Many experts consider bipolar disorder a progressive condition that worsens with age, especially without treatment. Some people notice changes in the frequency and severity of episodes as they age.


Bipolar disorder (BD) causes extreme changes in a person’s mood and energy, leading to emotional highs and lows. Although symptoms can vary between individuals, the frequency and severity of episodes tend to shift as people age.

The average age of onset for BD is around 25, although it can occur in the teenage years or even in childhood. However, doctors diagnose up to 10% of cases when people are aged 50 or older.

Read on to learn more about how bipolar disorder changes with age.

Bipolar disorder can present differently among people, and some research suggests it may worsen with age.

This evidence suggests that as individuals age, they have more frequent episodes, with more time in depressed rather than manic states. They may also experience new symptoms, such as cognitive issues.

Some people also find that symptoms become resistant to medications that have been effective previously.

Signs of progression in BD may include:

  • Increased frequency of mood episodes: People with progressing BD may experience more frequent shifts between manic highs and depressive lows.
  • Prolonged episodes: The duration of mood episodes may extend, leading to longer periods of mania or depression.
  • Greater severity: Symptoms during mood episodes may become more severe, affecting daily functioning and quality of life.
  • Treatment challenges: Individuals with progressing BD may find it increasingly challenging to manage their symptoms with standard treatments, necessitating adjustments in their treatment plans.

People may also experience cognitive dysfunction, memory issues, and an increased incidence of dementia in old age.

The reasons behind the progression of BD are complex. Several contributing factors include:

  • Neurobiological changes: As individuals age, there may be changes in brain structure and function. This can influence the course of BD.
  • Treatment adherence: Some individuals may become less compliant with their treatment plans over time, which can lead to worsened symptoms.
  • Coexisting conditions: The presence of other medical or psychiatric conditions can complicate the management of BD and contribute to symptom progression.
  • Lifestyle factors: Stress, substance use, and lifestyle changes can affect the severity of a person’s symptoms.

Bipolar disorder requires a multifaceted approach to manage symptoms effectively. For example, a doctor may recommend a combination of medication, therapy, and lifestyle changes.

Management strategies for BD include:

  • Medication: Doctors consider medications the cornerstone of BD management. The options include mood stabilizers such as lithium and anticonvulsants. Antipsychotics can help manage severe symptoms, and in some cases, antidepressants can alleviate symptoms of depression.
  • Psychotherapy: Key therapeutic approaches include cognitive behavioral therapy and interpersonal and social rhythm therapy. Interpersonal and social rhythm therapy helps people learn to regulate their moods using their own social and biological rhythms.
  • Lifestyle adjustments: Making lifestyle changes is integral to BD management. A person can establish and maintain consistent daily routines, prioritize sleep, and learn stress management techniques.
  • Social support: A robust support system can include family members and close friends. Individuals with BD can also join support groups alongside others who also live with the condition. This shared experience fosters a sense of belonging, reduces feelings of isolation, and provides insights into coping strategies.

Learn more about treatment for bipolar disorder.

If a person thinks their BD symptoms are worsening, it is a good idea to contact a doctor.

Examples of progressing symptoms include extreme mood swings, changes in energy levels, disrupted sleep patterns, and impaired daily functioning. People should also seek medical advice if their manic or depressive episodes become more frequent.

A doctor can recommend alternative medications or therapies to help individuals manage their mental health more effectively.

Bipolar disorder symptoms can vary as individuals age and may worsen for some. For example, older individuals may experience more frequent and severe episodes, with more time in a depressive phase.

Anyone noticing changes to their bipolar symptoms should seek advice from their doctor.

Different medications or therapies could help with symptom management, helping optimize the individual’s quality of life and well-being.