Avatar universal

Does BiPolar get worse with age?

I have seemed to get worse through the years, even though, I was just diagnosed (20 years as depression before now at BP1), it does seem that the episodes got worse and worse through the years.

As my father got older, he seemed to get worse, and worse (he wasn't diagnosed or medicated), and I just wonder what it's going to be like as I get older.  What does my family and friends have to "look forward to"?

I know we can get "stable", but does it continue to get worse?  Also, I have a history of dimentia in my family - I wonder if it's linked?

111 Responses
601528 tn?1224081498
Personally...mine progressed with age. I was more out of control as far as being rageful towards my family. But then learned to be more in control as an adult around friends and co-workers. Though I still wanted to rage. The flooding of anger..the hallucinations...the depressions, confusion...all of it until I finally really fell apart at the age of 38. I was a realtor and found myself unable to do much of anything, much less think clearly. So I gave that up. That's when I was finally diagnosed properly and medicated. I am not completely stable...but much more so then I was 5 years ago without meds. But anyway, yes I do believe it progresses with age.
Avatar universal
Scary, huh?  I wasn't diagnosed until this year (40), but the last year was the worst - manic episode.  It was psychotic without doubt.  I was on an antidepressant and amphetamine that apparently set me off on mania for a whole year. ....needless to say, the aftermath of the tornado was pretty bad.  

What scares me is getting older and older, being a single Mom, no real family support, etc., what will become of me and is it going to lead to dementia or something like my Grandmother?   If I can get stable (which I am more now than EVER!), I will be able to make it, but I don't want to end up in an institution.

I bottomed out at the end of 38, so I can relate.   I have a low stress job now, and I don't know how I managed to stay in banking / real estate for 20 years with BP.  
601528 tn?1224081498
I was a single mom too for years...It was sooooo tough being BP and everything on top of it. I have the same fears as you, My grandfather suffered from demetia. But don't worry...we will make it....somehow. I am actually kissing up to my son, so he will take care of me in my old age...LOL Hopefully he will fall for it.

Thats cool you were in real estate/banking for 20 years. We seems to have alot in common.
Avatar universal
I knew I was always ADD but have just been diagnosed as having manic depressive disorder. It seems to have gotten worse with my age, this year being my worse (49). Does anyone know of any treatment that works. Right now I'm participating in a reserach program using Abilify and Prozac. None of these stop my racing thoughts though.

Anyone with some information?
Avatar universal
OH LORD!  NO- Prozac is horrible for BP (manic progressive).  Just like you , I had been diagnosed with ADD, but it wasn't that at all.  I had been treated for depression, also.  The anti-depressant and adderall kicked me into psychotic mania.  

That's an experiment I wouldn't want to be involved in!  Talk to your pdoc....  

Bless your heart!
462570 tn?1273632977
It seemed to progress with age with me as well.  Diagnosed firmly at age 38.  I just went downhill like **** on a hot tin roof!  One day I seemed to have it together and then the next BOOM - fallin' apart.  That isn't really the case - I fell apart slowly and progressively- but still - all the books I've read talk about the disorder getting worse as we age or if it has been left untreated due to something called "kindling".  Look it up - research it.  There are only a couple of known mood stabilizers that have proven to reduce kindling and one (Lithium) that actually seems to reverse it.  Studies are being done every day with the newer classes such as Lamactil and Topamax to see if they can help with the kindling but no really hard proof has come about yet.  
There are links to early dementia with Bi Polar that has been untreated but the good news is that with proper medication - we don't have to go through it.
Avatar universal
Thanks a bunch.  I haven't heard the kindling word before.  I went to the NAMI website and was looking, but didn't find a lot about relationships of the two.  It's just weird to me that there is a history of this AND dementia.

I currently take Lamactil and it works well - I feel better than I have in my while life.  I miss my mania (energy ONLY) parts at time, but overall, I feel better than I could have imagined.  

