You Have Another Mental Health Condition
Bipolar disorder may also be linked to other mental health conditions. The National Institute of Mental Health links it to anxiety disorders, eating disorders, ADHD, and substance abuse disorders.
Because the exact relationship between bipolar disorder and other mental health conditions isn’t clear, it’s hard to say how likely people with certain mental health conditions are to have bipolar disorder, and vice versa. However, research does suggest that some mental health conditions can co-occur with bipolar. If you live with one of the following conditions, you may want to be on the lookout for symptoms of bipolar disorder:
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Substance abuse. A 2004 study published in the journal Bipolar Disorders evaluated 4,310 people receiving treatment for bipolar disorder at Veterans Administration facilities. Researchers found that 25% of these patients had alcohol use disorder, 10.4% abused cocaine, and 4.4% abused opiates.
- Psychosis. Research suggests that some types of psychosis episodes where a person has trouble differentiating between what is real and what’s not might be linked to developing bipolar disorder. A 2018 paper published in the American Journal of Psychiatry looked at 6,788 people who experienced substance-induced psychosis, which is when using alcohol or drugs triggers delusions or hallucinations. They found that 32.2% of the subjects developed either bipolar disorder or schizophrenia after their psychosis, typically within a few years’ time.
How The Health Questions Affect Simplified Life Insurance Underwriting For People With Bipolar Disorder
The questions on the application matter. If the carrier asks about bipolar disorder or, in some cases, generic mental/emotional disorder, on the application, then likely the disorder is a problem. In other words, they will decline your application.
Here are some real questions from carriers offering simplified underwriting:
These carriers would deny your application.
We obviously do not use these carriers for your situation. Who would we use then?
That is right. The carriers that dont ask about bipolar disorder on the application.Moreover, there are many carriers that will cover your health condition.
However, many of these applications have hospitalizations and drug/alcohol abuse questions. If you have recently been hospitalized due to your condition, for example, the carrier will deny your application.
Ok. Now that you know what the carriers look for when someone with bipolar disorder applies for life insurance, lets discuss the 4 types that are available.
What Tests Will The Doctor Use To Make A Bipolar Diagnosis
Your doctor may have you fill out a mood questionnaire or checklist to help guide the clinical interview when they assesses mood symptoms. In addition, your doctor may order blood and urine tests to rule out other causes of your symptoms. In a toxicology screening, blood, urine, or hair are examined for the presence of drugs. Blood tests also include a check of thyroid stimulating hormone level, since depression is sometimes linked to thyroid function.
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What Have You Learned As A Result Of Your Experiences
Living with bipolar, often for years, teaches you a lot about yourself, about mental health services, about medicationand sadly often about stigma, shame, and discrimination.
Id say for me it was a key driver for learning about mebut also a red herring as I feel I vested too much of my own identity in clinging to the life-raft of the diagnosis as an explanation of my life in my early 20sagain though, there are a range of perspectives:
Brian talks of the possibility of recovery:
Despite what others may tell you, or what you might believe, recovery is possible. I never thought I could be a worthwhile human being and have something meaningful to offer.
That’s just illness speak and the effects of learned stigma. It doesn’t need to be that way.
Anna points to learning about what is important in life:
I have learnt that I am more resilient than I could have ever imagined. I have discovered that there is more to life than getting a degree or a good job. I have learnt that I have amazing friends who never stopped believing in me, even when I couldn’t believe in myself.
Hannah draws on a theme park analogy to talk about assembling your team of helpers:
I feel like I’m riding a constant rollercoaster of moods. There are people who are too scared to come to the theme park, those that will hop on rides with you and those that watch sensibly in awe and sickness from a distance minding your bags.
All of those people have a valid and useful part to play in your life.
Bipolar 1 Disorder Or Bipolar 2 Disorder
The type of bipolar disorder matters as well. Some life insurance carriers lump all bipolar disorders together. We usually dont want to work with those carriers that do that. It shows they dont know how to properly underwrite your health condition.
