How Is It Diagnosed
Late-onset bipolar disorder is a diagnosis of exclusion, meaning that a healthcare professional will rule out other conditions that may be causing your symptoms, like cerebrovascular disease.
They will likely begin with a thorough medical and family history and conduct medical assessments like lab and imaging tests.
Symptoms that may be assessed when diagnosing LOBD can include:
- mania, with fewer and milder episodes than in early onset bipolar disorder
- depressive episodes
- psychomotor changes
- mental flexibility impairments
- cognitive impairments, more pronounced than in early onset bipolar disorder
Once potential medical causes for symptoms have been ruled out, you may be referred to a mental health professional for further evaluation and testing.
What Does Onset Of Bipolar Disorder Look Like
In some patients, the first sign of bipolar disorder is what appears to be a major depressive episode. Others experience full-blown mania or hypomania a less extreme form of mania. Still others experience a confusing combination of symptoms called a mixed episode, which has elements of both depression and mania.
Here is a closer look at what a first episode might look like:
Depression: When the first episode of bipolar disorder is depression, symptoms can develop slowly, reports Michael Strober, PhD, who is Distinguished Professor of Psychiatry, and Senior Consultant to the Youth Mood Disorders Treatment and Research Program at the David Geffen School of Medicine at UCLA. Bipolar depression usually includes not only the sadness or irritability we associate with depression, but delusions of failure, exaggerated feelings of guilt, mental confusion and profound physical slowness.
Despite these differences, Dr. Strober notes that symptoms of bipolar depression are often misdiagnosed as major depressive disorder early on, because alternating periods of mania may not appear until months or years later.
Mania: Unlike the gradual descent into depression, when the initial episode is mania the onset can be like a thunderclap, says Wendy Nash, MD, a child and adolescent psychiatrist. An initial manic episode might be characterized by grandiose thinking, risk-taking, accelerated speech and thought, and euphoria or irritability.
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 . .
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Bipolar Symptoms In Children: Presentation
Every childs symptoms differ, but during a manic phase, you may see signs like:
- Acting hyper, exuberantly happy, or incredibly silly behavior seemingly at random and in a way that is unusual to the childs personality
- Talking quickly or switching topics mid-sentence
- Hyperfocusing on a single subject or project that seems to come out of nowhere
- Erupting in extreme upset when obstacles arise or they are told no
- Highly imaginative coming up with complex storylines
- Angering quickly and becoming violent over small slights
- Not feeling tired or requiring much sleep, and showing little interest in napping, resting, or going to bed at night getting up frequently during the night
- Becoming preoccupied with sex or sexual thoughts talking about sex at inappropriate times
- Acting on sexual desires in public, dangerous, or age-inappropriate ways masturbating excessively or engaging in risky sex at a young age
- Seeing or hearing things that arent there
During a depressive phase, you might see symptoms like:
- Acting unusually weepy and sad
- Complaining of frequent stomachaches and headaches
- Sleeping longer than usual
- Eating too little or too much might gain or lose weight very rapidly
- Showing little interest in regular activities
- Talking about being a bad child, or wondering aloud if everyone hates them
- Becoming preoccupied with death talking about suicide or, for very young children, how it would be better for everyone if they went away forever or were never born
After Two Weeks My World Which Displayed Things Only In Monochrome Or Blinding Colors Began To Shimmer Gently
According to the health and wellness website Sharecare.com, bipolar disorder is hard to diagnose because there is no simple blood test or X-ray that indicates definitively one way or another. Yet, even with that challenge, approximately 6 million American adults struggle with the condition.
They are no farther away than my closest friends.
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What Is The Typical Age Of Onset For Bipolar Disorder
The average age of bipolar onset is around 25 years old, although it can vary.
Sometimes bipolar symptoms start in childhood or later in life. However, the most frequent range of onset is between the ages of 14 to 21 years.
Childhood bipolar is relatively rare, with only of children receiving this diagnosis.
According to the National Institute of Mental Health , about 4.4% of adults in the United States will experience bipolar disorder at some point in their lives. It affects men and women equally.
NIMH estimates that nearly 2.9% of adolescents those who are between 13 and 18 years old will experience bipolar disorder at some point, with the highest prevalence (
Despite common belief, bipolar disorder doesnt just occur in young people. In recent years, research has shown an increase in the diagnosis of late onset bipolar disorder .
According to a 2015 report from the International Society for Bipolar Disorders Task Force on Older-Age Bipolar Disorder , up to 25% of people with bipolar disorder are 60 years of age and older. Its estimated that between 5% and 10% of people start showing symptoms of bipolar disorder after the age of 50 years old.
People diagnosed with LOBD differ from those with early onset BD in several ways.
