Our daughter is in trouble at high school and has been suspended. She’s been diagnosed with bipolar disorder. Nothing has worked so far and now she won’t take her medications. What should we do?
 

Ask your daughter why she isn’t taking her medication. How does it make her feel? Many individuals like the euphoric feeling that comes with the manic phase of bipolar illness. Speak to her physician to see what changes might be made in medications. Many are facing the same issues you are. There are services available but have waiting lists or other criteria. There is an effort under way to maintain resources for families just like yours through initiatives in St. Charles County (Proposition 1), Jefferson County (Proposition Healthy Kids), and the City of St. Louis (Prop K for Kids). The suspension from school depends on a several factors. Does she currently have an Individualized Education Program? If yes, she has been recognized as a student with disabilities that interfere with her education. If she receives a suspension for more than ten days, there must be a manifestation determination. This is a meeting of her IEP team, including you, that determines if her suspension is related to her disability. They may still be able to suspend her, but they must continue to provide the special education services required in her IEP. A new IEP would be written immediately. If your daughter does not currently have an IEP, begin this process immediately. Ask the school to provide you with a parent rights handbook and an explanation of that process. Bipolar disorder is very treatable with proper medical and psychological interventions.

Audrey Yarbrough
Program Director
Family Advocacy and Community Training
636-949-2425

It has been estimated that bipolar disorder (manic depressive illness) affects close to 1 million children and adolescents in the United States at any given time. When the illness begins before or soon after puberty, often the mania and depression are mixed up together at the same time. Cycling between the two is fast. Often a person will cycle between mania (or hypomania) and depression many times a day. Rarely will they have days of any one state. Children who are destined to get bipolar disorder will often show other psychiatric disorders earlier in life. Two common ones are attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Learning as much as possible about bipolar illness – especially childhood onset, and effective ways to control the symptoms, are keys to not letting the illness control you. Doctors, nurses, families and other people with bipolar illness can be a resource. Cognitive behavioral therapy, in conjunction with medication, has been found effective. When they reach adolescence, at least 70% go through a phase of not taking their medication for one reason or another. The parents should follow up with the psychiatrist that administered the medication and focus on symptom reduction and relapse prevention. Recognizing the need for greater understanding of bipolar disorder in youth, the National Institute of Mental Health currently is funding several studies. Take heart, you are not alone.  

Delores H. Grady, MSW, LCSW
Child and Family Services Manager
BJC Behavioral Health
314-206-3716

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