What Are The Signs And Symptoms Of Bipolar Disorder
The defining sign of bipolar I disorder is a manic episode that lasts at least one week, while people with bipolar II disorder or cyclothymia experience hypomanic episodes.
But many people with bipolar disorder experience both hypomanic/manic and depressive episodes. These changing mood states dont always follow a set pattern, and depression doesnt always follow manic phases. A person may also experience the same mood state several times with periods of euthymia in between before experiencing the opposite mood.
Mood changes in bipolar disorder can happen over a period of weeks, months and sometimes even years.
An important aspect of the mood changes is that theyre a departure from your regular self and that the mood change is sustained for a long time. It may be many days or weeks in the case of mania and many weeks or months in the case of depression.
The severity of the depressive and manic phases can differ from person to person and in the same person at different times.
Signs and symptoms of manic episodes
Some people with bipolar disorder will have episodes of mania or hypomania many times throughout their life others may experience them only rarely.
Signs and symptoms of a manic episode include:
Most of the time, people experiencing a manic episode are unaware of the negative consequences of their actions. With bipolar disorder, suicide is an ever-present danger some people become suicidal in manic episodes, not just depressive episodes.
What Are The Treatments For Bipolar Disorder
There is no cure for bipolar disorder. Treatment generally needs to be lifelong to most effectively manage symptoms. Treatment for bipolar disorder typically includes a combination of the following:
- Psychotherapy: A psychotherapist builds a relationship of trust with a client and helps the client better cope with bipolar disorder. Psychotherapy methods include family therapy and behavior therapy, such as cognitive behavioral therapy. These therapies can help people recognize and work through the issues associated with bipolar disorder.
- Medications: A doctor may recommend medications to stabilize the extreme mood changes that occur with bipolar disorder. Medications may include mood stabilizers, antipsychotics, antidepressants, or a combination of these.
- Self-care management: This includes education about the disorder, recognition of early signs of episodes, and lifestyle changes, such as regular exercise.
- Other treatments: If psychotherapy and medications are not successful in managing symptoms, a doctor may recommend alternative treatments. These may include electroconvulsive therapy or transcranial magnetic stimulation.
Treatment for bipolar disorder varies from person to person. Work closely with your doctor and mental health professional to find the right treatment plan for you.
What Does The Research Say About Life Expectancy With Bipolar Disorder
Studies give varying numbers on life expectancy among people with bipolar disorder, but all note a reduction in years lived and a predisposition toward an earlier death.
Several studies have found a reduction in life expectancy by about 11 to 20 years for people with bipolar disorder. A 2015 study found that these estimates may be too high, though. This study estimated life expectancy among 25 to 45-year-olds with bipolar disorder to be reduced by about 12.0-8.7 years in males and 10.6-8.3 years in females. Interestingly, life expectancy reduction decreased the older a person got, with the highest risk being in early and middle adulthood.
It’s important to note that life expectancy is thought to be reduced for all types of severe mental illness, not just bipolar disorder.
A team from Oxford University found that severe mental illness generally reduced expectancy by 10 to 20 years, and noted that life expectancy among people with mental illness is slightly more than that of the reduced life expectancy among smokers, which is about 8 to 10 years.
The researchers estimated life expectancy to be reduced by 10 to 20 years in people with schizophrenia, 9 to 24 years in people with substance abuse disorders, and 7 to 11 years among people with recurring depression. Their estimate for people with bipolar disorder was a reduction in life expectancy between 9 and 20 years.
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How Do Doctors Diagnose Bipolar Disorder
The primary symptoms of bipolar disorder are related to mood changes. Your doctor may first rule out other possible causes for your mood swings.
Imaging tests or brain scans cannot diagnose bipolar disorder. However, they may identify underlying conditions that can produce drastic disruptions in your mood. These conditions include a brain tumor or stroke.
To further evaluate your mood changes, your doctor or mental health professional may ask you these questions:
- When did you first notice your mood swings?
- What moods do you experience when you have mood swings?
- How long do your mood changes last?
- Does anything make the mood changes better or worse?
- Do you have other symptoms?
- Do you have other psychiatric or medical problems?
- What medications are you taking?
- Do you drink alcohol?
- Are you using illegal drugs?
If your doctor rules out other medical conditions, they will most likely refer you to a mental health professional. This specialist will further evaluate your symptoms to confirm a diagnosis of bipolar disorder. You can then work closely with your doctor and mental health professional to create a treatment plan.
What Causes Bipolar Disorder
The exact cause of bipolar disorder is not known, but it is possible that there is a genetic link. According to the American Psychiatric Association, 8090% of people with bipolar disorder have a close relative with bipolar disorder or depression. It is also possible that an imbalance of chemicals in the brain or hormonal deficiencies cause bipolar disorder.
In some cases, the following may set off symptoms similar to those of bipolar disorder:
- sleep deprivation
- thyroid disease
- the use of certain drugs, including antidepressants, methamphetamines, and steroids
In these cases, a doctor typically will not give a diagnosis of bipolar disorder unless symptoms persist after treatment.