In addition, people with LOBD have vascular changes in their right brain hemispheres that have been
What Are The Symptoms Of Bipolar Disorder In A Teen
Teens with bipolar disorder often have abnormal mood swings. They shift between depression and mania. These episodes often last 1 or 2 weeks. But symptoms may be different for each teen.
Symptoms of depression may include:
Lasting feelings of sadness
Heightened energy level
Uncharacteristically poor judgment
Seeing or hearing things that are not there , or believing things that are not true
Symptoms of bipolar disorder, especially in a teen, may look like other problems. Make sure your teen sees his or her healthcare provider for a diagnosis.
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What Is Bipolar Ii Disorder
While mania is the main characteristic of bipolar I disorder, bipolar II has milder periods of elation known as hypomania. It also has episodes of major depression. According to the DSM-5, the diagnostic manual published by the American Psychiatric Association, the difference between mania and hypomania is “the degree of severity” as well as an absence of psychosis in hypomania and no negative impact from “high” symptoms in work and social functioning.
In Children And Adolescents
Bipolar illness symptoms in children and adolescents can be hard to spot. Sometimes, its difficult to discern if these ups and downs are signs of pressure or trauma or are indicators of such a mental health disorder other than a psychiatric disorder.
Although children and teens with bipolar disorder may experience significant depressive, manic, or hypomanic episodes, their behavior may differ from adults. Attacks can also cause mood swings that are pretty quick. Between bouts, some children may not have any mood symptoms at all.
Severe mood fluctuations that are not characteristic of adolescent mood swings are the most telling indicators of bipolar in this age group.
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What Causes Bipolar Disorder
The exact causes of bipolar disorder are unknown, but several factors may contribute to the illness.
For example, researchers are beginning to uncover genetic mechanisms that are linked to bipolar disorder and other mental disorders. Research shows that peoples chance of having bipolar disorder is higher if they have a close family member with the illness, which may be because they have the same genetic variations. However, just because one family member has bipolar disorder, it does not mean that other members of the family will have it. Many genes are involved in the disorder, and no single gene causes it.
Research also suggests that adversity, trauma, and stressful life events may increase the chances of developing bipolar disorder in people with a genetic risk of having the illness.
Some research studies have found differences in brain structure and function between people who have bipolar disorder and those who do not. Researchers are studying the disorder to learn more about its causes and effective treatments.
How Do Doctors Treat It
Although there’s no cure for bipolar disorder, treatment can help stabilize moods and help the person manage and control symptoms. Like other teens with long-lasting medical conditions , teens with bipolar disorder need to work closely with their doctors and other medical professionals to treat it.
This team of medical professionals, together with the teen and family, develop what is called a treatment plan. Teens with bipolar disorder will probably receive medication, such as a mood stabilizer, from a psychiatrist or other medical doctor. A psychologist or other type of counselor will provide counseling or psychotherapy for the teen and his or her family. Doctors will watch the symptoms closely and offer additional treatment advice if necessary.
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About Of Clinical Depression
There must be apparent difficulties in day-to-day life, such as job, school or social engagements, or relationships if a person is experiencing a severe depressive episode. There must be at least five of these symptoms to qualify as an episode:
A depressing state of mind, such as a sense of melancholy, emptiness, or a desire to cry
When not dieting, significant weight loss, weight gain, or an increase or decrease in appetite might occur.
- Insomnia or oversleeping can be the cause.
- Either agitation or sluggishness.
- Exhaustion or a lack of vitality
- Feelings of inadequacy or an overly or inappropriately high level of shame
- Inability to concentrate or think clearly, or a lack of self-confidence
- Suicide thoughts, plans, or attempts
Key Points About Bipolar Disorder In Teens
Bipolar disorder is a type of depression. A teen with this disorder often has abnormal mood swings that shift between depression and mania.
The exact cause of bipolar disorder is unknown. But it tends to run in families.
A teen must have both depressive and manic symptoms to a varying degree to be diagnosed with the disorder.
A mental health provider makes a diagnosis after a mental health evaluation.
Treatment may include medicine and talk therapy.
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How Do I Know If I Am Bipolar
Identifying bipolar disorder is very strategic because there are behavioral explanations that first need to be ruled out. Since the disorder is more commonly seen in teenage years than perhaps someone in their 40s, somebody might be inclined to gloss over symptoms as typical teenage behavior.
If the behavior of manic highs continues to be repeated over time with potentially dangerous consequences or depressed periods lasting longer than two weeks, a visit to a medical professional is in order. A routine physical including blood work can rule out other physical contributors and a full mental wellness evaluation can be performed.
Common Signs & Symptoms of Mania
- Showing intense happiness or silliness for a long time
- Having a very short temper or seeming extremely irritable
- Talking very fast or having racing thoughts
- Having an inflated sense of ability, knowledge, and power
- Doing reckless things that show poor judgment
These symptoms may be more manic and an episode may require hospitalization until the person can be stabilized, as in bipolar I.
