Question

Living With Bipolar Disorder

How could my bipolar disorder progress over my lifetime?

A Answers (2)

  • ARuss Federman, PhD, Psychology, answered on behalf of International Bipolar Foundation

    The question of prognosis with bipolar disorder is often difficult to answer in the early phases of the disorder. Each individual's experience with bipolar disorder is unique and thus each individual's future is impacted differently. What we do know is that the earlier the point of onset and the more unstable the early course of the disorder, the more unstable will be the longer course of the disorder. The flip side of this is that if the early course of the disorder is mild, then the longer term prognosis is fairly good. This phenomenon is referred to in the literature as "the kindling effect".

    A significant implication of the kindling effect is that it's important to do everything in your power to make healthy life adjustments early on. This involves elements such as developing a stable healthy sleep pattern, refraining from use of psychoactive substances, maintaining consistent daily routines and becoming excellent at your own stress management. These are all important components of living well with bipolar disorder.

    Unfortunately, you don't have the luxury of saying "I'll deal with implications of my disorder later. For now I just want to live life without worrying about lifestyle adjustment." By the time you get around to addressing a healthy lifestyle, the acuity of your mood variability may have already progressed to a degree where it is difficult to reel things back in.

  • The dramatic mood swings that characterize bipolar disorder will typically recur throughout life. If you have the disorder, you may be free of symptoms for varying amounts of time between episodes, or you may continue to have symptoms. Paying close attention to your symptoms is critical. You may begin to recognize warning signs and triggers for your mood swings. Working with your healthcare provider on appropriate treatment(s) will help manage the illness and its impact on your life. A very small percentage of people experience chronic unremitting symptoms, despite treatment.
    Another critical factor affecting the progression of the illness is the presence of other medical illnesses and mental disorders, known as comorbid conditions. It is common for someone with bipolar disorder to have other mental disorders (e.g. panic disorder), and alcohol or substance abuse problems. These comorbid conditions will affect the progression of bipolar disorder, particularly if they remain undiagnosed and untreated.
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