Bipolar Disorder In The United States
In this section, you will learn about various bipolar disorder statistics exclusive to the United States and the groups that make up its population.
Each year it is estimated that around 5.7 million adult Americans are struggling with bipolar disorder. This equates to about 2.6 percent of the adult population. Approximately 4.4 percent of them will develop this disorder at some point in their lives.
The majority of those diagnosed with bipolar disorder are within the 18 to 29 range, followed by those 30 to 44, then the 45 to 59 years of age. Nearly 83 percent of adults in the U.S. will experience severe impairment from the disorder.
Although the median age of onset for bipolar disorder is about 25 years old, the condition can appear at any age, and it is quite common among those aged 13 to 18 years old.
The adolescent group rivals the adults in terms of percentages. According to the National Institute of Mental Health, around 2.9 percent of adolescents had bipolar disorder.
However, because there arent as many adolescents as there are adults in the U.S., naturally, there will be fewer numbers overall.
In Men & Women
Males and females in the United States suffer from bipolar disorder at the same rates, which are at 2.9 and 2.8 percent, respectively.
Therefore, even though the figures are very close between males and females, it can present themselves and affect others differently.
In Ethnic Groups & Social Classes
Can You Have A Good Life With Bipolar Disorder
Absolutely. People with well-managed bipolar disorders have jobs, families, and are productive members of our society. Bipolar disorder, while a chronic condition, doesnt define you. Just like people who manage their diabetes or heart condition, you can learn to manage and control bipolar disorders with medications, therapies, and good lifestyle habits that sets you up for a successful life.
Living With Bipolar Disorder
Bipolar disorder is a condition of extremes. A person with bipolar disorder may be unaware they’re in the manic phase.
After the episode is over, they may be shocked at their behaviour. But at the time, they may believe other people are being negative or unhelpful.
Some people with bipolar disorder have more frequent and severe episodes than others.
The extreme nature of the condition means staying in a job may be difficult and relationships may become strained. There’s also an increased risk of suicide.
During episodes of mania and depression, someone with bipolar disorder may experience strange sensations, such as seeing, hearing or smelling things that are not there .
They may also believe things that seem irrational to other people . These types of symptoms are known as psychosis or a psychotic episode.
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What Is Rapid Cycling
Some people with bipolar disorder develop rapid cycling where they experience four or more episodes of mania or depression within a 12-month period. Mood swings can occur very quickly, like a rollercoaster randomly moving from high to low and back again over a period of days or even hours. Rapid cycling can leave you feeling dangerously out of control and most commonly occurs if your bipolar disorder symptoms are not being adequately treated.
The different faces of bipolar disorder
Bipolar I Disorder This is the classic manic-depressive form of the illness, characterized by at least one manic episode or mixed episode. Usuallybut not alwaysBipolar I Disorder also involves at least one episode of depression.
Bipolar II Disorder In Bipolar II disorder, you dont experience full-blown manic episodes. Instead, the illness involves episodes of hypomania and severe depression.
Cyclothymia Cyclothymia is a milder form of bipolar disorder that consists of cyclical mood swings. However, the symptoms are less severe than full-blown mania or depression.
What Are The Causes Of Bipolar Disorder
There is no single cause of bipolar disorder. Researchers are studying how a few factors may lead to it in some people.
For example, sometimes it can simply be a matter of genetics, meaning you have it because it runs in your family. The way your brain develops may also play a role, but scientists arenât exactly sure how or why.
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Bipolar Disorder In Women And During Pregnancy
Women and people with bipolar II disorder are significantly more likely to experience periods of rapid cycling than men with the same condition. Other research findings indicate that women with bipolar disorder may have more depressive episodes and more mixed episodes than do men with the illness.
Pregnancy and the postpartum period can exacerbate bipolar disorder symptoms. The body goes through so many hormonal changes and women who already have an underlying bipolar disorder can have their symptoms exacerbated by these changes, explains Dr. Narasimhan. Crazy enough, sometimes women who dont have bipolar disorders can develop one in the postpartum period. Called postpartum bipolar onset, the mood disorder may resolve itself after the postpartum period or it can sometimes remain.
The general consensus is that when theres severe mental illness, and someone gets pregnant, its not the time to take them off medication, Dr. Narasimhan says. That said, you have to have an honest discussion and know which medications have some risk during pregnancy and which can affect the fetus, she says. Oftentimes the risk of not being on medication is worse than the risk of stopping the medication. Dr. Narasimhan also says she has plenty of patients who dont want to take their medication during pregnancy, and for these patients, they weigh the risks and benefits carefully.
When Can It Be Diagnosed
According to several analyses, nearly 50 percent of individuals begin to show symptoms before the age of 21. Unfortunately, a review of more than two dozen surveys shows a lag of about 6 years from the onset of early symptoms of bipolar disorder and the start of treatment targeted to the disorder. So, while symptoms may start to appear in adolescence, the disorder often goes undiagnosed, meaning treatment is either not initiated or symptoms are treated as something else.