As you are aware, bipolar 1 disorder presents more intense and significant manic episodes than bipolar 2 disorder. People with bipolar 1 disorder may exhibit longer manic symptoms compared to those with bipolar 2. Carriers know this, and they know bipolar 1 could hinder normal activities compared to bipolar 2 disorders.
So, if you have bipolar 1 disorder, then your life insurance options will likely be limited compared to someone who has been diagnosed with bipolar 2 disorder.
As we have said, no worries. We likely can still help you obtain some level of life insurance.
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What Is The Treatment For Mania Hypomania And Depression
You can check what treatment and care is recommended for bipolar disorders on the National Institute for Health and Care Excellence website.
NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at:
The NHS doesnt have to follow these recommendations. But they should have a good reason for not following them.
What medications are recommended?
Mood stabilisers are usually used to manage mania, hypomania and depressive symptoms.
The mood stabilisers we talk about in this factsheet are:
- Lithium
- Certain benzodiazepine medication
Mania and hypomaniaYou should be offered a mood stabiliser to help manage your mania or hypomania. Your doctor may refer to your medication as antimanic medication.
If you are taking antidepressants your doctor may advise you to withdraw from taking them.
You will usually be offered an antipsychotic first. The common antipsychotics used for the treatment of bipolar disorder are:
- Haloperidol
- Quetiapine
- Risperidone
If the first antipsychotic you are given doesnt work, then you should be offered a different antipsychotic medication from the list above.
If a different antipsychotic doesnt work, then you may be offered lithium to take alongside it. If the lithium doesnt work you may be offered sodium valproate to take with an antipsychotic. Sodium valproate is an anticonvulsive medication.
Sodium Valproate shouldnt be given to girls or young women who might want to get pregnant.
Get Involved With Treatment
Ask if you can be involved with your partners treatment, which may include occasionally going to the psychiatrist together. Being a part of your partners treatment has multiple benefits, including:
- Gaining a better understanding of the illness.
- Providing additional insight for the psychiatrist.
- Learning to spot signs of impending episodes.
- Alerting the psychiatrist about mood changes.
Even if your partner hasnt signed off on you exchanging information with their psychiatrist, you can still report worrisome signs . This gives the doctor a chance to make quick medication changes that may help your partner avoid being hospitalized.
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Types Of Life Insurance That Are Available To People Who Have Bipolar Disorder
We have helped many people with bipolar disorder obtain life insurance. Here are the 4 types that are available. We also go into estimated costs, which are subject to change at any time.
As we said, the availability and eligibility really depend on your situation. Nevertheless, we are confident we can help you obtain some level of life insurance coverage.
Simplified Issue Life Insurance Burial Insurance
Burial insurance is also available. What is burial insurance? It is a whole life insurance policy with a small death benefit, like $30,000. The main purpose of the life insurance is, as the name suggests, is for your burial, funeral, and final expense needs.
Burial insurance is an easy application and underwriting. See the simplified underwriting section above. As long as
- the carrier doesnt ask about bipolar disorder,
- the carrier accepts your medication, and
- there is nothing else in your background that adversely impacts your application
you will obtain burial insurance. It is really that easy.
Additionally, term life insurance policies with small death benefits are available as well.
These policies are key for people who might be on SSDI or SSI, for example. In fact, we have helped many people with bipolar disorder on SSDI obtain burial insurance or small term life policies.
There are a couple of types of burial insurance:
- an immediate benefit pays the benefit, just as it sounds, immediately. If you pass away tomorrow, the carrier pays the benefitimmediately.
- However, a graded-benefit policy pays a percentage of the death benefit or return of your premiums in the first couple of years if you were to pass away.
People with moderate to severe health conditions usually end up with a graded-benefit policy.
As we said, however, we aim for immediate benefit policies. We have helped many people with bipolar disorder obtain immediate benefit life insurance policies.
