Bipolar disorder is a difficult disease to diagnose, but even more so for people over 60. There are a variety of reasons why, from its ability to mimic other diseases, to potential complications with medication.
First, some background:
What Is Bipolar Disorder?
The typical form of bipolar was originally known as manic depressive disorder, and characterized by experiences of soaring highs (called mania), followed by crushingly low depression. That mood disorder is now called bipolar type I.
Recently, a new form of bipolar has been discovered, called bipolar type II. It is characterized by significant episodes of depression with instances of slightly elevated, euphoric moods, called hypomania.
Type II usually goes undiagnosed because it’s difficult to define hypomanic episodes; it’s also commonly misdiagnosed as major depression.
Diagnosing Bipolar Disorder in 60-Plus
The most difficult part of treating bipolar in this age group is the prevalence of depression. Unfortunately, many older people are depressed, and may be treated for depression as an isolated disease.
However, depression and bipolar disorder often require different drug treatments. In addition, the metabolism of people over 60 affects how medications are processed in the body. This means that some otherwise helpful medications are not appropriate for the age group, which can make the diagnosis and treatment of bipolar even more difficult.
Furthermore, other diseases can mimic the signs of bipolar. For instance, like bipolar disease, Alzheimer’s can present with depressive and manic traits. Even problems with blood sugar can cause someone to seem depressed.
Bipolar Isn’t Just a Young Person’s Disease
Bipolar disorder is often thought of as a young person’s disease, and, in fact, it is more prevalent in people under 60. (According to Psychiatric Times, the incidence of bipolar in younger adults is 1.4%, while older adults experience it at only 0.4%.) However, if you have bipolar disorder in your youth, you’re highly likely to experience another episode later in life.
The other complicating factor is that bipolar disorder can go undiagnosed in younger adults; as a result, symptoms can intensify as people age.
Bipolar Symptoms: What to Look for
The signs of bipolar in people over 60 are slightly different than those generally seen in younger populations. Look for these signs:
- Elation
- Feeling on top of the world
- Agitation
- Irritability
- Distractibility
- Confusion
- Psychosis
- Hyperactivity
- Irritable depression
- Trouble with concentration, perception and memory
Specifically, irritability is pronounced in those over 60. Also, problems with perception, memory and problem solving are usually associated with dementia and Alzheimer’s, not bipolar. If you, or someone you love, are having perception symptoms in addition to depression and irritability, it’s worthwhile to look into bipolar disorder as a possible explanation.
How to Get Help for Bipolar Disorder
Although you may be self aware enough to realize you’re having symptoms, it’s more likely that a loved one will point them out to you. If they do, take it seriously; they may see you in ways you can’t see yourself.
Discuss the issue with your primary care doctor. Tell them how you’re feeling and ask for a referral to a specialist. This may be a psychologist, who can evaluate your cognitive symptoms, or a psychiatrist, who will focus more on the mood aspects. Either specialist can help diagnose bipolar disorder.
Most importantly, it’s in your best interest to investigate how you’re feeling. You don’t need to suffer, and you don’t need to feel on edge all the time. Focus on getting help through doctors, therapists, support groups, family and friends. This will help you to control your symptoms and live your best life possible.
