child should be expected to do what she can to curb her own behavior. Taking responsibility may include eating well, taking medication and learning to recognize symptoms (e.g., rapid cycling thoughts or feelings of invincibility) before they get out of hand and cause him or others to become injured.
Proactive Discipline
Parents of bipolar children shouldn't wait for behaviors to erupt before trying to employ discipline methods. According to "Bipolar Disorders: A Guide to Helping Children and Adolescents" by Mitzi Walsh, parents should consistently use preventative techniques such as: writing in a behavior diary to log and anticipate mood patterns, getting the child medical care on a regular basis, and setting up a clear daily routine in order to reduce instances of moodiness and misbehavior. Another preventative measure may be teaching a child a signal that can help parents and teachers recognize when he needs to take a "self time-out". For example, he may be allowed to leave something on his school desk that discreetly says, "I'm going to an agreed upon safe place to take a breather for a few minutes." Parents may also decide to obtain preventative emergency tranquilizing medications from the child's doctor.
Positive Reinforcement
Rather than punishing a bipolar child for bad behavior, Walsh recommends that parents focus on responding to good behavior with positive praise as well as some rewards. One example of a positive reinforcement system for parents to use is a behavior chart that rewards the child with stickers for behaving well, with the ultimate goal of obtaining enough stickers to earn a prize such as a favorite dessert or a small desired toy.
Choosing Battles Wisely
The parents of a bipolar child shouldn't completely stay away from punishing the child's misbehavior, but the response to misbehavior may need to vary based on the cause. Walsh says that parents can become educated enough about bipolar disorder to eventually be able to distinguish the difference between symptomatic behaviors and intentional bad behavior. Consequences for the outcome (going to "time out" for hitting) may still be the same, but parents who know that their child's behavior is probably due to a manic episode should hold back on immediate lectures or else the behavior may escalate instead of cease.
The Parental Example
Parents of a bipolar child may occasionally find themselves about to "crack" because of stress. These times of stress are prime opportunities for parents to set a good example for the bipolar child. Hearing a parent say, "I am feeling angry and about to lose control of my thoughts and words, so I am going to go to my room and count to 10," demonstrates to the child that stress-relieving techniques are effective for everybody.
References
- National Alliance on Mental Illness: Child and Adolescent Bipolar Disorder
- Child & Adolescent Bipolar Foundation: Pediatric Bipolar Disorder
- Patient Centers: Bipolar Disorders - A Guide to Helping Children and Adolescents
- HealthyPlace: Disciplining Your Bipolar Child
- School Behavior: Accommodating Students with Mood Lability
