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Medically reviewed by Timothy J. Legg, Ph. Defining bipolar disorder Importance of early diagnosis Diagnosing older adults Treatment Contact your doctor Overview Bipolar disorder is a mental illness that manifests with extreme shifts in mood. Defining bipolar disorder. Importance of early diagnosis. Diagnosing bipolar disorder in older adults.
Treating bipolar disorder in older adults. Severe bipolar episodes of mania or depression may include psychotic symptoms such as hallucinations or delusions. People with bipolar disorder who have psychotic symptoms can be wrongly diagnosed as having schizophrenia. To be diagnosed with bipolar disorder, a person must have experienced at least one episode of mania or hypomania. People with hypomania can often function well in social situations or at work.
Some people with bipolar disorder will have episodes of mania or hypomania many times throughout their life; others may experience them only rarely. Moods can rapidly become more irritable, behavior more unpredictable and judgment more impaired. During periods of mania, people frequently behave impulsively, make reckless decisions and take unusual risks.
Most of the time, people in manic states are unaware of the negative consequences of their actions. With bipolar disorder, suicide is an ever-present danger because some people become suicidal even in manic states. The lows of bipolar depression are often so debilitating that people may be unable to get out of bed. Typically, people experiencing a depressive episode have difficulty falling and staying asleep, while others sleep far more than usual.
When people are depressed, even minor decisions such as what to eat for dinner can be overwhelming. They may become obsessed with feelings of loss, personal failure, guilt or helplessness; this negative thinking can lead to thoughts of suicide.
Depression associated with bipolar disorder may be more difficult to treat and require a customized treatment plan. Scientists have not yet discovered a single cause of bipolar disorder. Currently, they believe several factors may contribute, including:. To diagnose bipolar disorder, a doctor may perform a physical examination, conduct an interview and order lab tests.
While bipolar disorder cannot be seen on a blood test or body scan, these tests can help rule out other illnesses that can resemble the disorder, such as hyperthyroidism. If no other illnesses or medicines such as steroids are causing the symptoms, the doctor may recommend mental health care. To determine what type of bipolar disorder a person has, mental health care professionals assess the pattern of symptoms and how impaired the person is during their most severe episodes.
The largest research project to assess what treatment methods work for people with bipolar disorder is the Systematic Treatment Enhancement for Bipolar Disorder , otherwise known as Step-BD. Step-BD followed over 4, people diagnosed with bipolar disorder over time with different treatments. People with bipolar disorder and psychotic symptoms can be wrongly diagnosed with schizophrenia.
These other illnesses and misdiagnoses can make it hard to treat bipolar disorder. For example, the antidepressants used to treat OCD and the stimulants used to treat ADHD may worsen symptoms of bipolar disorder and may even trigger a manic episode. Symptoms of manic episodes include:. Symptoms of depressive episodes include:. A person can receive a bipolar disorder diagnosis at any age. However, if a healthcare professional diagnoses it in a person over 50 years old , it is considered to be older age bipolar disorder.
For example, this could happen if the person lived with depression for most of their life but only recently showed symptoms of mania. Unlike early onset bipolar disorder, older age bipolar disorder is less likely to run in families. Healthcare professionals tend to associate it with changes in the brain or cerebrovascular disease. Older adults with bipolar disorder tend to experience severe depressive episodes more often than younger people. Also, generally, the more preexisting conditions an older adult has, the higher their risk of suicide.
Bipolar disorder is a lifelong condition. Because treatment focuses on managing the condition, it is important to seek help when a person first notices symptoms. The condition is complex, and the alternating manic and depressive episodes can make it difficult to distinguish from other mental health conditions.
According to one study, some people may wait up to 10 years to receive a diagnosis. Getting an early diagnosis means that a person can manage their symptoms and improve their quality of life.
When bipolar disorder symptoms are well controlled, a person is less likely to think about or attempt suicide. Bipolar disorder shares symptoms with other conditions, so a healthcare professional should first rule them out using psychological tests and physical examinations.
When diagnosing bipolar disorder in older adults, the healthcare professional must consider the varied signs and symptoms. Older adults are also likely taking medications for other conditions. This makes prescribing some types of drugs more difficult. To diagnose bipolar disorder in an older adult, the healthcare professional will :. Learn more about diagnosing bipolar disorder here. Although older adults will receive the same, or very similar, medications as younger adults, a healthcare professional may need to adjust the dosage to prevent side effects.
They may also need to consider the other medications a person is taking to avoid potentially harmful drug interactions. Although there is not much information about the effectiveness of psychosocial therapies in older adults, medication adherence training appears to be effective.
This training teaches people how to take their medications and what to expect from their treatment. When older adults with bipolar disorder receive this training, they are less likely to stop taking their medication. Healthcare professionals may prescribe several different medications for older adults with bipolar disorder.
Antipsychotic drugs, which help treat mania, can cause side effects. The Food and Drug Administration FDA warns that there is a higher likelihood of antipsychotics causing serious side effects in people with dementia , which is more common among older adults.
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