Centre for Accessibility Services

Bipolar and related disorders

What is bipolar disorder?

Bipolar disorder is a brain disorder that impacts an individual’s moods, energy, and daily living. Moods can range from extreme elevation (manic) to extremely low (depressive) episodes. These episodes can last for undetermined timeframes, based on the type of disorder and its severity. It can be treated by a combination of medication and psychotherapy.

Common types of bipolar disorder with DSM-5 coding

  1. Bipolar I disorder – DSM-5 code: 296.41-296.46
  2. Bipolar II disorder – DSM-5 code: 296.89
  3. Cyclothymic disorder – DSM-5 code: 301.13
  4. Other specified, unspecified and related disorders – DSM-5 code: 296.80-296.89

Symptoms & common characteristics

There are several types of symptoms related to each specific diagnosis of bipolar disorder and are often categorized under mania or hypomania and depression. Although mania and hypomania have the same symptoms, they are distinguished by the severity of the symptoms. Hypomania is a milder form of mania and lasts for less time than a manic episode.

Manic and hypomania symptoms:

  • Period of elevation, expansive, or irritable mood
  • Abnormal and/or persistent increased activity, energy, agitation
  • Increased self-esteem, grandiosity
  • An exaggerated sense of well-being and self-confidence (euphoria)
  • Decreased need for sleep
  • Talking more, a flight of ideas, racing thoughts
  • Increase in goal-directed activity; involvement in activities that have painful consequences
  • Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments

Depressive symptoms:

  • Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)
  • Marked loss of interest or feeling no pleasure in all — or almost all — activities
  • Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression)
  • Either insomnia or sleeping too much
  • Either restlessness or slowed behavior
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Decreased ability to think or concentrate, or indecisiveness
  • Thinking about, planning or attempting suicide

Centre for Accessibility support for bipolar disorder may include

  • Alternate format materials (texts into PDF/E-Text)
  • Breaks from class as needed
  • Note-taking services
  • Preferential seating in the classroom
  • Recording lectures

Statistics

  • One percent (1%) of Canadians aged 15 years and over reported symptoms that met the criteria for a bipolar disorder in the previous 12 months. About 1 in 50 adults aged 25-44 years or 45-64 years reported symptoms consistent with bipolar disorder at some point in their lifetime. The proportion of men and women who met the lifetime criteria for bipolar disorder decreased slightly with age. (2002 Mental Health and Wellbeing Survey, Statistics Canada).
  • Nearly 9 out of 10 Canadians who reported symptoms that met the 12-month criteria for bipolar disorder (86. 9%) reported that the condition interfered with their lives (2002 Mental Health and Wellbeing Survey, Statistics Canada).
  • While most people with bipolar disorder (or depression) will not commit suicide, the risk of suicide among those with bipolar disorder is higher than in the general population.

Sources

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

National Institute of Mental Health

Tips and tools for supporting students with bipolar disorder

Notes and handouts: Provide lecture notes and course materials in a variety of formats (i.e. electronic and compatible with assistive technology). Provide hand-outs electronically in advance of lectures, and during class display the main points to be covered in each session.

Projects, presentations, and assignments: Provide students with detailed instructions on major projects, presentations, and assignments through written and oral explanations. When marking projects, presentations, and assignments, provide feedback on content, structure and encourage the use of a computer and software to improve presentation.

Teaching strategies: Allow for stretch and bathroom breaks in the classroom, especially for long lectures.

Syllabus: Provide a detailed syllabus with clear identifiers of your contact information, office hours/drop-in hours, course objectives, deadlines for assignments/projects, and exam dates. This information will allow students to seek support with upcoming deadlines that may not be clear to them. 

Study guide/review sheets: Provide study guides or review sheets for exams.

Questions around disability: Due to the individuality of the disability, instructors are encouraged to have conversations with students to discuss their needs. When you are unsure about a student’s progress or participation in the class, ask the student privately without drawing attention to the student or their disability. Be patient when waiting for a response from a student, as it may take them longer to process information and formulate their response. It may feel awkward to leave several seconds of silence, but allow them the time they need and try not to rush them or answer for them.

Resources and websites

Mayo Clinic 

Canadian Mental Health Association 

HealthLink BC

Tips and tools for students with bipolar disorder

Emotions: If you are feeling emotional, take a breath and try to think of something positive. It may help to keep a list of positive things that you can focus on. Find strategies that help calm you down such as counting to ten, going for a walk, or deep breaths. Take a break and come back to what you were doing once you are more relaxed. Write down your feelings and consider speaking with a counsellor and/or doctor about your challenges.

