Regardless of the mental health condition, it’s common for someone to wonder if their symptoms will worsen or change over time. Understanding how bipolar disorder, a condition that affects millions of people worldwide, emerges or evolves as one ages can be essential for effective management and treatment.
Experiencing bipolar symptoms later in life, especially post-50, presents a unique set of characteristics. That makes it all the more important to understand this condition's trajectory across a lifetime.
Here, we’ll explore how bipolar disorder impacts older adults, how symptoms and treatment needs might shift with age, and what you or loved ones could do to help manage these changes.
While bipolar disorder is often diagnosed in younger individuals, the prevalence of bipolar disorder among those in their later years has gained more attention. Studies indicate that about 5-10% of new bipolar disorder diagnoses are in adults over 50, sometimes referred to as ‘late-onset bipolar disorder.’
Why does this happen? It’s likely due to a variety of factors, including symptom overlap with other conditions and evolving views of the importance of mental health.
Late-onset bipolar disorder can be challenging to diagnose due to its likelihood to exhibit symptoms differently, the complexity of symptoms, and the presence of other age-related health issues.
Bipolar disorder in older adults can present predominantly with depressive episodes. Since these episodes can look very similar to clinical depression, it's not uncommon for the condition to be misdiagnosed as unipolar depression.
Additionally, manic phases in those with bipolar disorder who are post-50 might not be as pronounced as in younger individuals. Sometimes, these manic episodes are less about traditional mania and more about irritability or less obvious changes in energy, which can be easily overlooked or misattributed.
In some cases, there could be a misdiagnosis of dementia in patients who are actually experiencing bipolar disorder, or vice versa. The overlap in symptoms for both dementia and the depressive or manic phases of bipolar disorder can include:
Both dementia and bipolar disorder can include behavioral disturbances, too. In the case of bipolar disorder, these might be part of a manic episode, whereas, in dementia, they could be due to cognitive decline, making the correct diagnosis challenging.
It’s no secret that mental health was heavily stigmatized and a taboo conversation topic in previous decades. Back then, this stigma often prevented individuals from seeking help or even acknowledging mental health issues.
As societal understanding and acceptance of mental health issues have improved, more older adults could be seeking treatment for symptoms that may have been present but unaddressed for decades. This shift could explain an increase in diagnoses of late-onset bipolar disorder as well as re-evaluations of misdiagnoses.
In short: Reasons for late diagnoses could be that people now in their 50s and beyond grew up during times when psychiatric treatment options weren’t as advanced or as socially accepted as they are today.
Typically diagnosed after the age of 50, late-onset bipolar disorder can present unique challenges and considerations. Unlike early-onset bipolar disorder, which generally appears in adolescence or early adulthood, late-onset bipolar disorder can be influenced by a range of factors.
The development of bipolar disorder in adults age 50 and older can often be explained by the significant changes the brain and body undergo as part of the aging process. Some of the reasons why bipolar disorder might emerge late in life include:
These triggers could complicate treatment plans, and, in some cases, a multidisciplinary approach to treatment will be needed.
Neurological changes, other medical conditions, and hormonal imbalances can present symptoms that mimic those of bipolar disorder. Other explanations for those signs could include:
The complexity of diagnosing the issue could require careful psychological and medical evaluation.
As individuals step into their later years, the intensity and presentation of bipolar symptoms undergo significant transformations. Let’s explore how aging impacts bipolar disorder.
Bipolar symptoms can shift with age. For instance, older adults might experience more depressive episodes and fewer manic episodes, or they may find that their episodes are more prolonged than when they were younger.
Additionally, research suggests that while the frequency of manic episodes may decrease with age, depressive episodes can become more severe and last longer. This effect of aging on bipolar disorder can significantly impact an individual’s quality of life and requires tailored treatment.
Symptoms also could blur into a mixed emotional state, making it challenging to differentiate between mania and depression.
The impact of age on the brain further complicates the clinical picture. Aging affects brain structure and function, which can make symptoms harder to manage and predict.
Studies have pointed to the possibility of accelerated brain aging in those with bipolar disorder, potentially influencing symptom severity and treatment responsiveness.
Managing bipolar disorder is crucial to maintaining quality of life. People with bipolar disorder may have a shortened lifespan and may experience biological aging at a faster rate. The disorder’s associated behaviors and comorbid conditions such as cardiovascular disease can also impact life expectancy.
Additionally, because one could experience more severe depressive episodes in their later years, thoughts of suicide could become more prevalent, increasing the risk of self-harm or suicide attempts.
Remember: Seek immediate help if you're ever thinking about acting on suicidal thoughts, in a crisis, or experiencing extreme emotional distress.
Regular monitoring and support for mental health alongside strategies to reduce these risks and maintain safety should be aspects of one’s treatment plan in their later years. It’s also vital for adults in their 50s and above to have routine health screenings and maintain a comprehensive care treatment plan that addresses both mental and physical health.
The short answer: Most likely. As you age, both your body and your brain can undergo significant changes that can alter your symptoms and the way you respond to bipolar treatment options.
Because of that, it can become important to make bipolar treatment adjustments in older age to account for these physiological and psychological developments. Let’s explore some of the common modifications people in their 50s and beyond may need to make.
With age, the way drugs are processed can be affected in the following ways:
Considering some may experience cognitive decline in their later years, more straightforward medication routines may be needed to make it easier to stick to taking medications while aging with bipolar disorder.
Therapy can be a cornerstone of treatment at any age. However, the focus might shift towards addressing specific life stage concerns, including retirement, loss of loved ones, and changes in independence.
Cognitive behavioral therapy (CBT) and other forms of psychotherapy can be tailored to help cope with the transitions that aging naturally brings.
Explore more: A Guide to Finding A Therapist For Bipolar Disorder
Lifestyle adjustments and non-medical interventions can be a critical addition to finding balance while living with bipolar disorder, including:
All of these strategies can enhance quality of life and support overall well-being.
While aging with bipolar disorder can present new challenges, understanding these changes can lead to better management strategies and a higher quality of life. It's important to consult licensed professionals who can tailor treatment plans with age-associated adjustments.
After all, the aging process affects all of us differently. Some may feel and function just like they did in their younger years, while others may have developed health conditions that impact their mobility, ability to drive, or ability to perform daily tasks.
Because retirement and aging can bring about many life transitions, you may want to consider online therapy and virtual medication management. Some of the benefits of choosing an online mental health service like Cerebral over traditional in-person visits include:
Plus, Cerebral offers more flexible scheduling options than traditional in-person visits. This flexibility is particularly beneficial for individuals with bipolar disorder, whose symptoms can fluctuate unpredictably, requiring more frequent support or prompt interventions.
Explore more: How Does Cerebral Work?
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*The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.
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