Bipolar Disorder

Bipolar disorder is a severe, chronic psychiatric condition that causes people to suffer from extreme swings between high and low mood states. Older people tend to develop more depressive and manic symptoms, unlike the euphoric moods and grandiosity experienced by younger representations of the disorder.

It is estimated that 10 to 25 percent of all individuals over the age of 50 suffering from a mood disorder are diagnosable as having Late Onset Bipolar Disorder (LOBD). Unfortunately, there is still the possibility of these numbers being an underestimate considering the disorder’s high rate of misdiagnosis.

What are the Symptoms of Bipolar Disorder?

The symptoms of late-onset bipolar disorder often appear to be more severe and frequent than that of younger individuals. Symptoms of late-onset bipolar disorder include:

  • Persistent sadness
  • Difficulty moving
  • Slowed perception of time
  • Lack of interest in hobbies
  • Frequent outbursts of emotion
  • Sense of helplessness over loss of control
  • Weight fluctuations
  • Impaired memory or decision-making
  • Ambiguous medical concerns
  • Increased risk of suicide

Bipolar Disorder Causes

Even though the specific causes of LOBD are relatively unknown, there have been a number of factors linked to the development of this condition. Some of the potential causes of late-onset bipolar disorder include:

  • Genetic factors - This factor does not seem to be as strong for the early onset type of bipolar.
  • Neurological illness - There is some evidence that LOBD is associated with dementia.
  • Cerebrovascular disease
  • White matter hyperintensities - These are small lesions found throughout the brain.
  • Posterior Cortical Atrophy - Also known as Benson’s syndrome, this is a condition causing shrinkage in the back portion of the brain.

Treatments for Bipolar Disorder

Because the causes of late-onset bipolar disorder are still somewhat unknown, there are debates within the medical community as to which method of treatment is the most effective. Here are some different ways we can treat bipolar disorder in seniors:

Mood stabilizers - Mood stabilizers help individuals with Bipolar manage the intense highs and lows that come with the disorder.

Lithium - is the most common mood stabilizer used to treat Bipolar disorder.

Valproic Acid - is another mood stabilizer used to treat the manic phase of Bipolar.

Antipsychotics - Antipsychotics are typically prescribed with a mood stabilizer and used to combat insomnia, anxiety and other symptoms of Bipolar, like agitation. Three common antipsychotics used to treat Bipolar disorder include Abilify, Clozaril, and Zyprexa.

Antidepressants - Antidepressants are not typically recommended by a physician to be the only medication treating an individual with bipolar. In some cases, an antidepressant can be added to the medication regimen to help lessen the symptoms of depression in Bipolar.

Electroconvulsive Therapy - This treatment is sometimes used for patients who are severely depressed or manic, and who do not respond well to medications. This can be a quick and efficient way to help people who are at a high risk for attempting suicide. The procedure involves inducing a grand mal seizure lasting less than one minute by the use of electrodes placed on the scalp. Although the method lost public credibility following distorted and negative portrayals in 1960’s media coverage, modern procedures have been shown as both safe and effective.

Vagus or Vagal Nerve Stimulation (VNS) - Involves a small device implanted into the vagus nerve in order to mitigate depressive symptoms.

Transcranial Magnetic Stimulation (TMS) - A small electromagnetic coil treats the symptoms of depression by stimulating nerves in the mood centers of the brain.

Light Therapy - For people suffering from bipolar disorder and seasonal affective disorder, sitting under a special light box capable of emitting full-spectrum light can help to treat depressive symptoms associated with the changes in weather.

If it’s suspected that you or an elderly loved one is developing LOBD, don’t hesitate to reach out to your healthcare provider to pursue a treatment option.