Can Bipolar Disorder Just Appear? - An Expert's Perspective

Bipolar Disorder is often diagnosed in teens and 20s but more attention is being paid to those diagnosed later in life - learn about late onset Bipolar Disorder from an expert's perspective.

Can Bipolar Disorder Just Appear? - An Expert's Perspective

Bipolar disorder is a chronic mental illness that can have a profound personal and public health toll. It is often diagnosed in a person's teens and 20s, but more and more attention is being paid to those diagnosed later in life. Older adults who discover they have bipolar disorder may have been misdiagnosed throughout their lives or have only initial symptoms of the condition. Most patients with bipolar disorder start before the fifth decade of their lives, but a significant number of patients start the disease after age 50, which is commonly referred to as late-onset bipolar disorder.

Age of onset can have a significant impact on the nature and course of bipolar illness. We report an interesting case of late-onset bipolar disorder when evaluating secondary mania. The patient was a 76-year-old African-American woman with religious and sexual concerns, reduced need for sleep, and auditory hallucinations. Magnetic resonance imaging of the brain revealed diffuse atrophy and two localized lesions on T2-weighted images. Diagnosing late-onset bipolar disorder requires a thorough evaluation of all possible secondary causes.

This can be difficult given the number of agents that confuse and the associated cost. However, a thorough analysis to rule out secondary causes remains the centerpiece for correctly diagnosing and effectively treating late-onset bipolar disorder. A person can be diagnosed with bipolar disorder at any age. However, if a health professional diagnoses it in someone older than 50, it is considered elderly bipolar disorder. Bipolar disorder is also thought to be related to genetics, as it appears to run in families.

But Bipolar Disorder Can Be Deceptive. Symptoms May Defy Expected Manic-Depressive Sequence. Rare episodes of mild mania or hypomania may go unnoticed. Depression can overshadow other aspects of the disease. Sometimes, symptoms of depression and mania can occur at the same time. And substance abuse, if present, can cloud the picture.

Scientists believe bipolar disorder is the result of a complicated relationship between genetic and environmental factors. Research suggests that a person is born with a vulnerability to bipolar disorder, which means they are more likely to develop the disorder. However, this is not the only factor in determining if a person will get sick. Environmental factors, such as stressful life events, also seem to play a role in that they can cause the onset of the disease or trigger a relapse of symptoms. People with bipolar disorder often have cycles of high and depressed mood that fit the description of manic depression.

The NIMH estimates that nearly 2.9% of adolescents between 13 and 18 years old will experience bipolar disorder at some point, with the highest prevalence (up to 4.3%) seen in young people aged 17 to 18. Substance abuse can make bipolar episodes (mania and depression) more frequent or severe, and medications used to treat bipolar disorder tend to be less effective when someone uses alcohol or illicit drugs. We discontinued trazodone and mirtazapine, and this in itself could have contributed to clinical improvement, considering that antidepressants can cause patients with underlying bipolar disorder to have manic outbreaks. In recent years, research has shown an increase in the diagnosis of late-onset bipolar disorder (LOBD). For example, a person with a parent who has bipolar disorder has a 15-30% risk of developing the disorder. This leaves room for the possibility that environmental factors play a role in the expression of bipolar disorder among some individuals. People with bipolar disorder and their families can get help from health professionals and support groups.

Although bipolar disorder is a lifelong condition, you can manage mood swings and other symptoms by following a treatment plan. Taken together, these factors make bipolar disorder difficult to diagnose when symptoms aren't obvious. Untreated substance abuse can make it virtually impossible to control mood symptoms of bipolar disorder if both disorders are present. Family members of someone with bipolar disorder have a higher risk of developing it themselves. A person should contact a health professional as soon as they experience symptoms of bipolar disorder.

If any of your family members have experienced bipolar disorder, you're also more likely to develop it.

Cassandra Laudat
Cassandra Laudat

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