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Sometimes, a person may receive a bipolar disorder diagnosis later in life. This is called late onset bipolar disorder, or older age bipolar disorder.

This does not necessarily mean that the condition is new. A person could have been living with bipolar disorder for years and only recently received a diagnosis.

The average age of bipolar disorder onset is 25 years, and it affects both males and females in relatively equal numbers. Although the condition is not as prevalent among younger children and older populations, more research is necessary to understand why.

Read on to learn more about receiving a diagnosis of bipolar disorder later in life.

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People with bipolar disorder experience extreme shifts in mood, activity levels, and concentration. Although they usually alternate between manic and depressive episodes, some people also experience mixed episodes.

These mood changes often affect a person’s behavior, work, and relationships.

Symptoms of manic episodes include:

  • feeling elated, jumpy, or “wired”
  • not needing as much sleep
  • losing one’s appetite
  • talking very quickly about a lot of different things
  • having racing thoughts
  • making risky or destructive decisions
  • feeling important or powerful

Symptoms of depressive episodes include:

  • feeling sad, worried, and hopeless
  • feeling restless
  • having difficulty falling asleep
  • sleeping too much
  • having changes in one’s appetite
  • talking very slowly
  • having difficulty concentrating
  • feeling unable to do simple things
  • lacking sex drive
  • thinking about death or suicide

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 2011 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:

  1. Look at the person’s medical history.
  2. Conduct several psychological and neuropsychological tests.
  3. Perform a physical examination to rule out other conditions.
  4. Run blood and urine tests and request neuroimaging.
  5. Treat the underlying condition, which could be bipolar disorder, or change the person’s current medication to help alleviate the symptoms.

Learn more about diagnosing bipolar disorder here.

A treatment plan for bipolar disorder may include a combination of therapy and medication.

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.

The following sections look at some treatment options for bipolar disorder in more detail.

Psychosocial therapy

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.

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.

Healthcare professionals may decrease the dosage of some medications for older adults. This is due to the increased risk of side effects and interactions with other treatments.

Medication for manic episodes

Treatment for manic episodes includes:

Medication for depressive episodes

Treatment for depressive episodes includes:

  • lithium
  • anticonvulsant mood stabilizers
  • atypical antipsychotics
  • antidepressants

Learn more about medications for treating bipolar disorder here.

A person should contact a healthcare professional as soon as they experience bipolar disorder symptoms.

Diagnosing bipolar disorder can be a long process, so it is important that people talk about their symptoms with a healthcare professional as soon as possible.

People with diagnosed bipolar disorder should contact a healthcare professional if they experience significant mood shifts or suicidal thoughts. They should also seek help if their medication has stopped working or if they experience unpleasant side effects.

Receiving a bipolar diagnosis can be challenging, especially later in life. People and their loved ones may find the following organizations useful when looking for education and support:

Bipolar disorder can affect people of all ages. However, the average age of onset is 25 years. When a person has older age bipolar disorder, they tend to experience more depressive episodes.

Certain underlying conditions can interact with some bipolar disorder medications. For example, antipsychotics can be harmful to people with dementia. A healthcare professional may also have to reduce the dosage of some medications due to potential interactions with other treatments.

Receiving a new diagnosis later in life can be difficult. People with bipolar disorder and their families can get help from healthcare professionals and support groups.