607502 tn?1288247540
You can read about kindling here : http://***.***

The reality is that it has not been proven conclusively yet but it does look interesting.  Bipolar is a progressive illness - the symptoms and episodes grow with age and this is one of the major reasons why early diagnosis and treatment is important - Untreated bipolar's have a hugely increased risk of early onset dementia for one.

Treatment and management are vital.  I do worry seriously about someone doing a trial with abilify and prozac - neither of these drugs is new and their affect are know - SSRI drugs are the new big thing in Bipolar treatment and thats alarming considering they can send a significant portion of patients into dysphoric mania (also know as mixed episodes) which is the most dangerous state for bipolars - most suicide attempts for bipolar's come during mixed episodes.

If you are taking any anti depressant and are a bipolar you should be carfully monitored and those around you aware of the symptoms of a mixed epsiode - MOAI and Tricyclic AD's can also cause mixed states which is why there is a lot of debate among doctor about using AD drugs in the maintenance phase.
Avatar universal
So true on the dysphoric mania - that is a SCARY situation.  I was in the mixed episode when I attempted suicide and wasn't even aware at the time that I was eating pills like tic tacs.  

It's a little scary to me since I was diagnosed at 40 - just got treatment - and my Dad got worse when he was at 45.   With dementia running in my family - as well as, the BP, it makes me think I am in for a rough row to hoe.    

The message blanked out the web address - can you send me a direct message with the web address?  

As always - you are the best -

561706 tn?1333947274
I have found my illness has stabilized a lot more the past few years (I'm 41).  I'm pretty happy with my current med regime.
My dad suffered with manic depression his whole life with only Li as treatment for a long time.  As he got older his episodes became less severe and then less frequent. He took Paxil for many years alone - luckily with only good effects.

Later a VA doc put him on Seroquel and Depakote.

He suffered episodes of depression sometimes, but never had another manic episode after about 60 years of age (he lived to be 78).
Avatar universal
i have to agree with everyone else, believe my really syarted coming out at 38-39, certainly progressed with age until i was finally diagnosed at 41, should have been dx earlier but i was in denial an refused all attempt of family an freinds for help. Sure made fore a rough 3 years , still trying to get meds an all straight its a tuff ride an i do see it getting worse with age
607502 tn?1288247540
I will dig up the address and email it to anyone who needs it - I have no idea why this has started happening now, blanking of website addesses.

Dysphoric mania is the single most dangerous phase for anyone to be in because you just do not realise you are there and if you do not have people around you who know its an incredibly dangerous place to be.  Ironically I am reading an article from the Australian Prescriber which is a mag for pharmacists (my pharmacist prints out interesting articles for me from it) about acute treatment of bipolars that has some interesting stats : quoting

" Patients with bipolar disorders face significant risks of morbidity and mortality and present medical practitioners with considerable diagnostic and management challenges. The lifetime prevalence of bipolar disorders is estimated at 1-4% of the general population.1   Suicide is attempted by 25-50% of sufferers2, and overall 15% of people with bipolar disorders die by suicide.3

Accurate diagnosis depends on recognising often under-reported symptoms of elevated mood. Mixed states (combined depressive and elevated symptoms) and comorbid substance misuse frequently cloud the initial diagnosis. These diagnostic complexities along with often impaired patient insight lead to a third of Australian patients suffering illness for more than ten years before accurate diagnosis is made and appropriate treatment given."

The suicide attempt figure is alarming and when you add to it that men are many times more likely to successfully commit suicide the risk factors grow more.

Interestingly the article also has this to say :

"Bipolar I involves manic symptoms which last for at least a week and are severe enough to markedly impair functioning or require hospitalisation. In contrast, bipolar II involves hypomania in which elevated symptoms are less severe but still clearly different from usual mood and last for at least four days. In both forms of the illness, depressive episodes tend to be more frequent and disabling than mania. Sufferers spend 32-50% of follow-up in depressive episodes and only 1-9% in elevated states.5   Most patients have inter-episode periods of recovery, but over 90% relapse without medications.6 "

Which goes to another thread on here where someone doubted they were BP because they were not needing meds.  Its a fools game in the end.