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Dont Panic Over Your Bipolar Brain
I know the picture and research above are alarming! However, just as bipolar can destroy grey matter, lithium re-grows it:
Just four weeks of treatment with lithium increases gray matter volume in the human brain, according to a study by Wayne State University School of Medicine on the bipolar brain. This regrowth is due to lithium helping with cognitive functions that are otherwise difficult for bipolar patients.
Think of lithium aiding the brain like a knee brace for a bad knee that allows someone to continue to lift weights and build muscle they otherwise would not be able to.
What Are The Signs And Symptoms
A person with bipolar disorder will go through episodes of mania and at other times experience episodes of depression . These aren’t the normal periods of happiness and sadness that everyone experiences from time to time. Instead, the episodes are intense or severe mood swings, like a pendulum that keeps arcing higher and higher.
Symptoms of mania include:
- anger, worry, and anxiety
- thoughts of death or suicide
In adults, episodes of mania or depression usually last for weeks or months, although they can be shorter in length. In children and adolescents, though, these episodes can be much shorter, and a kid or teen can even go back and forth between mania and depression throughout the day.
Episodes of mania or depression may happen irregularly and follow an unpredictable pattern or they may be linked, with a manic episode always following a period of depression, or vice versa. Sometimes episodes have a seasonal pattern. Mania in the spring, for example, may be followed by depression in the winter.
Between episodes, someone with bipolar disorder usually returns to normal functioning. For some people, though, there is little or no “break period” between their cycles. These mood swing cycles can change slowly or rapidly, with rapid cycling between mania and depression being much more common in women, children, and adolescents.
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Do Other Illnesses Mimic Symptoms Of Bipolar Disorder
Mood swings and impulsive behavior can sometimes reflect psychiatric problems other than bipolar disorder, including:
- Substance use disorders
- Attention deficit hyperactivity disorder
- Certain anxiety disorders such as post-traumatic stress disorder
Psychosis can occur not only in bipolar disorder but other conditions such as schizophrenia or schizoaffective disorder. In addition, people with bipolar disorder often have additional psychiatric problems such as anxiety disorders , and social anxiety disorder), substance use disorders, or personality disorders that may complicate an illness presentation and require independent treatment.
Some non-psychiatric illnesses, such as thyroid disease, lupus, HIV, syphilis, and other infections, may have signs and symptoms that mimic those of bipolar disorder. This can pose further challenges in making a diagnosis and determining the treatment.
Other problems often resemble mania but reflect causes other than bipolar disorder. An example is mood or behavior changes caused by steroidmedications like prednisone . .
How Is Nimh Addressing Bipolar Disorder
The National Institute of Mental Health conducts and supports research on bipolar disorder that increases our understanding of its causes and helps develop new treatments. Researchers continue to study genetics and bipolar disorder, brain function, and symptoms in children and teens who have bipolar disorder, as well as family history in health and behavior.
Learn more about NIMHs research priorities and current studies.
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Have You Been Hospitalized
Hospitalization due to bipolar disorder could impact the underwriting decision. The following is a general guide. If you have been in the hospital within 2 years of the application for bipolar disorder, expect a rating or a decline.
If it has been between 2 and 5 years, expect a moderate table rating. Additionally, if it has been over 5 years, then probably a low rating to none at all.
If suicide ideation or attempts were the reason for the hospitalization, that could change the underwriting picture. Usually, any suicide attempt is a decline with most carriers. However, no worries. We still have life insurance options for you.
Information For Family Carers And Friends
How can I get support?
You can speak to your GP. You should be given your own assessment through NHS mental health services to work out what effect your caring role is having on your health. And what support you need. Such as practical support and emergency support.
These are some other options for you:
- Join a carers service
- Join a carers support group
- Ask your local authority for a carers assessment
- Read about the condition
- Apply for welfare benefits for carers
Rethink Mental Illness run carers support groups in some areas. You can also search for groups on the Carers Trust website:
- Rethink Mental Illness: www.rethink.org/about-us/our-support-groups
- Carers Trust: www.carers.org/search/network-partners
How can I support the person I care for?
