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Children with early-onset bipolar
disorder may present with a wide variety of symptoms that range from mild to extreme and that may begin as early as infancy (Papolos & Papolos, 1999).
These may include irritability, unpredictability, hyperactivity and attention problems, conduct problems, social problems, childhood depression, eating
disorders, self-mutilation, and suicidal ideation (NIMH, 2000; Papolos & Papolos).

Early-onset bipolar disorder is difficult to diagnose because symptoms overlap with other disorders as well as with normal childhood development. Once a diagnosis has been made by an appropriate professional, early intervention is imperative (Bardick & Bernes, 2005)

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"Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks" (National Institute of Mental Health, 2018).

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"Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling" (Mayo Clinic, 2020).

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People dealing with Bipolar Disorder tend to have rather unusual and intense emotions, changes in sleep patterns and activity levels, and uncharacteristic behaviors (National Institute of Mental Health, 2018).
-having either or both manic (highs) and depressive (lows) episodes that come on everyday for the majority of the day

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Having one or more of these symptoms everyday, most of the day for about two weeks consecutively:
-feeling of hopelessness
-being sad for no reason
-being irritable
-interest loss in most things usually found fun, exciting, or intriguing
-appetite and/or weight changes
-thoughts of death, suicide, or suicidal attempts
-low mood
The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness (National Institute of Mental Health, 2018).

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- Delusions
- Hallucinations (both of sound and sight)
- Disorganized thinking or speech
- Extremely disorganized or abnormal motor behavior (body movement)
- Negative symptoms (lack of ability to function normally)
(Mayo Clinic, 2020)

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*Mental Health Clinic of Greenville, (903) 274-4140, https://www.mhcgreenville.com

*Hunt Regional Healthcare - Behavioral Health, (903) 886-2238, https://www.huntregional.org/our_services/behavioral_health.aspx

*Depression and Bipolar Support Alliance (DBSA), (817) 654-7100, http://dbsadallas.org/

*Pandora's House Psychiatric Mental Health Providers, (972) 784-3064, https://pandorashousepsychiatry.com

*Hometown Counseling LLC, (903) 689-2324, https://hometowncounseling.com

*Schizophrenia and Related Disorders of America, (240) 423-9432, https://sardaa.org/

*HERE for Texas, (972) 525-8181, http://www.herefortexas.com/index.html

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The school counselor may act as a consultant or resource person for parents, teachers, and school personnel (Bardick & Bernes, 2005).   The school counselor can help make referrals for accommodations for the student, but counseling the student is not necessarily what the school counselor is capable of. School counselors have limited capacity in dealing with these students, as we focus on short term focused counseling. Students should be referred out when necessary.

Step 1: Student concern arises.
Step 2: Student referred to school counselor, concern identified.
Step 3:  Once a concern is identified, the school counselor uses objective and subjective data to assess the situation and determine the level and type of intervention to be taken on the student’s behalf .
Step 4:  Interventions are implemented and the student’s progress is monitored. The student’s response to the intervention will be reassessed and the intervention plan modified as needed.
Step 5: School counselor maintains contact and consults local school board policies regarding student confidentiality (ethical) and family privacy (legal) as well as procedures to follow for a referral to a community agency.
(Missouri Professional School Counselors and Counselor Educators, 2015)

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Andrew Lee (2019) explains that, "The Individuals with Disabilities Education Act (IDEA) requires schools to provide special education and related services to eligible students. But not every child with learning or attention issues qualifies. To be covered, a child’s school performance must be “adversely affected" (para 1).

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The ASCA Ethical Standards for School Counselors (2016) section A.2.f states that school counselors will recognize their primary ethical obligation for confidentiality is to the students but balance that obligation with an understanding of parents’/guardians’ legal and inherent rights to be the guiding voice in their children’s lives. School counselors understand the need to balance students’ ethical rights to make choices, their capacity to give consent or assent, and parental or familial legal rights and responsibilities to make decisions on their child’s behalf (ASCA, 2016).

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Section 504 of the Rehabilitation Act of 1973 (commonly referred to as Section 504) is a federal law designed to protect the rights of individuals with disabilities in programs and activities that receive federal financial
assistance (PACER Center, 2020).

Breakdown of how it works in schools to get the help the child is in need of.
- child need
- parent request or teacher referral for evaluation
- Does it inhibit one or more major life activities? NO - does not qualify, YES - does qualify for Section 504---determine action plan, create accommodations, staff carries out accommodations for child.

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Amber Schneider
Professional School Counselor
903.259.5546
schneider@greenvilleisd.com

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American School Counselors Association. (2016). ASCA Ethical standards for school counselors. Alexandria, VA: Author. Retrieved from https://www.schoolcounselor.org/asca/media/asca/Ethics/EthicalStandards2016.pdf

Bardick, A. D., & Bernes, K. B. (2005). A closer examination of bipolar disorder in school-age children. Professional School Counseling, 9(1), 72-77. https://doi.org/10.5330/prsc.9.1.k2153125rh517

Depression. National Institute of Mental Health. (2018, February). https://www.nimh.nih.gov/health/topics/depression/index.shtml.

Lee, A. M. I. (2020, October 22). The 13 disability categories under IDEA. IDEA Disability Categories. https://www.understood.org/en/school-learning/special-services/special-education-basics/conditions-covered-under-idea.

Missouri Professional School Counselors and Counselor Educators. (2015). School counselor referral process guide: A school counselor’s guide to the referral process. Retrieved from https://dese.mo.gov/sites/default/files/guid-respon-serv-referral-process-guide.pdf

Schizophrenia. Mayo Clinic. (2020, January 7). https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443.

Section 504 of the Rehabilitation Act of 1973 - PACER Center. PACER Center - Champions for Children with Disabilities. (2020). https://www.pacer.org/parent/504/.