Article is here (add http in front) www.australianprescriber.com/magazine/31/3/73/6/
Avatar universal
Thanks  - disphoric is a scary place to be.  I truly think I was in that state for a whole year during the episode of me being on Cymbalta and Adderall-prior to my diagnosis.  That was a completely psychotic year for me and ultimately, it took a close friend to insist I talk to my medical doctor who INSISTED strongly (with the threat of hospitalization immediately), that I go back to my pdoc.  It's also where my suicide attempt happened.  

I think one of the main reasons men are more "successful" in the suicide attempt is the method.  I have seen that most women (like me) attempt overdose, however, men, are more likely to self-inflict like gunshot.  It's scary - truly.

The website you gave us on the black dog was interesting.  If you would send me the kindling website, I would appreciate it.

I have some personal "man's perspective" questions that I am going to message you later.  

Thanks, John.

607502 tn?1288247540
Indeed the reason for success rates in men is very much related to method - men are more likely to choose a violent method such as gun or hanging or jumping than women but its also related to the fact that women are more likely to talk to friends or family and seek help - there is very much a male code of silence on health and mental health and this is especially compounded in Australia where the image of the ocker aussie man who is strong and silent and never gets hurt is built into the culture along with the ANZAC hero image that young men are still brought up on - its no joke that Australia is still in many place a country where men drink beer and dont talk about their feelings and if you do otherwise youre a poofter - no its not a stereo type that attitude still exists.

This has presented major problems for groups ike Black Dog and Beyond Blue here for reaching men - one of the big successes they have had believe it or not as signs on toilet doors and above urinals - men read them because well you dont look anywhere but in front of you at the urinal.. It works, it reaches men.  Reaching them is the hard part.

Ive lost 2 people i know to suicide - 1 of them a guy I worked with but wasnt close to who went through a messy divorce and custody battle and one day went home from work and shot himself and another an ex flatmate who tried 4 times and on the 5th try succeeded.

Asking for help is hard, Im lucky in that my suicide attempt was caused by mania and though I get suicidal thoughts now and then I truly do not think I would do it again - but that does not mean you dont take the thoughts seriously.

Kindling is here (put http:// in front) bipolar.about.com/cs/brainchemistry/a/0102_kindling2.htm
Avatar universal
I dont beleive BP gets worse with age. If untreated of course BP would symptomatically get worse. Thanks to modern medicine we don,t have to let this disorder ruin our lives. I also dont beleive that BP is totally hereditory. Maybe the genetics allow a certain suseptibility for pyschological disorders, but these are only triggered by a traumatic or painful experience, however long ago.The effects of the BP or DP for some reason doesnt manifest until adolescents or adulthood (18-30yrs). BP and DP does not come from nowhere! Therefore sufferers can lead a normal happy healthy life no matter how old u may be.
Avatar universal
p.s, my family has no links to dementia so in my case this theory is not valid.
Your family has a lot to look forward to, you will not pass this on through genetics, just your beliefs.You will have a strong happy healthy life ahead of you. Keep on your medication, and start looking inside yourself. You will find more than u thought.
607502 tn?1288247540
Bipolar has been proven to get worse with age, its not a matter of belief its a matter of medical study - all mental illness gets worse with age as our brains age too and mental illness gets worse.

Regardless of meds you cannot control BP completely, the meds act as control factors but sometimes and often over time your body adapts and meds need to be tailored.

Bipolar is not triggered by trauma and it is not trigged by psychological injury - those are both outdated theories discredited years ago - the most likely cuplrit for bipolar is a genetic abnormality if you follow current thinking and its not something you can get, you are not sucspetible to bipolar if you are born with it you will develop it - they do not talk about it in terms of catching its talked about in terms of onset because it lies dormant until early teens and adulthood and no its not just 18-30 year olds its now being seen in full cases in pre adolescents - again the 18-30 is old data now proven to be changed.