For example, as a 2019 study published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging noted, bipolar disorder is initially misdiagnosed as major depressive disorder in about 60 percent of individuals seeking mental health disorder diagnosis. Researchers said the two disorders share some symptoms, especially since bipolar disorder first often manifests in a depressive phase, and this can delay accurate diagnosis by up to 10 years. In addition, depression typically starts during adolescence, which could cloud a diagnosis of bipolar disorder. Furthermore, a core problem in both major depressive disorder and bipolar disorder is emotion processing.
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Diagnosing Bipolar Disorder In Adults
Bipolar disorder, also known as manicdepressive illness, is a medical condition that causes a person to experience intense mood swings that alternate between depression and mania. These mood swings can last for hours, days, or even weeks.
Mental health specialists at NYU Langone Psychiatry Associates, such as psychiatrists, psychologists, and licensed clinical social workers, can help determine if a person has bipolar disorder and, if so, how best to manage symptoms.
What Can I Do To Manage My Symptoms
You can learn to manage your symptoms by looking after yourself. Selfcare is how you take care of your diet, sleep, exercise, daily routine, relationships and how you are feeling.
What lifestyle changes can I make?
Making small lifestyle changes can improve your wellbeing and can help your recovery.
Routine helps many people with their mental wellbeing. It will help to give a structure to your day and may give you a sense of purpose. This could be a simple routine such as eating at the same time each day, going to bed at the same time each day and buying food once per week.
Your healthcare professionals should offer you a combined healthy eating, exercise and sleep programme.
You can find more information about wellbeing any physical health at:www.rethink.org/advice-and-information/living-with-mental-illness/wellbeing-physical-health/.
What are support groups?
You could join a support group. A support group is where people come together to share information, experiences and give each other support.
You might be able to find a local group by searching online. The charity Bipolar UK have an online support group. They also have face to face support groups in some areas of the country. Their contact details are in the Useful contacts at the bottom of this page.
What are recovery colleges?
Unfortunately, recovery colleges arent available in all areas. To see if there is a recovery college in your area you can use a search engine such as Google.
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Causes Of Bipolar Disorder
Both genetic and environmental factors can create vulnerability to bipolar disorder. As a result, the causes vary from person to person. While the disorder can run in families, no one has definitively identified specific genes that create a risk for developing the condition. There is some evidence that advanced paternal age at conception can increase the possibility of new genetic mutations that underlie vulnerability. Imaging studies have suggested that there may be differences in the structure and function of certain brain areas, but no differences have been consistently found.
Life events including various types of childhoodtrauma are thought to play a role in spurring bipolar disorder in those who are already vulnerable to developing the condition. Researchers do know that once bipolar disorder occurs, life events can precipitate its recurrence. Incidents of interpersonal difficulty and abuse are most commonly associated with triggering the disorder.
What Is Bipolar Disorder
Bipolar disorder is a chronic or episodic mental disorder. It can cause unusual, often extreme and fluctuating changes in mood, energy, activity, and concentration or focus. Bipolar disorder sometimes is called manic-depressive disorder or manic depression, which are older terms.
Everyone goes through normal ups and downs, but bipolar disorder is different. The range of mood changes can be extreme. In manic episodes, someone might feel very happy, irritable, or up, and there is a marked increase in activity level. In depressive episodes, someone might feel sad, indifferent, or hopeless, in combination with a very low activity level. Some people have hypomanic episodes, which are like manic episodes, but less severe and troublesome.
Most of the time, bipolar disorder develops or starts during late adolescence or early adulthood. Occasionally, bipolar symptoms can appear in children. Although the symptoms come and go, bipolar disorder usually requires lifetime treatment and does not go away on its own. Bipolar disorder can be an important factor in suicide, job loss, and family discord, but proper treatment leads to better outcomes.
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Bipolar Disorder Or Depression
Doctors sometimes find it hard to distinguish between bipolar disorder and depression, and this can lead to misdiagnosis. People with bipolar disorder are more likely to seek help during a low mood because depression is more likely to have a negative impact on their health and wellbeing. During a high mood, they may feel exceptionally well.
Factors that increase the chance of this happening include the following:
- Depression is the dominant mood.
- Depression is the first episode you have.
- You have experienced mania or hypomania but not realized it could be significant.
Its essential to get an accurate diagnosis in order to work out a treatment plan. Antidepressants may not be effective in treating bipolar disorder.
In addition, some antidepressant medications can trigger a first manic or hypomanic episode if youre susceptible to them, and this could complicate both treatment and the outcome.
If you go to see your doctor with depression, be sure to tell them about any of the following, as these can help get an accurate diagnosis:
- a family history of bipolar disorder or other mental health conditions
- any other conditions that affect your mental or physical wellbeing
- any medications, drugs, or other substances youre taking or have used in the past
- if youve already tried antidepressants and they did not help
Symptoms Of Late Onset Bipolar Disorder
One of the reasons bipolar disorder is often misdiagnosed in seniors is because the symptoms are slightly different.
