[Crazy Hitch]

I teach high school students (and I'm a year level coordinator) and one of my students has been displaying extremely erratic behaviour, aggression and anger in his classes across the board.

I had a 1:1 with him last week where he told me he is on an SSRI and has not seen his psychiatrist for ages. He did not disclose his diagnosis.

Due to a number of incidents last week, I rang mum today to request she comes into the school for a meeting on Thursday.

She had a complete breakdown on the phone to me and said she is at a loss. The mother told me she has bipolar and she suspects her son has it too. But he can't get an official diagnosis until he is 16 (just the way it works in Australia).

So currently he's on an SSRI for general anxiety. I told her he needs a med review.

In the interim .... what strategies can I put in place and relay to his teachers in order to support him?

My first strategy is, to issue him with a 'coordinator's pass' (time out card) so if he feels that he is about to snap he can come straight to my office and see me or another year level coordinator.

But I don't feel this is enough. Those of you with diagnosed bipolar, what would have helped you at school. Something your teachers could have done to support you, but never did?

I'd like to be able to offer some concrete suggestions.

Disclaimer: As the student has not officially been diagnosed, and the mother 'suspects' he has a mood disorder, I have decided to post this here. I'm absolutely no medical professional what so ever so I can't diagnose him either. But I see the writing on the wall (I'm bipolar too ) <- not that the mum knows that!!!!

The coordinator's pass sounds like a good plan. I wish I had one of those.

Do you have counseling services at your school? I think it would help him if you could set him up with a counselor, since they specialize in this sort of stuff.

[Crazy Hitch]

Originally Posted by bluebicycle

The coordinator's pass sounds like a good plan. I wish I had one of those.

Do you have counseling services at your school? I think it would help him if you could set him up with a counselor, since they specialize in this sort of stuff.

Yes, I am making a referral to our welfare department to see if they can support him.

I’d like the teachers to have some strategies too that they can use. Like sitting him on his own near the teachers desk so there’s less distractions per say

Originally Posted by Crazy Hitch

Yes, I am making a referral to our welfare department to see if they can support him.

I’d like the teachers to have some strategies too that they can use. Like sitting him on his own near the teachers desk so there’s less distractions per say

That's great

Have you talked to the counselor about ideas? That person might have some great ideas based on what they learned during their training.

Also, this might just be me... but if I were sitting on my own near the teacher's desk (away from other students), I'd feel singled out and embarrassed because it would attract unwanted attention to me. (Kids notice.) But sitting him in the front of the classroom in the middle would probably help.

[neverending]

I was dealing with bullying behavior of students around me and depression undiagnosed when I was in 8th grade. One of my teachers tried the desk solution you suggested and I just sobbed until she put me back into my regular seat. I did not want to be singled out.

That was over 50 years ago but your mention of the desk solution brought it immediately to my mind.

The teacher was trying to help me. But I could not deal with that type of solution.

Don't know if this helps you at all.

When I was in school I had what's called here a 504 plan, which said I could go to the nurse's office or guidance anytime I felt I needed to and I could have extensions on homework assignments, it was really helpful. I'm not sure if you have something like that in Australia or if he would need a diagnosis for that though.

[luvyrself]

The problem of being an undiagnosed bipolar is that they see the depression and give you antidepressants which can send bipolars into a hypomanic state or into mixed episodes—very common. Some of us should never be on an antidepressant,especially SSRIs. It depends on the patient. I applaud you for being so caring and trying to get him to the school counselor. I am so sorry to say this, tho. As you know bipolar is very complicated and few people understand it. If the mother who is bipolar has had proper care, she may understand it best,tho his bipolar might have different symptoms . She could consult her psychiatrist and/or psychologist for advice until her teen is old enough to be assessed. What a barbaric rule. Even young children can have bipolar,tho it usually doesn’t show up til later.Many many bipolars are misdiagnosed with only anxiety or depression and hence given the wrong medications. That happened to me. I finally had to diagnose myself, then get it confirmed by a psychiatrist. The poor kid is probably frustrated by not understanding what is going on with him. As a teen he is gong through a lot of adjustments of growing up anyway. Your experience must be helping so much and he is lucky to have you.. Do the parents have the money to have him assessed in another country?