The reason for its onset is likely linked to hormonal and life changes as we grow - this is one of the theories presented for why we see it younger and younger now; doctors are seeing menstruation in girls as young as 8 these days and it may very well have something to do with all of the hormones pumped into our food these days (one of the theories I have read) but no one knows as we have not studied BP anything like some of the other mental illnesses.

No one is saying all children of bipolars will have BP nor are all BP's the children of BP's - the way it is put is there is significant evidence that in a large percentage of cases there is a familial link - that does not mean that all BPs come from a family of them but more and more seem to do so.  

As for dementia - there are factual linkages out there that show that untreated BP patients are far more likely to suffer early onset dementia regardless of family history - again this does not mean all will and it does not mean treatment prevents it.

I think people miss the point - youre not treating the disease with the drugs that are used you are treating the symptoms - you cannot treat the disease at this point.

Positive attitude, healthy lifestyle and education are important parts of being bipolar but that also has to include a sober and intelligent understanding of the realities of the problem, sugar coating it its pointless because the monster is your head no matter what - the best way to fight it is to know how it thinks and works but you are never going to beat it.

I suspect that like many people and me most of the time you have a mild and controllable case of BP - we sometimes forget we are the lucky ones - there are people I know and others who post here who fight every day for control of their lives against the disease - positive thinking and drugs doesnt always work.  At best many of the modern drug theories work in ways not really understood and the proper dosages and mix is a cocktail of experimentation and side effect hell.

561706 tn?1333947274
Well stated.  Especially about the reality of symptom management v. curing or "beating" it.  Excellent posting. (I was going to say essay, but I don't know if that fits for this form).
581210 tn?1220834780
Yes it tends to get worse, especially untreated.  For one thing, depression causes brain damage.  But for some people lithium can reverse some of the brain damage and they get better and may not get as bad as they once were.

For example, my cousin was hospitalized at 18 with severe mania to the point of being delusional (the FBI was out to get her, etc.)  She spent several months in the hospital, and has been on lithium since and has since gone to college and adopted two children.  That was about 18 years ago.  She had one adjustment in her lithium a few years ago, and I think stress may have had something to do with it, because becoming a parent, even by adoption, is a big stress.  She is one of the success stories of overcoming bipolar.

I've been under the radar for bipolar most of my life.  It became blatantly obvious three years ago with a severe mania with so much anxiety I hospitalized myself.  Probably a good thing I got so scared, since I literally stopped sleeping and was going to have to wait several more weeks to see a psychiatrist and could have died from exhaustion of become delusion myself.

Perhaps stress doesn't "cause" bipolar, but it sure can trigger episodes, which is why I got so manic when I did.  Ten years before, I could have handled the same stress without a hitch.  I think prevention is worth a pound of cure in latent cases like mine.  One of my best friend from grade school grew up with mental illness in her immediate family and goes to great lengths to take care of her own health so that she doesn't have a mental breakdown--so far it's worked for her.

