Course of the Illness
Bipolar disorder can be severe and long-term, or it can be mild with infrequent episodes. The usual pattern of bipolar disorder is one of increasing intensity and duration of symptoms that progresses slowly over many years. (Patients with the disease, however, may experience symptoms in very different ways.) A typical bipolar disorder patient averages 8 to 10 manic or depressive episodes over a lifetime. However, some people experience more and some fewer episodes.
Bipolar disorder can occur at any time, but usually begins before age 35. People between the ages of 15 and 25 years have the highest risk of developing this disorder. However, the delay between the first signs and symptoms of the disorder and proper diagnosis and treatment is often 10 years. The type, severity, and duration of mood episodes can vary. In most cases of bipolar disorder, the depressive phases far outnumber manic phases, and the cycles of mania and depression are neither regular nor predictable. Many patients, in fact, experience mixed mania, or a mixed state, in which both mania and depression coexist.
For example, some individuals may have more manic episodes or more depressed episodes, while others may have an equal number of depressive and manic episodes. The length of time that someone is in a normal mood state after an episode also can vary greatly. Without treatment, people living with bipolar disorder frequently experience shorter periods of normal mood and more periods of depression, hypomania, and mania. For most people, this increase in mood episodes ends after three to five episodes. Over a 10-year period, the average person living with bipolar disorder will have about four mood episodes.
Even among people who have frequent severe episodes, there may be long periods with normal mood states. Some doctors, consumers, and family members may be tempted to interpret these periods of wellness as evidence that the diagnosis of bipolar disorder was incorrect. Unfortunately, this is seldom the case. Bipolar disorder often has natural periods of remission, but those who meet criteria for bipolar disorder will almost always relapse without treatment.
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7 years ago
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