Self-care planning: Staying organized and creating a self-care plan that can model positive self-care strategies ensures you are taking care of yourself amongst the stressors of post-secondary life.

Daily routine: To ensure that you are successful in your time at university, creating a routine that provides you with enough sleep, healthy eating and regular exercise can be beneficial to your overall health. A proper routine will decrease or eliminate the symptoms of your disability and allow you to maintain good mental, emotional and physical health.

Support: A strong support system can allow you to lean on those that understand your disability the best. This can include community resources, university resources, friends, family, and pets. Students can bring their support systems to see counsellors, advisors or accessibility advisors through written consent.

Mental thoughts: The symptoms of a disability can often lead us into "thinking traps", where problems become very difficult to solve or situations can be unbearable to deal with. Healthy thinking allows you to use techniques that balance your thoughts and allow you to see the problems or situations for what they are. Counsellors or support workers can provide you techniques that can move you away from thinking traps and become solution-focused. Visit Anxiety Canada for some examples of thinking traps and ways to challenge your thinking traps.

Mental health planning: As life gets busy, we often forget to take care of ourselves or check-in with how we are doing. Creating a Mental Health Meter for yourself can allow you to determine where you are on the continuum of happiness to sadness. Writing in a journal, asking yourself questions or talking to a friend/support worker about how you are feeling can help self-identify if things are good or bad. Taking a Mental Health Meter or creating your own can provide you with the awareness for you to reach out to support. Connecting with local supports as early as possible allows you to strengthen easily accessible relationships, provide awareness around your disability and build accommodations around your disability. Talking to a professional about your experiences, symptoms, and challenges can allow you to work through problems, build self-confidence, and get the required support in any situation.

Meet with your instructor: You are your own best advocate so regular communication with your instructors and support team is recommended to ensure that your needs are being met. Instructors provide information about their office hours and ways to communicate at the beginning of the course. Utilize these times to check in with your progress, ask questions and receive feedback.

Deadlines: Technology can be difficult to manage at times, but when it comes to supporting us with our everyday tasks, it can be a lifesaver. Our cell phones, laptops, tablets, and computers come with a variety of tools that can help manage our daily lives. There are an assortment of software or apps that can assist with creating to-do lists, events calendars, and reminders. These tools can highlight important tasks and ensure projects meet the required deadlines. In any case, embrace the technology and find an app that works for you. Try to use one device or sync your device to others so information can be easily accessible.

Lack of attention/focus: It may take longer to do things now. Take breaks and rest as needed. Try to focus on one thing at a time rather than multi-tasking. Reduce distractions by working in an uncluttered area and wear ear-plugs to block out sounds that may be pulling your focus.

Study area organization: It is important to get organized to ensure life can stay simple and allow you to focus on the deadlines that come up fast. Having a place for everything can decrease the hours of searching for that piece of paper with your brilliant notes, or arriving to class on time. Creating systems with organizational tools including hooks, baskets, clear boxes or visual reminders will simplify your life and help you naturally organize necessary items. As for supporting you in the classroom, having color-coded binders for each class, clear labels and highlighted important dates can help.

Study time: Identify what your best time to study is. If the symptoms of your disability tend to be worse at a particular time of day, plan your studying around that so you aren’t trying to focus on studying when you are in pain. Manage your time effectively, as you are less likely to encounter as many problems with deadlines.

CAS accessibility advisor: Students are encouraged to meet with an accessibility advisor four months before the beginning of the course or program to ensure accommodations are set up from the start. Your accessibility advisor will explore needs, options and supports during your time with the university. It is important to work with your accessibility advisor to help you communicate effectively with your instructors about what is helpful/unhelpful for your learning. You can review the university accessibility policies and procedures online or through the department.

Counselling services: The counselling department offers support with career planning, study tools and tips, crisis support with personal issues and workshops on special topics.

The Academic Success Centre (ASC): The Academic Success Centre (ASC) offers free student-focused tutoring, workshops, online resources, and support programs. Peer tutors work with students on personal learning strategies and approaches and provide writing and subject-area support under the supervision of the Learning Strategist and the Coordinator of the Academic Success Centre.

Resources and websites

Mayo Clinic

Canadian Mental Health Association

HealthLink BC

HeretoHelp

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