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How Do Bipolar Disorder Symptoms Change With Age
We dont really know if someone is born with bipolar disorder, or if onset happens during early childhood, in the teen years, or sometime after that. Many people question, can bipolar people tell they are bipolar, and the answer is, yes. Many live with it for years, decades even, before being diagnosed.
So, how does bipolar change with age?
When we think about bipolar disorder and aging, there are two ideas of aging that need to be considered and how bipolar disorder affects these differing instances: aging with bipolar disorder and being diagnosed at an older age. These instances change how symptoms can change with age.
Children: According to the National Institute of Mental Health , bipolar disorder in children and teens includes symptoms of intense emotions and drastic, noticeable changes to energy levels and activities, sleep habits, thought patterns, and behavior.
Young children and adolescents with bipolar disorder may have a manic episode, depressive episode, or both. Their mood swings can cause symptoms that might last for days or weeks. During a bipolar disorder episode, a child will likely exhibit symptoms each day, and theyll typically last most of the day.
Its common for bouts of mania and depression to continue into adulthood, and they can become more frequent and severe with untreated bipolar disorder.
- High blood pressure
- Generalized anxiety disorder
- Other phobias or anxiety disorders
Having A Severe Mental Illness Means Dying Young
Allen Frances MD is Professor Emeritus of Psychiatry and former Chair at Duke University
People diagnosed with serious mental illness — schizophrenia, bipolar disorder, or severe depression — die 20 years early, on average, because of a combination of lousy medical care, smoking, lack of exercise, complications of medication, suicide, and accidents. They are the most discriminated-against and neglected group in the U.S., which has become probably the worst place in the developed world to be mentally ill.
In many previous blog posts I have bemoaned the shameful state of psychiatric care and housing for people with severe mental illness. My conclusion was that the United States has become the worst place, and now the worst time ever, to have a severe mental illness. Hundreds of thousands of the severely ill languish inappropriately in prisons. Additional hundreds of thousands are homeless on the street.
But it gets worse. Having a severe mental illness also means that you will probably die very young. I have asked Dr. Peter Weiden to explain why, and to suggest what we should do about it. He is a professor of psychiatry at the University of Illinois College of Medicine and has spent his professional career working on improving outcomes and reducing side effects and complications for people with serious mental illness.
Dr. Weiden writes:
Allen Frances is a professor emeritus at Duke University and was the chairman of the DSM-IV task force.
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How Is Bipolar Disorder Diagnosed
To diagnose bipolar disorder, your healthcare provider may use many tools, including:
- A physical exam.
- A thorough medical history, which will include asking about your symptoms, lifetime history, experiences and family history.
- Medical tests, such as blood tests, to rule out other conditions that could be causing your symptoms, such as hyperthyroidism.
- A mental health evaluation. Your healthcare provider may perform the evaluation, or they may refer you to a mental health specialist, such as a psychologist or psychiatrist.
To be diagnosed with bipolar disorder, you must have experienced at least one episode of mania or hypomania. Mental health providers use the Diagnostic and Statistical Manual of Mental Disorders to diagnose the type of bipolar disorder a person may be experiencing.
To determine what type of bipolar disorder you may have, your mental health provider assesses the pattern of symptoms and how much they affect your life during the most severe episodes.
People with bipolar disorder are more likely to also have the following mental health conditions:
- Post-traumatic stress disorder .
- Substance use disorders/dual diagnosis.
Because of this, as well as the fact that memory is often impaired during mania so people cant remember experiencing it, it can be difficult for healthcare providers to properly diagnose people with bipolar disorder.
Does Bipolar Damage The Brain
The mental disorder, Bipolar disorder otherwise known as manic depression, is caused by an abnormality in the brain. The brains chemistry is significantly disturbed by the illness. This causes the moods to swing from being extremely high to being extremely low in such a short period of time. It is a serious mental illness that has the power to destroy your life and it needs to be treated right away. The best way to treat the Bipolar disorder is to have a proper conversation with your doctor. This will help them to prescribe you the right medication. The medication will help to balance out the chemicals in your brain so that you will not have any more mood swings and you will be able to get back to the normal life that you were leading before..
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When Should I Go To The Emergency Room For Bipolar Disorder
If youre experiencing any of these situations, its essential to call 911 or get to the nearest emergency room:
- Thoughts of death or suicide.
- Thoughts or plans of hurting yourself or others.
- Experiencing hallucinations and delusions.
- Symptoms of lithium toxicity , such as severe nausea and vomiting, severe hand tremors, confusion and vision changes.
A note from Cleveland Clinic
Bipolar disorder is a lifelong illness. But long-term, ongoing treatment, such as medication and talk therapy, can help manage your symptoms and enable you to live a healthy, purposeful life. Its important to see your healthcare team regularly to monitor your treatment plan and symptoms. Know that your healthcare providers and loved ones are there to support you.
Last reviewed by a Cleveland Clinic medical professional on 04/12/2022.
