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Does Bipolar Get Worse With Age?

When a loved one receives a diagnosis of bipolar disorder, our first thoughts often focus on the immediate impact of this condition. But it is also important to consider the potential long-term effects. For example, can the symptoms of bipolar disorder change as a person gets older? Will an individual with bipolar disorder experience greater distress later in life? Does bipolar get worse with age?

What Are the Symptoms of Bipolar Disorder?

Bipolar disorder is an umbrella term that may refer to three distinct diagnoses: bipolar I disorder, bipolar II disorder, and cyclothymic disorder. Depending on which type of bipolar disorder a person has, they may experience manic episodes, hypomanic episodes, and/or major depressive episodes. They may also have hypomanic and depressive symptoms that don’t last long enough to qualify as a hypomanic or major depressive episode.

  • Manic episodes are characterized by increased energy, elevated self-esteem, enhanced confidence, and greater activity. During a manic episode, a person may begin several projects. They may also engage in impulsive or reckless behaviors related to spending, sex, eating, and gambling. Manic episodes last for a week or longer.
  • Hypomanic episodes include the same types of symptoms as manic episodes, but these symptoms don’t last as long. A hypomanic episode may end after only four days.
  • Major depressive episodes involve profound sadness, low energy and motivation, abnormal sleep patterns, diminished self-confidence, lack of appetite, thoughts of death, and a pervasive sense of worthlessness. Major depressive episodes will last for at least two weeks.

Does Age of Onset Influence Bipolar Symptoms?

In addition to exploring if the symptoms of bipolar disorder get worse with age, researchers have also investigated the impact that age of onset can have on a person’s experience. According to a 2021 study in the Industrial Psychiatry Journal, symptoms of bipolar disorder typically appear before a person reaches age 30. To explore the relationship between age of onset and symptom severity, the authors of the 2021 study organized 162 subjects into three groups:

  • Early-onset: These people developed symptoms of bipolar disorder at age 21 or younger.
  • Middle-onset: Symptoms first appeared between ages 22-34.
  • Late-onset: Symptoms began to appear after age 35.

All subjects were people who had been admitted to inpatient treatment while experiencing manic episodes. The research group’s work produced the following findings:

  • The early-onset group had more episodes each year than did the members of the other groups.
  • Members of the early-onset group were more likely to have a family history of mood disorders.
  • Those in the early-onset group rated higher on assessments for irritability, depressed mood, thought disorders, and delusions.

The authors of the 2021 report also noted that a previous study found that people who first experience symptoms of bipolar disorder at age 20 or younger were more likely to experience hypersexuality, depressed mood, disinhibition, and psychosis. The people in the early onset group from the previous study also had a greater overall severity of symptoms.

Does Bipolar Get Worse With Age?

The studies that were mentioned in the previous section indicate that the early onset of symptoms is associated with a greater risk for certain effects. But what happens as these symptoms persist? Does bipolar get worse with age? 

One report suggests that some symptoms of bipolar disorder get worse with age for some (but not all) people. This report, which was published in the August 2009 edition of the journal Psychological Medicine, evaluated people who had either bipolar I disorder or schizoaffective manic disorder. All the people who were evaluated for this report had completed at least 20 years of follow-up assessments through the National Institute of Mental Health (NIMH) Collaborative Depression Study.

The authors of the 2009 report organized the subjects according to how old they were when they began to participate in the NIMH study. There were three groupings:

  • Youngest: Age 18-29 when they entered the NIMH study
  • Middle: Age 30-44 when they completed their first NIMH assessment
  • Oldest: Age 44 and above when they first engaged with the NIMH study 

The researchers found that depressive symptoms of bipolar disorder got worse with age for those in the youngest and middle groups. Those who did not begin to be assessed until age 44 did not show the same progression in terms of increased severity of depressive symptoms.

The report’s authors concluded that, regardless of when a person first experiences symptoms, “the passage of decades in bipolar illness appears to bring an increase in the predominance of depressive symptoms in individuals in their third, fourth and fifth decades.” In other words, for people in their 20s through their 40s, this report suggests that the depressive aspect of bipolar does get worse with age. 

How is Bipolar Disorder Treated in Atlanta, GA?

Bipolar disorder is usually treated with a combination of prescription medication and psychotherapy. Beneficial medications for people who have bipolar disorder may include antidepressants to address depressive symptoms and mood stabilizers or antipsychotics for manic or hypomanic symptoms.

The therapeutic component of treatment for people who have bipolar disorder may include individual, group, and family sessions. Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are often incorporated into treatment. Educational and skill-development sessions may also be valuable. 

Depending on various factors, treatment for bipolar disorder may occur at the residential, partial hospitalization, intensive outpatient, and outpatient levels. Some people may receive bipolar disorder treatment at multiple levels of care. Others may enter and exit treatment at the same level.

Begin Treatment for Bipolar Disorder in Atlanta, GA

If you have been seeking treatment for bipolar disorder for yourself or someone that you care about, Peachtree Wellness Solutions is here to help. Our center in Atlanta, Georgia, is a safe and welcoming place where adults receive customized services and comprehensive support from a team of skilled professionals. To learn more, give us a call or visit our admissions page today to learn more.