I had my first major bipolar episodes at 14 and 15 years old. It definitely affected my behavior at school, and everywhere. That was over 30 years ago, though. At my school in the US, once the major problem really showed itself, my guidance counselor took over advising my parents. I don't know if you're the equivalent of a guidance counselor or if you have the equivalent in Australia.

In the US, it is/was my assumption that such a school official has/had a protocol for handling such matters. In any case, the very first step was to strongly encourage my parents to get me to a child therapist. If your student takes medications, I'd think that a psychiatrist, or other psych medication prescriber, should also be notified about the student's issues at school. In my case, my parents had to do that. I don't know if some schools now have formal mental health counselors that can take such initiatives. I never had children.

In my youngest nephew's case (and even my brother's), the schools referred to a special school. Both eventually returned to regular public schools.

I recall at a point when I was clearly depressed, a guidance counselor tried hard to find classes for me that I would derive more satisfaction from. That helped a little, but not enough.

I sort of like your idea of a coordinators pass, but with some reservations. My reservations are if the student used that private time for harmful behavior. Like others, I am not sure being at the front of the class is necessarily best. Perhaps ask the child if he'd like that. Sometimes the back of the class is better.

[sarahsweets]

I think offering some leeway with his work might help if he feels pressure. I know the lack of focus and feeling overwhelmed with the bipolar and school work caused things to flare up more. I am not saying he shouldnt do the work just maybe that it may have smaller amounts spread out over multiple days or maybe extensions with due dates. During the worst of my BPII in high school my grades sucked because I was dealing with everything else. I am 44 now so even back then they knew nothing about BP so I suffered until I tried saint Johns wort and I bounced back eventually and then got treated properly in my 20's.

[Crazy Hitch]

Originally Posted by bluebicycle

That's great

Have you talked to the counselor about ideas? That person might have some great ideas based on what they learned during their training.

Also, this might just be me... but if I were sitting on my own near the teacher's desk (away from other students), I'd feel singled out and embarrassed because it would attract unwanted attention to me. (Kids notice.) But sitting him in the front of the classroom in the middle would probably help.

Yes, I did think of that too ... but the articles I read online last night suggest this strategy when there is a lack of focus. It might be something we'd have to discuss with him first to let him decide.

[Crazy Hitch]

Originally Posted by neverending

I was dealing with bullying behavior of students around me and depression undiagnosed when I was in 8th grade. One of my teachers tried the desk solution you suggested and I just sobbed until she put me back into my regular seat. I did not want to be singled out.

That was over 50 years ago but your mention of the desk solution brought it immediately to my mind.

The teacher was trying to help me. But I could not deal with that type of solution.

Don't know if this helps you at all.

Thank you. Yes. Very helpful

[Crazy Hitch]

Originally Posted by spikes

When I was in school I had what's called here a 504 plan, which said I could go to the nurse's office or guidance anytime I felt I needed to and I could have extensions on homework assignments, it was really helpful. I'm not sure if you have something like that in Australia or if he would need a diagnosis for that though.

We do have a school nurse who visits every Friday. I can certainly suggest that he touches base with her.

[Crazy Hitch]

Originally Posted by luvyrself

The problem of being an undiagnosed bipolar is that they see the depression and give you antidepressants which can send bipolars into a hypomanic state or into mixed episodes—very common. Some of us should never be on an antidepressant,especially SSRIs. It depends on the patient. I applaud you for being so caring and trying to get him to the school counselor. I am so sorry to say this, tho. As you know bipolar is very complicated and few people understand it. If the mother who is bipolar has had proper care, she may understand it best,tho his bipolar might have different symptoms . She could consult her psychiatrist and/or psychologist for advice until her teen is old enough to be assessed. What a barbaric rule. Even young children can have bipolar,tho it usually doesn’t show up til later.Many many bipolars are misdiagnosed with only anxiety or depression and hence given the wrong medications. That happened to me. I finally had to diagnose myself, then get it confirmed by a psychiatrist. The poor kid is probably frustrated by not understanding what is going on with him. As a teen he is gong through a lot of adjustments of growing up anyway. Your experience must be helping so much and he is lucky to have you.. Do the parents have the money to have him assessed in another country?

Mum has told me that he has seen multiple psychiatrists, paediatricians and psychologists, none of whom want to diagnose him or change his meds ...

