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Bipolar Disorder

Bipolar Disorder, formerly referred to as Manic-Depressive Disorder, refers to a chemical imbalance in which moods swing between severe depression and extreme mania. The term Bipolar refers to the extreme highs and lows experienced. Between these two poles are varying degrees of mania and depression.

Manic phases in Bipolar Disorder can take many different forms:

  • Euphoria – I’ve never been so happy and nothing can get me down
  • Extreme optimism – I can do anything, and everything I try is going to work out
  • Inflated self-esteem – I am the best, and I deserve the best of everything
  • Poor judgment – Impulsivity, acting before thinking about consequences
  • Rapid speech – Often I am loud, intrusive, and difficult to interrupt
  • Racing thoughts – My brain is going 100 miles per hour
  • Aggressive behavior
  • Agitation – irritable, can’t sit still for long
  • Increased physical activity – Usually goal-oriented, like drawing, writing, or building
  • Risky behavior
  • Spending sprees * Increased drive to perform or achieve goals
  • Increased sexual drive – and impulsive/risky sexual behavior
  • Decreased need for sleep – Decreased by two or more hours per night for my age without daytime fatigue
  • Tendency to be easily distracted
  • Inability to concentrate
  • Drug abuse
  • Extreme irritability – in episodes, often with a pulsating, volatile quality
  • Aggressive and/or self-injurious behavior due to irritability
  • Grandiose thinking – planning and/or starting huge and/or bizarre projects
  • Psychosis – Seeing/hearing something or someone who isn’t there; false beliefs that are firmly held

Depressed phases in Bipolar Disorder may include:

  • Sadness
  • Hopelessness
  • Suicidal thoughts or behavior
  • Anxiety
  • Guilt
  • Sleep problems
  • Appetite problems
  • Fatigue
  • Loss of interest in daily activities
  • Problems concentrating
  • Irritability – extreme rages or meltdowns over trivial matters
  • Chronic pain without a known cause
  • Things that used to please you no longer do

Diagnostic Difficulties

Figuring out a diagnosis of Bipolar Disorder can be very complicated and frustrating. Several other diagnoses are frequently present in children together with the diagnosis of Bipolar Disorder. These include Attention Deficit/Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), Anxiety Disorders, and substance abuse. Experts agree that Bipolar symptoms must be treated and reigned in first, and then treatment can address other diagnoses.

Fluctuations in mood cause by substance abuse are frequently misdiagnosed as Bipolar Disorder. Similarly, mood swings which are common to Cluster B/Borderline personality traits are often misdiagnosed as Bipolar Disorder. Cluster B/Borderline mood swings are triggered by fear of abandonment and rejection, where Bipolar Disorder mood fluctuations are caused by chemical imbalances. Similarly, it is difficult to tell the difference between irritability and problems concentrating due to ADHD versus those associated with Bipolar Disorder.


Bipolar Disorder must be managed through proper medication first and foremost. Logan River Academy offers a secure and supportive environment where students work together with their therapist and psychiatrist to get medications worked out to be just right for them. Once the effects of Bipolar Disorder are under control, the therapist works closely with the parents and student to understand Bipolar Disorder, including its symptoms and treatment. Students work closely with their therapist to build skills, especially communication and problem solving in the areas of symptom management, emotional regulation and impulse control.