Disciplining the Bipolar Child

Bipolar children present a challenge for their parents. They are almost impossible to discipline without stabilization. Stabilizing bipolar children often involves a combination of therapy, medication, diet, and exercise. The defiance and risk-taking behaviors of bipolar children can reach extreme levels at an alarmingly early age. Parents can feel powerless, scared, and confused. Perhaps the most difficult issue in disciplining a bipolar child is getting an accurate diagnosis, especially when distinguishing between bipolar and ADHD, which have many overlapping symptoms. Bipolar symptoms include the following:

· Inability to concentrate, racing thoughts, very fast speech

· Very little need for sleep

· Boredom and irritability

· Morbid thoughts

· Extreme mood swings - the ups and downs of bipolar can cycle much more rapidly in a child than in an adult. A bipolar child can be up and down several times a day.

· Aggression and tantrums that can last for hours

A child psychiatrist in Austin, Texas told me that if a child becomes angry and has "an episode" after being told no or not getting her way, that's ADHD. If nothing in particular immediately precedes it, then it's bipolar. That really simplified it for me. Obviously a full case history had been done and all the other symptoms were present. Please don't diagnose on your own.

If your child has been diagnosed bipolar, what about discipline? In general, you don't need to change your parenting approach in light of a diagnosis. And all children require limits, structure, routine, clearly defined rules, and consistent consequences for breaking rules. Trust your parenting instincts, they will serve you well if they are based on a secure, loving attachment to your child.

Here are some ideas, given with the best of intentions by well-meaning people with non-bipolar children. They work well, just not for bipolar children: Placing the child in timeout, distracting the child with something else, reward charts with cute stickers, ground the child or take away some privileges.

So what type of discipline does work for a bipolar child? What can the parent do to be more effective?

The most important thing you can do is understand the bipolar illness. Read everything, surf the Internet, talk to professionals and other parents with bipolar children. Knowledge is definitely power when disciplining bipolar children. The more you know, the fewer ineffective strategies you'll try and the less frustrated you'll feel.

Reinforce good behavior. This does not mean going over the top into a cheerleading routine every time your child behaves as required. But do acknowledge it when you see it. If you don't see it very often (at least twice an hour), you may even have to restructure some things to ensure opportunities for good behavior such as breaking tasks into smaller steps. Also reward your child's efforts to reduce problem behaviors. If your child would normally throw a tantrum and doesn't, then a special reward is in order. It's important that the bipolar child (or any child, frankly) not hear negative comments constantly.

Take the child to a therapist. A trained therapist can help the child develop mood awareness and learn ways to manage reactions. The therapist can also offer suggestions to you for more effective discipline.

Provide lots of love and a lot of structure. Most of the child's time should be structured and scheduled - stability is crucial.

Address the illness, not the child. In other words, know when the illness is talking. When talking to your child, do so in a way that separates the child from the illness - for example, "It seems like your mood is not very energetic right now and that makes brushing your teeth harder, but you must still brush them."

Listen to your child without interruption and without trying to fix anything - just listen.

Pick your battles. Not everything is worth mentioning. Decide for yourself what is a big deal and what is a small deal.

Be okay with being unconventional. You won't be able to parent or discipline a bipolar child as you would a non-bipolar child. There is a certain freedom in that. Now you can boldly trust your gut, experiment, and find that unique method of interaction that works for you, your family, and your child.