Kids, in general, can experience heightened anxiety about the future and feeling out of control without information about what's coming next. (Who wouldn't?) This feeling can be magnified in children with bipolar disorder. Maintaining control is crucial for such kids, especially when internally everything seems to be spinning beyond their means. Given this, they may become quickly and easily unhinged when routines change without warning or information is sprung on them the last minute. As a result of not coping well with change, your child may be medicated for anxiety. This is an intervention strategy, not prevention. Maintaining a personal schedule, such as many of us use, may enable your child to feel safe and comfortable and in control of knowing what's coming next, thus reducing anxiety without additional medication.
The advantages to supporting your child in initiating a personal schedule are as varied as they are for us all. Our visual daily schedules keep us focused and oriented with respect to time, sequence of events, priorities, and knowledge of what's coming next. Without this structured information, we may become lost or even panicked.
Few of us are without some sort of timekeeping device such as a pocket calendar, Palm Pilot, computer calendar, or desk planner with space for events up to a day, week, or month ahead of time. Many people joke that they couldn't function without their schedule and are totally at a loss without it. Have you ever misplaced yours? If so, then you may be in a position to appreciate the kind of nervous anxiety experienced by kids who rely on the adults in their life to keep pace with what's coming next. The longer you go without having your schedule—and knowing you are still responsible for sticking to it—the more upset and distressed you're likely to become. Why should your child be without a similar way of independently tracking time and keeping current with upcoming events and activities? This may be why a lot of kids do well during the school day. Their schedule is established at the beginning of the school year, and it's blocked out in specific segments of time. The same kids can become really undone at home after school, evenings, weekends, and on holidays or vacations because of big blocks of unstructured time.
The first step in nurturing your child's independence in maintaining a personal schedule is selecting the schedule itself. If your child is a computer whiz and is good with other electronic equipment, help him to select a Palm Pilot that suits his needs and interest. If your child can write well and likes to write, he may prefer a hard-copy date book, like the planners available at any office supply store. Whatever is decided upon, your child should select what appeals to her most and is within your budget.
Each evening, partner with your child to set up the schedule for the next day. (Scheduling to schedule may need to be an entry in the schedule!) As part of a bedtime routine, some parents verbally review the day's events and talk about what's coming up for the next day, a simple concept that builds upon all that good and thoughtful stuff by making it tangible and concrete. Knowing the night before what tomorrow is supposed to look like, and having it all recorded so there's no forgetting or mistaking it, may be one more strategy to enable your child to rest and relax enough to shut down for the night. Once your child gets the hang of filling out his own schedule, you may wish to fade out your support unless it makes for some good parent-child quiet interactive time. Teens will probably want more independence in doing this, but you may want to check the schedule, with your child's permission, to make certain it's being used.
If your child chooses a hard-copy book for his schedule, he may wish to personalize it. The covers could be decorated with his original art or stickers related to favorite television shows or cartoons, or racecar or music personalities. Personalizing the schedule in this way creates an investment in the schedule itself, and an incentive to see it as something personal instead of a task you insist upon, which could create resistance.
How It Works
As you've probably already guessed, the times when the schedule will be most effective are during those large, unscheduled, unstructured blocks of time like evenings, weekends, holidays, and summer vacation. It's probably going to be best to arrange the schedule in a specific sequence. Start by setting it up like a to-do list that many people use to visually identify what needs to get done, and monitor the progress on what they've accomplished (which can be really satisfying). Begin with scheduling one or two preferred activities that relate to your child's passions or interests, so long as they meet your approval for what's acceptable. Following the preferred activities, try scheduling a “nonpreferred” activity, like a household chore or homework—this should all be in keeping with the rules you've established about expectations and responsibilities. Continue in this sequence—preferred/nonpreferred/preferred—as much as possible. When you partner with your child to build a schedule in this way, you create an incentive for her to use it rather than run from it because it's all nonpreferred stuff, and that's no fun! (Otherwise the schedule may be perceived as a punitive device used by you to control or manipulate your child into compliance.) The schedule may also be used to indicate birthdays, anniversaries, special events, and appointments of all kinds. As soon as your child gets comfortable using the schedule, give her room to take the lead in setting it up with minimal assistance from you.
The great thing about the schedule is that, in disputes, it becomes the perfect “patsy.” For times when your child is nagging you repeatedly with the same questions over and over again, or if he protests or procrastinates about a nonpreferred activity, simply refer him back to the schedule. After all, it's all there in black and white just as he entered it originally. Your response to these situations should be a consistent, “Well, what does your schedule say is next?” A confrontation that could quickly escalate out of control between you and your child can be significantly softened when he realizes that you can't argue with what's concrete. (This doesn't mean that you never exercise reasonable parental leniency, as you'd grant any child, but consistency, more often that not, is key).
It's probably best not to schedule activities by specific time frames. Your child may be the type to put undue pressure on himself if the schedule isn't on track down to the last minute. However, most children should find it to be a very useful tool for feeling safe and comfortable and in control of knowing what's coming next.