According to professor of clinical psychiatry at Columbia University, Michael First, M.D., seniors seldom exhibit the classic signs of a manic episode. Instead of feeling elated and displaying risky behaviors, seniors are more likely to show signs of agitation and irritability. This is often confused with the normal feelings of aging, leading to misdiagnosis.
Some of the other symptoms commonly noted in seniors with bipolar disorder include,
When bipolar disorder does appear in adults over 60, the symptoms can be sudden and severe. It often seems to cycle faster between depression and mania, and some seniors report experiencing both episodes at the same time.
Seniors with bipolar disorder frequently experience problems with cognitive function that often include,
- Problems with memory
- Loss of perception and judgement
- Difficulty problem solving
Since these are also common signs of dementia and Alzheimers, the bipolar disorder is often misdiagnosed.
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What Do You Do To Keep Well
Keeping well when you have bipolar is an interesting concept. For some it revolves exclusively around manging moods. For others it means fitting life around moods.
For me, and others like me who are deep into a recovery that seems to be holding, its about keeping an eye, and investing in the things that help us all boost our mental health.
For many, if not most people with bipolar, life and keeping well includes taking medication.
Blogger Tanya said:
The thing I most prioritise with keeping myself well is to be strict in taking my medication. Missing doses or tweaking them without professional help can be devastating.
Again, Im going to buck the trend and say I dont take medication routinely. I took lithium for a decade, and then wanted, once I knew myself and had done my research, to try tapering off. That was eight years ago, and Ive managed it. I did it carefully, over two years, with support, whilst learning other techniques.
For 13 years, I took medication, but in the past six months, Ive been trying to cope without it. So I have to be super careful, and alas, super boring. I dont drink a lot, I have relatively early nights when I can.
Bipolar can also be triggered by trauma, or other life events and sometimes part of therapy is addressing underlying concerns to get someone to a point where they can start to see a life worth living.
Hannah has a rigid menu:
How Do Psychiatrists Determine Which Medication To Prescribe
People with bipolar disorder typically need medication, but choosing the right drug or drug combination often requires some trial and error. To determine the right treatment, the psychiatrist may start with a low dose and gradually increase it based on the patientâs response and tolerance. They will seek feedback from the patient, and prescribe one medication at a time to find the best fit.
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What Risks And Complications Can Bipolar Disorder Cause
There can be complications and risks for people who live with bipolar disorder. But these risks can be lessened with the right support and treatment.
What about suicide and self-harm?
You might have an illness where you experience psychosis, such as schizophrenia or bipolar disorder. Your risk of suicide is estimated to be between 5% and 6% higher than the general population.
You are more likely to try to take your own life if you have a history of attempted suicide and depression. It is important that you get the right treatment for your symptoms of depression and have an up to date crisis plan.
There is also research that suggests you are 30% – 40% more likely to self-harm if you live with bipolar disorder.
What about financial risk?
If you have mania or hypomania you may struggle to manage your finances. You may spend lots of money without thinking about the effect that it may have on your life.
You could make a Lasting Power of Attorney. This is a legal process. This means that you pick someone that you trust to manage your finances if you lack mental capacity to manage them by yourself.
You can work with your carer and mental health team. You can form an action plan. This can say what they can do if you have a period of mania or hypomania and you start to make poor financial decisions.
What about physical health risk?
What about alcohol and drugs risk?
If you want advice or help with alcohol or drug use contact your GP.
What about driving risk?
Who Does It Affect
More than 2% of the population will have bipolar disorder at some point in their lives. About 1% of people have experienced bipolar disorder in the past year. Unlike other causes of depression, men and women seem to experience bipolar I in equal numbers. Bipolar II, however, is more likely to affect women. Both types of bipolar affect people of all ages, but tend to appear first in young adulthood, and the risk decreases slightly with age. Bipolar disorder looks quite different in children than it does in adults. Bipolar disorder does seem to run in families. Having a close relative who has bipolar disorder or another mood disorder increases your risk of having bipolar disorder.
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Age Of Onset And Gender Issues In Bipolar Disorder
How early in childhood can the first bipolar symptoms appear? And the impact of bipolar disorder on girls and women.
It is being increasingly recognized that bipolar disorder often has its onset in adolescence or early adulthood. First affective symptoms appear in early teenage, and even in preadolescence. There is a growing interest, with little consensus, in the affective and behavioral symptomatology in childhood and adolescence preceding the first onset of a clearly diagnosable bipolar disorder. There is a significant time-lag between the onset of the illness and first treatment. This may put patients at risk of increased morbidity, including effects on personality, school, work and social functioning. There is growing evidence in the schizophrenia literature that this time-lag may predict a poorer response to treatment. Although there is no clear evidence of this in bipolar disorder, this issue should be borne in mind.
Gender Issues Associated with Bipolar Disorder
About the author: Vivek Kusumakar, MD, FRCPC is an Associate Professor, Head of the Division of Child & Adolescent Psychiatry, and Director, Mood Disorders Group, Dept of Psychiatry, Dalhousie University, Halifax, Nova Scotia.