Does bipolar disorder get worse with age?


Bipolar disorder is a mental health condition that is characterized by significant changes in a person’s mood, energy, and focus.

While the average age of onset for bipolar disorder is 25, some people develop the condition much later in life.

On A quarter of all people with bipolar disorder are 60 or older, and that number is expected to reach about half by 2030.

While the symptoms of bipolar disorder can vary with age, the frequency, severity, and overall impact of the disorder is generally different in older people compared to younger people.

In this article, we’ll look at how bipolar disorder changes with age, including how advancing age can affect symptoms, severity, and overall mental health.

In people living with bipolar disorder, age can affect:

  • how the symptoms appear
  • how severe are the symptoms
  • how the disorder affects the brain

Although many people with bipolar disorder are diagnosed at an early age, approximately 5 to 10 percent are 50 years of age or older at the time of diagnosis. Only about 0.5 to 1.0 percent of older adults are affected by bipolar I and bipolar II disorder, but the condition accounts for about 6 to 10 percent of psychiatric visits to communities for the elderly.

So how does bipolar disorder show up in older people compared to younger people, and how do symptoms change with age?

Mood changes in bipolar disorder result in distinct episodes called:

  • Mania: a significantly elevated or “high” mood
  • Hypomania: an elevated state that is not as extreme as mania
  • Depression: a “low” mood

Changes in the frequency and severity of episodes are among the most obvious changes in bipolar disorder in old age. Research suggests that older people with bipolar disorder often experience:

  • more frequent episodes
  • more depressive episodes and less time spent in manic or hypomanic states
  • less severe manic symptoms and fewer psychotic features with mania
  • new symptoms, such as irritability and poor cognition
  • lower suicide risk, although this may be due to survival bias
  • resistance to treatment options, such as certain medications

Because research on bipolar disorder in older adults is still lacking, it is difficult to determine exactly how these changes may affect different types of bipolar disorder.

According to experts, bipolar disorder can accelerate aging and contribute to cognitive decline. Older studies have found a link between bipolar disorder and cognitive decline, as well as an increased risk of dementia with each episode of bipolar disorder.

While bipolar disorder appears to negatively affect executive function and verbal memory in all age groups, older people are also more likely to be slower to process information. For this reason, older people with bipolar disorder may exhibit reduced neurocognitive ability, which can lead to a much lower quality of life.

Some of these changes may be due to the way bipolar disorder affects brain tissue. Many of these neurological changes can also be accentuated by a variety of factors, including:

  • natural changes of aging
  • other medical conditions
  • repeated mood swings
  • substance use or misuse

End-stage bipolar disorder

Although there is no official classification for end-stage bipolar disorder, mild structural changes in the brain that lead to cognitive dysfunction can significantly reduce a person’s quality of life, especially towards the end. of life.

Research from 2014 shows that older people with bipolar disorder appear to have significantly less gray matter in the frontal area of ​​the brain. This area contributes directly to emotional behaviors and emotional regulation. Other studies have also suggested that bipolar disorder may impact other areas of the brain related to cognition, memory, and more.

So while many older adults already experience changes in mood, cognition, and memory as part of the natural aging process, people with bipolar disorder may experience more intense changes.

Without the right treatment, daily living can be more difficult and overall quality of life can be lower towards the end of life.

If you’ve been diagnosed with bipolar disorder, it’s important to seek treatment for the condition, as it can get progressively worse if left untreated.

Although treatment varies from person to person, doctors usually treat bipolar disorder with medication and psychotherapy.

  • Medications are often the first-line treatment option for people with bipolar disorder. Medications help reduce the chronic (long-term) symptoms of the disease. Common medication options for bipolar disorder include:
  • Psychotherapy is often used along with medications to help reduce the behavioral symptoms of bipolar disorder. Useful approaches include:

As we age, it becomes much more difficult for our bodies to metabolize certain drugs. In the elderly with bipolar disorder, it can change how traditional mood-stabilizing medications work.

For example, a 2007 study found that older participants who took lithium or antipsychotic drugs had significantly reduced cognitive functioning. This suggests that older people may be more susceptible to the negative side effects of these drugs. With this in mind, it is important that older adults with bipolar disorder fully consider the treatment options available to them.

If medications don’t help, doctors may suggest electroconvulsive therapy (ECT). During ECT, electrical currents are briefly sent to your brain to stimulate it. It is usually a last resort to help treat depressive symptoms, but studies found it effective.

Research from 2015 suggests older people with bipolar disorder tend to die 10 years earlier than the general population. This could be because bipolar disorder is often accompanied by other health conditions, such as:

With the right combination of medication, therapy, and lifestyle changes, people with bipolar disorder may be able to lessen these changes and significantly improve their overall quality of life.

If you’ve been diagnosed with bipolar disorder, it’s important to contact a doctor to discuss a treatment plan and find the options that are right for you.


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