You might find it easier to support someone with bipolar disorder if you understand their symptoms, treatment and self-management skills.
You should be aware of what you can do if you are worried about their mental state. It can be helpful to know contact information for their mental health team or GP.
You could find out from your relative if they have a crisis plan. You could help your relative to make a crisis plan if they dont have one.
As a carer you should be involved in decisions about care planning. But you dont have a legal right to this. The medical team should encourage the person that you care for to allow information to be shared with you.
You can find out more information about:
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What Does It Mean If Your Partner Is Bipolar
Bipolar disorder is a mental health condition marked by intense mood changes. People with the illness switch back and forth from mania or hypomania to having episodes of depression.
The lifelong condition tends to run in families, although the cause of bipolar disease is unknown. However, it can often be successfully managed through treatment. There are two primary types of bipolar disorder:
What Are The Symptoms Of Bipolar Disorder
Bipolar disorder symptoms can make it difficult to deal with day-to-day life. It can have a bad effect on your relationships and work. The different types of symptoms are described below.
Mania
Symptoms of mania can include:
- feeling happy or excited, even if things arent going well for you,
- being full of new and exciting ideas,
- moving quickly from one idea to another,
- racing thoughts,
- sleeping too much or not being able to sleep,
- eating less or over eating,
- losing or gaining weight, when you dont mean to, and
- thoughts of death or suicide, or suicide attempts.
Psychosis
Sometimes you can have psychotic symptoms during a severe episode of mania or depression. Symptoms of psychosis can be:
- hallucinations. This means that you may hear, see, or feel things that are not there, and
- delusions. This means you may believe things that arent true. Other people will usually find your beliefs unusual.
Psychotic symptoms in bipolar disorder can reflect your mood. For example, if you have a manic episode you may believe that you have special powers or are being monitored by the government. If you have depressive episode, you may feel very guilty about something you think you have done. You may feel that you are worse than anybody else or feel that you don’t exist.
You can find more information about:
- Depression by clicking here.
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What Increases Your Risk
Bipolar disorder can be passed down through families. If anyone in your family has been diagnosed with bipolar disorder, your risk of having it is higher.
Some things can increase your risk of a manic episode or depression. These include:
- Changes in sleep or daily routines.
- Antidepressant medicine. This can happen if you haven’t been diagnosed with bipolar disorder and are seeking treatment for depression.
- Stressful events.
- Quitting your medicine for bipolar disorder. Even if you’re feeling better, it’s important to take your medicines as prescribed.
Alcohol or drug use or abuse puts you at a high risk for having a relapse of mood disturbances.footnote 6
How Do I Get Help If I Think I Have Bipolar Disorder
The usual first step to getting help is to speak to your GP.
It can help to keep a record of your moods. This can help you and your GP to understand your mood swings. Bipolar UK have a mood diary and a mood scale on their website. You can find their details in the Useful contacts section at the bottom of this page.
Your GP cant diagnose bipolar disorder. Only a psychiatrist can make a formal diagnosis. Your GP may arrange an appointment with a psychiatrist if you have:
- depression, and
- ever felt very excited or not in control of your mood or behaviour for at least 4 days in a row.
They might refer you to a psychiatrist at your local NHS community mental health team .
Your GP should make an urgent referral to the CMHT if they think that you might have mania or severe depression. Or there is a chance that you are a danger to yourself or someone else.
Your GP should refer you to your local NHS early intervention team if you have an episode of psychosis and its your first one.
Bipolar disorder can be difficult to diagnose because it affects everyone differently. Also, the symptoms of bipolar disorder can be experienced by people who have other mental illness diagnoses. It can take a long time to get a diagnosis of bipolar disorder.
You can find more information about:
- NHS mental health teams by clicking here.
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