But if you are like my cousin and have major episodes early on from out of nowhere, then there isn't really a way to prevent that.  Lithium works great for her as a restorative.  It doesn't work for me (right now I'm trying Tegretol.)  We seem to have different flavors of the illness, so it's no wonder we require different treatments.
Avatar universal
From what I've read so far most of you are older than I am. I am now 29 and have come to recognize a distinct pattern or cycle with my bi polar.  I was diagnosed as bi polar and clinically depressed at 13. I was in therapy as young as 11 for depression. Sleeping endless amounts of time seem to be the caution sign for my mother. I was also a very troubled child and seem to get into trouble at school, with the law, and with any adult that tried to control me. The two together seemed to be the reason my mother committed me to treatment centers several times. At 17 I started using heavy drugs, stop taking my medication and continued to use heavily until I was 21. I continued to use though not everyday like before. I was always under the assumption that all I had was depression and that the drugs manifested manic episodes. However after being clean for 4 years I am now completely aware of my cycles. It's beginning to become a little scary. There are people in my life that will say I have these problems with depression because I am simply lazy. I don't deny being lazy but the days I can't seem to get out of bed without a major struggle and at least one break down in the morning has to be more than just laziness. I would rather die than have to face the rest of my day at work with my son with anyone else that requires any emotional connection with me. It seems to be more than just laziness to me. I am not on any medication and have not been diagnosed in 8 years. It's hard for me to say whether it's gotten worse over the last 4 years but I'm terrified I'm going to just lose it and commit myself and lose my son who will be 3 in Jan. I need help. I don't have insurance and can't afford medication. I know there are places you can go to get help with medication but I'm scared to take the medication as well. I don't want to be a zombie. Any advice would be more than appreciated. I keep trying to tell myself if I can control it if I can manage it or if I can just get by I'll be ok. I had a friend tell me last night that was not possible and my only choice is to take medication. I'm starting to freak out. Over the last 15 years I've had at least 45 jobs. I'm scared I'll never be able to keep a job. I try so hard and no one sees it because no one really understands or knows what I deal with everyday.
Avatar universal
In my case, my BP1 has gotten much worse over the years since I was diagnosed. ( I believe there were also at least 10 yrs. of undiagnosed manic depression in my teen years before I needed to be hospitalized during my first severe full blown psychotic mania when I was given my official diagnosis.)  Looking back, I see some medical treatments which were common during the 70's and 80's and the social services back then that were not available. These improvements have led to the better rates of recovery that are seen today.  I'm not saying that it's easy for patients now but a lot of people like me didn't have the range of medicines available to make more choices.  The medicines that were around had much more serious side effects. The options I had when first diagnosed were Lithium, Haldol, Stelazine, and ECT.  They used to seriously overmedicate and mental health advocacy was unheard of.  When I gained more and more weight on Lithium, the doctors said my sanity was more important than my physical health.  I put on 100 lbs. in the first year, which I've never shed.  That did not help my mood or sanity whatsover. As time progressed and the docs decided to add anti-psychotics to the mix, I gained much more.  I've since lost some of that additional weight through hard work, but it is ONLY possible when I am on the correct medicines.  It seems, looking back, that the use of anti-depressants-esp. the MAOI's and tricyclics- might have added to the severity of the manic sides of myself and other bipolars, or at least caused more mixed states.  That seems to be what  has happened in my case.
   Since the medicines were so bad, ECT was used more. But if you were on the dole, they let docs train on you.  You are only supposed to lose the memory of the events around the time you receive the treatments.  However, I lost large amounts of long term memory as well.  Like music scores and math-skills learned long before. I can not learn in the same fashion as before. My friends have told me of trips we took together which I have forgotten about!  Very strange but even more than that, very disturbing.
   My current doc thinks that the best treatment for somebody just starting out is to find the most effective stabilizer with the least amount of side effects AND if possible, to avoid taking any antidepressants.
   Socially, there are more resources, support groups, and club houses today.  I am figuring out computers, and now look, there's this support group online!
   Although the hospitals often let patients out too soon now due to insurance problems, the opposite was true for many years. We were left staring at the cracks in the walls for weeks. I spent most of the '90's in hospitals taking whatever great new "wonder" (experimental) drug they decided to test on us. A bunch of us got diabetes on Xyprexa.
You name the drug, they guinea pigged it on us. When I moved in '02 to see my ailing brother it was the first time I ever saw a computer with a mouse (and actually the first time I had used the internet too!)
   My family has all died.  My brother died at 45 due to emphysema but he had bipolar 1 also and got very ill and was homeless for 3 yrs. Despite taking my medicines, his death was too great a stressor, and I became psychotic and became homeless for 6 months. I don't smoke, drink alcohol, or do street drugs, but still I got so ill and a lot of bad stuff happened out there.  I'm just lucky to be alive.  Our parents were dead.  I live by myself but have wonderful pets. I am too old to have children but decided years ago that it wouldn't be wise given my diagnosis and that of my brother's too.  My father believed that he was probably BP2.  They didn't know much about all of this around WWII but he believed it helped him for the most part, yet he did suffer with depression and he was very moody. Now, in his cas, he did get better with age. Maybe this was because he didn't self medicate or take medicine. I've noticed a tendency towards mood disorders-like cyclothymia and BP1-on his side of the family; with his brother and sister; none have been medicated, and they have mellowed with age.  Unfortunately, in older times, a relative or two may have been institutionalized when that was the standard practice. One, I believe, was put into a sanitarium for post-partum depression before they knew what that was.
   I hope this wasn't too negative an answer. Lots of people get better as they age. I think that once they find the medicines that work for them and get support they do can get back to doing more as time goes by.  
Avatar universal
No, it wasn't negative to me.  My fear is that I already have a history of dementia in my family on both sides (maternal and paternal grandmothers) and with my diagnosis coming at 40 - believing that I have always been this way - treated for depression and ADD (which set my mania into motion big time) for 15+ years - it's scary to me.

