Bipolar disorder is a mental health condition that is characterized by significant shifts in a person’s mood, energy, and concentration. Many people get bipolar disorder as older adults, though it’s possible to develop it anytime.
While the symptoms of bipolar disorder can vary with age, the frequency, severity, and overall impact of the disorder are generally different in older adults versus younger people.
In this article, we’ll dive into how bipolar disorder changes with age, including how older age can affect symptoms, severity, and overall mental health.
In people living with bipolar disorder, age can affect:
- how symptoms appear
- how severe symptoms are
- how the disorder affects the brain
Although many people with bipolar disorder are diagnosed at an early age, around
So, how does bipolar disorder appear in older adults versus younger people, and how do the symptoms change as someone ages?
Mood shifts in bipolar disorder lead to distinct episodes that are referred to as:
- Mania: a drastically elevated or “high“ mood
- Hypomania: an elevated state that’s not as extreme as mania
- Depression: a “low“ mood
Changes in the frequency and severity of episodes are among the most evident changes in bipolar disorder at an older age.
- more frequent episodes
- more depressive episodes and less time spent in manic or hypomanic states
- less severe manic symptoms and fewer psychotic features with mania
- new symptoms, such as irritability and poor cognition
- lower risk of suicide, although this may be due to survivorship bias
- resistance to treatment options, such as certain medications
Since research on bipolar disorder in older adults is still lacking, it’s difficult to determine exactly how these changes can affect the different types of bipolar disorder.
While bipolar disorder seems to have a negative effect on executive function and verbal memory in all age groups, older adults are also more likely to be slower at processing information. Because of this, older adults with bipolar disorder may experience lowered neurocognitive ability, which can lead to a much lower quality of life.
Some of these changes may be due to how bipolar disorder affects the tissues within the brain. Many of these neurological changes can also be heightened by a variety of factors, including:
- natural changes of aging
- other medical conditions
- repeated mood episodes
- substance use or misuse
End stage bipolar disorder
Although there is no official classification for end stage bipolar disorder, mild structural changes in the brain that lead to cognitive dysfunction can severely reduce someone’s quality of life, especially toward the end of life.
So, while many older individuals already experience changes in mood, cognition, and memory as a part of the natural aging process, people with bipolar disorder may experience more intense changes.
Without the right treatment, day-to-day living can be harder, and the overall quality of life may be lower toward the end of life.
If you’ve been diagnosed with bipolar disorder, it’s important to seek treatment for the condition, as it can become progressively worse if left untreated.
Although treatment varies from person to person, doctors usually treat bipolar disorder with both medication and psychotherapy.
- Medications are often the first-line treatment option for people with bipolar disorder. Medications help reduce the chronic (long-term) symptoms of the disorder. Common medication options for bipolar disorder include:
- mood stabilizers
- second-generation antipsychotics
- Psychotherapy is often used along with medication to help reduce the behavioral symptoms of bipolar disorder. Helpful approaches include:
- cognitive behavioral therapy (CBT)
- family-focused therapy
As we age, it becomes much more difficult for our bodies to metabolize certain medications. In
For example, one
If medication does not help, doctors may suggest electroconvulsive therapy (ECT). During ECT, electrical currents are sent to your brain briefly to stimulate it. It’s usually a last resort to help treat depressive symptoms, but
Research from 2015 suggests that older adults with bipolar disorder tend to die
- metabolic syndrome
- hypertension (high blood pressure)
- cardiovascular disease
With the right combination of medication, therapy, and lifestyle changes, people with bipolar disorder might be able to lessen these changes and greatly improve their overall quality of life.
If you’ve been diagnosed with bipolar disorder, it’s important to reach out to a doctor to discuss a treatment plan and find the options that work for you.
Primary care doctors can diagnose bipolar disorder or refer you to a mental health professional for diagnosis and treatment. Because bipolar disorder is linked to a greater risk of other health conditions such as diabetes and heart disease, your primary care doctor can also monitor for these conditions and prescribe treatment.
Psychiatrists and psychiatric mental health nurse practitioners can diagnose and treat bipolar disorder. They may prescribe antipsychotics, antidepressants, mood stabilizers, or other medications. They may also provide or recommend psychotherapy or electroconvulsive therapy.
A psychologist, licensed clinical social worker, or licensed professional counselor can evaluate and treat mental health conditions with talk therapy. They can help you cope with challenging thoughts and feelings, engage in healthy behaviors and routines to help manage your mood, and learn effective ways to manage daily stress that may impact your mood.
People with bipolar disorder are at increased risk of developing alcohol and drug dependencies, which can make the symptoms of bipolar disorder worse. A substance use counselor or mental health professional can help you manage your substance use by prescribing medication or counseling.
Tell a mental health professional if you’re having suicidal thoughts or call 988 for the Suicide & Crisis Lifeline. If you’re at immediate risk of harming yourself or others, contact emergency medical services. You may need inpatient care at a hospital or residential treatment center.
In a mental health crisis, you might not be able to direct your own care. A psychiatric advance directive (PAD) is a legal document that outlines your treatment instructions. A lawyer can help you set up a PAD.
A case manager or licensed clinical social worker can help you develop strategies and find resources to manage work or school, finances, housing, healthcare, and other aspects of daily life. Licensed clinical social workers can also diagnose bipolar disorder and provide psychotherapy.