Common Signs & Symptoms of Depression
- Feeling very sad or hopeless
- Feeling lonely or isolating themselves from others
- Eating too much or too little
- Having little energy and no interest in usual activities
- Sleeping too much
Why Seek Treatment
If you or someone you know is struggling with a mental health disorder that might be related to bipolar disorder, there may be help available. Mental health disorders are often treatable, but if theyre left unaddressed, they often worse ones health over time. Bipolar disorder can lead to both mental and physical health complications. Insomnia and sleep disturbances can cause long-term health problems like obesity and heart disease. Major depressive episodes can also lead to suicidal thoughts. Bipolar has been shown to increase a persons suicide risk significantly. To start taking steps toward better mental health today, learn more about bipolar disorder and how it can be treated.
Written by: Joseph Raspolich
About Vista Pines Health: Vista Pines Health is a mental health treatment program that is dedicated to providing quality care to those who are suffering from mental disorders. Conveniently located in sunny Pembroke Pines, Florida, we help clients, from all over the country, find healing from conditions such as depression, anxiety, PTSD, and more. Our programs are designed to put the client first every step of the way, helping them conquer the struggles they deal with on a daily basis.
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When To Seek Help
Children and adolescents with bipolar disorder experience severe mood and behavior changes that are extreme and represent a major change from their typical mood and behavior. It might be difficult to know when the symptoms are severe enough to warrant evaluation and, potentially, diagnosis, so consider these three basic factors: functioning, feeling, and family.
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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How Can I Help My Child Or Teen
Help begins with the right diagnosis and treatment. Talk to your family health care provider about any symptoms you notice.
If your child has bipolar disorder, here are some basic things you can do:
- Be patient.
- Encourage your child to talk, and listen to your child carefully.
- Pay attention to your childs moods, and be alert to any major changes.
- Understand triggers, and learn strategies for managing intense emotions and irritability.
- Help your child have fun.
- Remember that treatment takes time: sticking with the treatment plan can help your child get better and stay better.
- Help your child understand that treatment can make life better.
Bipolar Disorder Symptoms Has Several Subtypes Such As:
A manic up stage that lasts about a week or is so intense that you require medical attention indicates bipolar I illness. Extreme down periods, on the other hand, can last up to two weeks.
However, its not as severe as bipolar I, which means youll have erratic mood swings.
Mania and depressive episodes lasting one year in adults or one year with children and adolescents are the hallmarks of this type of disease. Compared to bipolar I or II, the symptoms are less severe.
Since the term bipolar disorder no longer encompasses all of the mood and stress symptoms associated with manic or hypomanic episodes, the word undisclosed or other unspecified bipolar illness has gained popularity.
In patients with manic I or II, rapid-cycle is not an illness but rather a term used to describe their conditions duration. This rule applies if a person has four or more depressive episodes in a year.
It can occur at any point during bipolar disease and is more common in women than in men. Suicidal thoughts or actions frequently accompany sudden mood swings, and depression is a common cause.
Drug and alcohol abuse can exacerbate any form of bipolar disorder. Dual diagnosis is a condition in which a person has behavior disorders and alcohol abuse disorder.
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Can Lifestyle Habits Increase The Risk Of Bipolar Disorder
Lack of sleep increases the risk of having an episode of mania in someone with bipolar disorder. In addition, antidepressants, particularly when taken as the only medication, may also trigger a switch into a manic state.
Excessive use of alcohol or drugs can also trigger bipolar symptoms. Research has shown that about 50% of bipolar sufferers have a substance abuse or alcohol problem. Sufferers often use alcohol or drugs in an effort to reduce unpleasant feelings during low mood periods, or as part of the recklessness and impulsivity associated with manic highs.
How Can Bipolar Signs & Symptoms Affect Daily Life
If left untreated, some side effects that come with bipolar may affect a persons daily life:
- Job or education responsibilities
- Inability to care for dependents or self
- Financial stress, possibly bankruptcy, eviction, or car repossessed
- Loss of social connections as friendships suffer
- Dysfunctional family relationships displaying codependency, resentment, family estrangement, or divorce
If a person is diagnosed with a severe impairment that impedes their ability to work, it may make them eligible for disability benefits.
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Who Is At Risk Of Bipolar Disorder
More than 10 million Americans have bipolar disorder. Bipolar disorder affects men and women equally, as well as all races, ethnic groups, and socioeconomic classes.
Although men and women appear to be equally affected by bipolar disorder, rapid cycling is seen more often in women. Women also tend to experience more depressive and mixed state episodes than do men. A man’s first experience with bipolar disorder may be in a manic state women tend to first experience a depressive state.
Bipolar disorder can present itself at any age, but typically, onset occurs around age 25.