My family (immediate family) isn't supportive because they have to deal with the issues that have surrounded many in my family and the guilt for not suggesting I get help (very much a hush - don't discuss it family).  I do have 2 wonderful children (all be it a challenging 19 year old at times), and a ex-family that's very supportive of me and my issues.  My friends are wonderful and I can't imagine life without them.  SO, I understand the lonliness of not having immediate family, but family is what you make it.

I am cautiously optimistic that since I am the first in my family to be diagnosed with my BP1 - I will escape the family legacy of dementia.  Who knows - I hope to be a healthy old broad that bugs my kids and spoils grandchildren.  My fear is that I will be the old woman in the nursing home that doesn't remember anyone and no one comes to visit anyway.  

Thanks for your comments!  You will love this community - I am glad you found us.

561706 tn?1333947274
It sound like I have a similar history to yours.  I was diagnosed with depression when I was 11 after a suicide attempt, but meds were not offered at that time ('77").  I was in counseling for two years without much progress as I recall.  At 17 another suicide attempt and hospitalization for several months.  

I was given Lithium and a tryicyclic.  But really struggled for many years.  With psychotic manias, and depressions that destroyed relationships and jobs and my first shot at college.  Been homeless brieflly.

And I'm also without family and I'm single. I'm just sharing all this to hopefully make you feel a little less alone.

Now for the positives:  I've been able to work at a good job in my profession for 10 years.  I've been hospitalized twice in that time for manias, but was not fired from my job (partly because I had a good record due to my stability).  I've been on a lot of medications and what I've been taking the past ten years has really been a godsend.  

My meds were not that great for the first 7 years I was able to work again, but after a hopitalization 3 years ago, my meds have been been awesome.  I'm one of the lucky ones that does not have a lot of bad side effects.  I pretty much have none at this point.  I did suffer a long depression after my dad died a year ago, but a new psychiatrist finally tried me on Prozac this summer.  I am on two mood stabilizers, whic is critical if you're BP and taking anti-depressents.

The Prozac helped eliminate my near-constant suicidal feelings and plans.  My main problem now is some residual depression.  I like my job but when I'm home alone I'm not very motivated to take care of things.  But I'm used to this.

So, my point is that meds are clinically proven to help and they've helped a lot of people on this forum.  I'm not a big fan of Pharma, but these newer meds have helped me in a way the older drugs couldn't.  I'm sorry you're afraid.  Remember you can try and if you don't like it you don't have to take them.  But there are a lot more options now that in the 70's and 80's.
561706 tn?1333947274
Just re-read your post and I think I got a little confused between your post and someone else's on here.  So I hope you won't take offense.  But the part about us having things in common is still true, and actually it helped me today to read your story (not the other way around).  I never had ECT though, but it was offered.  Thanks and sorry for being confused.
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