Lithium Treatment Over The Lifespan In Bipolar Disorders
- 1Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
- 2Department of Psychiatry, Schlosspark Hospital Berlin, Germany
- 3Department of Psychiatry and Psychotherapy, University Hospital, Technical University of Dresden, Dresden, Germany
Lithium has been the treatment of choice for patients with bipolar disorder for nearly 70 years. It is recommended by all relevant guidelines as a first-line treatment for maintenance therapy. In this review, we outline the current state of evidence for lithium in the treatment of BD over the lifespan. First, we summarize the evidence on efficacy in general, from relapse prevention to acute anti-manic treatment and its role in treating mood episodes with mixed features and bipolar depression. As patients are often treated for many years and different aspects have to be considered in different phases of life, we discuss the particularities of lithium in the treatment of paediatric BD, in older aged individuals and in pregnant women. Lastly, we discuss the evidence on lithium’s proposed suicide-preventive effects, the dangers of rapid discontinuation and lithium’s adverse effects, particularly with regard to long-term treatment.
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Does Bipolar Lead To Dementia
Its not clear whether bipolar disorder causes dementia. The reason is the small number of studies on the subject performed so far. If a person has a history of dementia in their family, then its likely that the dementia is caused by a very different gene. There is only a small chance that the gene that causes dementia is also one that causes bipolar disorder..
Main Findings And Interpretation
To our knowledge, this is the first meta-analysis examining life expectancy and YPLL in people with bipolar disorder. Our main analyses showed that patients with bipolar disorder experienced reduced life expectancy relative to the general population, with approximately 13 years of potential life lost. Consistent pooled estimates of life expectancy were observed in sensitivity analyses correcting for publication bias and using the leave-one-out method, indicating that our synthesised results were stable and robust. Significant heterogeneity was detected across studies for life-expectancy estimates, and was partly explained by gender and study period. However, as most included studies examining YPLL did not report measures of uncertainty , level of heterogeneity for YPLL could not be quantified in our meta-analysis.
Differences in access to and quality of healthcare services and lifestyle factors might also contribute to the variations in life expectancy across regions. In this context, regional variations in YPLL, which indicates difference in lifespan between patients and the general population, would provide more informative cross-regional comparisons. Of note, our findings of regional differences should be treated with caution as all of the continents reported in this meta-analysis except Europe were represented by one or two studies only. Moreover, data from the African study was based on a small sample size .Reference Fekadu, Medhin, Kebede, Alem, Cleare and Prince15
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Mentally Ill Have Reduced Life Expectancy Study Finds
People suffering from serious mental illnesses like schizophrenia or bipolar disorder can have a life expectancy 10 to 15 years lower than the UK average.
Researchers tracked the lives of more than 30,000 patients through the use of electronic medical records.
They found that many were dying early from heart attack, stroke and cancer rather than suicide or violence.
Mental health groups say vulnerable people need to be offered better care to prevent premature deaths.
The research was carried out at the Biomedical Research Centre for mental health at the Maudsley Hospital in London and published in the online journal PLoS ONE.
The study examined life expectancy for people suffering from specific mental illnesses like schizophrenia, serious depression and bipolar disorder, or those being treated for substance misuse.
Life expectancy across all the illnesses studied was well below the UK average of 77.4 years for men and 81.6 years for women.
Those most affected were women with schizoaffective disorder – problems with mood or sometimes abnormal thoughts – whose average life expectancy was reduced by 17.5 years, and men with schizophrenia whose lives were shortened by about 14.6 years.
The researchers believe a combination of factors – higher-risk lifestyles, long-term anti-psychotic drug use and social disadvantage – could be to blame.
Greater Than The Sum Of Their Parts
While there are obvious benefits to improvement in any one of these areas, the researchers saw the most profound effect in cases where there was effective management of all three.
SMI may appear at any time in life, and Dregan and his colleagues found a positive change in longevity when the management of the three areas was in place early.
When considering a scenario that involved tackling all these factors, the researchers saw that life expectancy increased by 4 years for people with bipolar disorders and 7 years for people with schizophrenia.
For people over the age of 65 years with SMI, the authors also noted the benefits of taking control later on. The data showed a 3-year increase in lifespan for older adults with bipolar disorder and 4 years for those with schizophrenia.
The analysis indicates, says Dregan, that when considering different approaches to help those with severe mental illness, the whole is greater than the sum of the parts, and there is more benefit if a multifaceted approach is taken, which addresses behavior, healthcare, and social issues simultaneously.
The researchers findings indicate that medical providers should consider a holistic view of their patients with SMI.
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What Is End Stage Bipolar Disorder
___ is a mental disorder characterized by an extended period of depression and by periods of elevated mood. Most people with bipolar disorder have the depressive phase first. An individual with bipolar depression may have a low self-esteem, low energy and a poor perception of their life. They may feel like a failure and be extremely pessimistic about the future. They may be so sad that they may not be able to bring themselves to get out of bed..