Written by Hafsa Saleemi,
6 Minute Read
Medically reviewed by:
Erin O'Callaghan, PHD
Director of Therapy
10 Minute Read
- If left untreated, bipolar disorder can worsen with age.
- Monitor changes in frequency or intensity of episodes to identify early-warning cues of mood changes and seek help accordingly.
- With proper treatment and support, you can manage bipolar disorder throughout life.
Bipolar disorder is a complex diagnosis, and it can be overwhelming for those who are just learning about it. Often those who have been diagnosed with bipolar disorder have many questions, including whether bipolar disorder gets worse with age. We want to answer some of these questions, and help you learn about some of the signs to look out for.
When are people generally diagnosed with bipolar disorder?
We tend to see symptom onset most often in younger adults, as is consistent with most other major mental health diagnoses. In part, this is due to so many life changes and transitions happening at younger ages.
This is important when you remember that the brain continues to develop through age 25 or so. Coupled with risk factors, the onset of many life changes—and a still-developing brain—can lead to the development of a mental health condition.
Bipolar disorder is caused by a combination of biological and environmental factors. Risk factors include:
- Intense emotional conflicts within families
If you would like to discuss your mental health concerns with a licensed mental health professional, Brightside Health can help. Start with a free assessment.
Does bipolar disorder get worse with age?
Similar to other medical conditions that can worsen if left untreated, bipolar disorder can worsen with age if not treated. Mental health practitioners can help you manage symptoms of bipolar disorder so that you can live a more meaningful and fulfilling life.
It is worth noting that there seems to be a prevalence of comorbid medical conditions in older adults with bipolar disorder. According to multiple studies, “older adults with BD experience higher rates of chronic medical diseases,” including:
- Cardiovascular disease
- Chronic pulmonary disease
Additionally, older adults with bipolar disorder tend to have “higher levels of obesity, endocrine/metabolic, and respiratory disease compared with older adults with major depressive disorder” according to the same report published by the International Journal of Geriatric Psychiatry.
The authors of the report found that:
Some comorbid medical disorders may be viewed as a consequence of mood disorder, while others may contribute to the pathogenesis [how the disease progresses from initial symptoms to worsening presentation] (Leboyer et al., 2012). Furthermore, treatments for medical disorders may contribute to mood disorder symptoms, and some mood disorder treatments, such as antipsychotic medications, may contribute to or exacerbate medical conditions.
The implication seems to be that the “worsening” of bipolar in the aging process seems to be tied up in the overall health of the individual, and can have much to do with other medications and conditions. It’s important to know that the mind and body work together and can influence each other. Taking care of yourself with the right treatment for bipolar disorder can help set you up for success in other areas of your life, including your physical health.
Does bipolar II get worse with age?
As we’ve discussed in our blog, there’s a diagnostic differentiation in bipolar disorder. These are often characterized as bipolar I and bipolar II.
People with bipolar I have experienced at least one manic episode and one major depressive episode. The National Institute of Mental Health explains that bipolar I is characterized by “manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks.”
Bipolar II features the same major depressive episodes as bipolar I, but without manic episodes. Instead, those with bipolar II will experience hypomanic episodes, which are shorter and less disruptive than the manic episodes described above.
While both major types of bipolar disorder can get worse over time, especially if not successfully treated, there seems to be a decrease in manic episodes as individuals age. In fact, as Dr. Eric Youngstrom explains to the American Psychological Association:
The biggest way that the illness seems to change with age is that older individuals are more likely to experience depression and less likely to have mania, whereas in childhood it is more mania or a mixture of high energy with negative mood. Researchers and clinicians have described that pattern for more than a century.
The key takeaway from this is that bipolar disorder is a lifelong mental health condition that can change over time.
Signs that bipolar is getting worse
One of the first things to watch out for as you age with bipolar disorder is a change in episodes. Whether they are manic or depressive episodes, you should contact your mental healthcare provider if you are experiencing them more frequently or notice a difference in intensity. It’s also a good idea to let people close to you know, such as your closest support network, so they can watch for any changes too.
As we said above, older individuals with bipolar disorder are more prone to experience depressive symptoms than manic symptoms, so be on the lookout for the symptoms of bipolar depressive episodes. These may include:
- Difficulty concentrating
- Changes in appetite
- Changes to your sleep patterns
- Feeling hopeless, worthless, or helpless
- Little interest in activities you usually enjoy
- Suicidal thoughts or ideas of self-harm
If you start to experience these symptoms more frequently than you did in the past, it may be a sign that your bipolar disorder is getting worse. In every case, it’s worth a discussion with your mental health provider.
Even as there seems to be evidence that bipolar can get worse with age, there’s plenty of reason for hope. With proper treatment, support, coping skills, and a watchful eye on your symptoms, you can manage bipolar disorder throughout life.
One of the best approaches to thinking about long-term management of bipolar and related disorders is to take it day to day. Evaluate your symptoms, and stick to your treatment plan.
If you are concerned about bipolar disorder, or about any mental health symptoms you may be experiencing, contact Brightside Health today.
If you are in emotional distress or thinking about hurting yourself in any way please make use of these resources:
- Visit: If you are having a medical or mental health emergency, call 911 or go to your local emergency department
- Text: The Crisis Text Line provides 24-hour free and confidential help. Text ‘HOME’ to 741-741 to connect with a counselor immediately
- Call: You can call the National Suicide Prevention Lifeline simply by dialing 988 to talk with a live counselor 24 hours per day