[Crazy Hitch]

Originally Posted by BirdDancer

I had my first major bipolar episodes at 14 and 15 years old. It definitely affected my behavior at school, and everywhere. That was over 30 years ago, though. At my school in the US, once the major problem really showed itself, my guidance counselor took over advising my parents. I don't know if you're the equivalent of a guidance counselor or if you have the equivalent in Australia.

In the US, it is/was my assumption that such a school official has/had a protocol for handling such matters. In any case, the very first step was to strongly encourage my parents to get me to a child therapist. If your student takes medications, I'd think that a psychiatrist, or other psych medication prescriber, should also be notified about the student's issues at school. In my case, my parents had to do that. I don't know if some schools now have formal mental health counselors that can take such initiatives. I never had children.

In my youngest nephew's case (and even my brother's), the schools referred to a special school. Both eventually returned to regular public schools.

I recall at a point when I was clearly depressed, a guidance counselor tried hard to find classes for me that I would derive more satisfaction from. That helped a little, but not enough.

I sort of like your idea of a coordinators pass, but with some reservations. My reservations are if the student used that private time for harmful behavior. Like others, I am not sure being at the front of the class is necessarily best. Perhaps ask the child if he'd like that. Sometimes the back of the class is better.

I am busy drafting the coordinator pass. So far I have written down:

The conditions are: -

It is NOT a 'get out of jail free' card if she does not like the lesson - Only if she is in distress - Must come straight to the coordinator's office - Must show you the pass first (ie: can not just walk out)

[Crazy Hitch]

Originally Posted by sarahsweets

I think offering some leeway with his work might help if he feels pressure. I know the lack of focus and feeling overwhelmed with the bipolar and school work caused things to flare up more. I am not saying he shouldnt do the work just maybe that it may have smaller amounts spread out over multiple days or maybe extensions with due dates. During the worst of my BPII in high school my grades sucked because I was dealing with everything else. I am 44 now so even back then they knew nothing about BP so I suffered until I tried saint Johns wort and I bounced back eventually and then got treated properly in my 20's.

I agree with managing the work load correctly. It's something I can discuss with his teachers so that he does not feel overwhealmed.

[Crazy Hitch]

*sigh*

And he had a punch on by the lockers and will be suspended ...

So far for my notes for the meeting I've drafted:

- Coordinators pass card before he rages up (his current mood level sits on an 8/10 daily)
- Water bottle in class (calms thinking)
- Seated in the front by the teacher, on his own (although reading feedback here that's not a crash hot idea so we can negotiate this with him first and see what he wants to do)
- Mum has requested he is put in contact with wellbeing
- Is he being challenged enough in class given his high IQ ? (tested as having superior intelligence - do teachers know this or is his misbehaviour masking his intelligence)
- Should Mum be contacting Head Space?
- Test conditions - does he need extended time for anxiety? Given this GA is his given official diagnosis by a psychiatrist (mum told me this yesterday on the phone)
- Video taped presentations rather than speaking in front of the whole class???
- Compass to be updated to reflect GAD under medical conditions as this is not stated

[Victoria'smom]

Can he have a separate testing area and extra time? It may help collect his thoughts to focus on the tests.

I second a middle seat in the classroom and to follow up with his counselor for additional thoughts on ways to encourage him. I would also look for signs of bullying by peers or siblings. Communicating his progress to his parents will be important. Chances are that if his mother has received a diagnosis of Bipolar, when he is of age, he will be able to find diagnosis also. Encouragement and an open door for extra help might be another way to help find out what his obstacles are.

[Crazy Hitch]

Originally Posted by Miguel'smom

Can he have a separate testing area and extra time? It may help collect his thoughts to focus on the tests.

Not a bad suggestion! I can organise this quite easily.

[Crazy Hitch]

Originally Posted by AB2371

I second a middle seat in the classroom and to follow up with his counselor for additional thoughts on ways to encourage him. I would also look for signs of bullying by peers or siblings. Communicating his progress to his parents will be important. Chances are that if his mother has received a diagnosis of Bipolar, when he is of age, he will be able to find diagnosis also. Encouragement and an open door for extra help might be another way to help find out what his obstacles are.

So far I have not seen signs of bullying by other students but it's certainly something I am always mindful of