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Question for people over 35: Bipolar disorder over time

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Hello,

I've heard a lot of stuff about bipolar disorder getting "worse" over time, but usually in reference to it being unmedicated.

I'm 32, almost 33. I was only diagnosed 4 years ago, although I suspect I've had it essentially my entire life. I remember being depressed and suicidal when I was eleven. I just didn't realize I was suicidal because I didn't have a word to describe how I was feeling, at the time.

So my question is: for those of you who are older than me - I mean like, over 35 - does this get worse over time? Does it get better? Does it not change? Could I look forward to maybe the latter part of my life being pretty okay? Is there a point where you're old enough that you basically just... calm down? Mom used to seem like she had a lot of problems, herself, but she never took medication and she seems like she's been fine starting with when she went through menopause.

My own experience: Depressed around 9 y.o. Really depressed around 11 y.o... I got "better" when I was maybe 14 or so, and was okay until I was maybe 24. Then things went downhill, until I was diagnosed at 28, with a bumpy ride until around 30. I started taking medication when I was 29, and I still take medication. I still have a lot of anxiety and occasional suicidal ideation - particularly at night - but it goes in cycles. It gets worse in the spring, but it's been... less bad? I think the big change that made things a lot better was finding my current fiancé

I'm switching from Seroquel to Latuda (almost there), and hoping I can drop the lamictal and just take one pill for the rest of my life, but I don't know if that's possible. I just really wish it was.

Edited by Bubble

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I don't have an answer, but it sounds like we're in a similar place age-wise and age-of-diagnosis-wise, and I wanted to say I have similar worries. 

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This is anecdotal, but I believe it because it happened to me.  So FWIW:

I've been told things seem to get better (not the MI, just how you do things, your thinking, and Idk what else except just in general) around 40 +/- years old.  My mom belongs to NAMI and has talked to others outside of NAMI as well, and all the people she talked to said that things tend to get better around 40 years old.  It isn't a night and day thing, it happened gradually.  I'm not saying this happens to everyone, but it did happen to me (Idk what I did, but my mother told me because how I was doing in general when I was in my later 30s/early 40s).  (I am 43 right now).

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I'm 49. I was first hospitalized when I was about 27, though had symptoms for years earlier. In some ways it was better as time progressed, in that I was no longer freaking out when I had suicidal thoughts and I developed a routine for my episodes,  you know hospital, med. change, etc.  But then medication kind of stopped working and my depression got real bad till I was psychotic. I finally got ECTs which brought me back stability and had maintenance ECTs for a bit over 4 years, just recently stopped those. I haven't had an episode since the ECTs and have been getting progressively better. I am thinking more clearly than I have since I had my first hospitalization, actually probably more clearly than I have since I went through puberty. The doctor seems to think I am going to be stable indefinitely, we will see.

So it could be the ECTs did all of it, or it could be age like melissaw said, or it could be that my life is mostly less stressful. I did have 5 kids in 7 years and untreated ptsd. Now I've had good therapy for several years and my children are all grown so I don't suffer from sleep deprivation. I still have anxiety, but without the mood swings it is easier to deal with. I still couldn't hold a job, too much anxiety, but I like my life now. I am content.

Edited by wadjet
misspelled word
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I'm 45 and I didn't get properly medicated until fairly recently. I was diagnosed ? At 10, SAD at 20, MDD at 27, bipolar at 37 and again at 43, and bipolar with psychotic features at 44. Those ages also correspond with my worst episodes. I was hospitalized at 10 and 27, for suicide attempts.

Anyway, my experience generally jibes with the 'it gets worse with time' appraisal. My bad episodes have certainly gotten worse over the years, even as my stress levels have gone down. There were some less severe episodes in between the bad ones, though, so it's not like each new episode was always worse than the one before. And despite having worse episodes, I've managed to stay out of the hospital for a long time now, even though I came really close a few times.

The episodes have also been getting longer while the remissions have been getting shorter, especially since my early 30s. That said, I've had a long remission recently (almost one year) thanks to finding an antidepressant that works. And now that I've been stable a long time, I'm about to go off of daily meds. The hope is that I can manage the bipolar with my PRN, at least for a while.

Oh, another "bonus" that came with age is dysphoric mania, the dreaded mixed episode. I got that at 43. I think I was also rapid cycling during that time, although my pdoc only recognizes one big mixed episode. In any case, it was one hell of a wild rollercoaster ride. And a year later I had a bad spell of psychosis, which was also new. I had experienced delusions and hallucinations before, but never so many of them. 

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I'm 52. Mostly, it's gotten worse. But lithium has pretty much stopped my hypo/mania, and now I'm getting depressive episodes again. I've also been having dysphoric manias since I was 42, and became psychotic for the first and only time (so far) when I was 48(?). I feel not quite stable a lot of the time, and just had a pretty significant depression (but not my worst by any means). I wasn't getting better, so I switched APRNs, and started feeling better in about a month, and really feel much better now.

Actually, when I look at this, it looks like maybe I'm getting better. I think it is that the dysphoric mania is so awful, it's what my mind automatically turns to.

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I was (finally) diagnosed 11 years ago.  I was given Lamictal, Serqoquel, and Lunesta.  It was the perfect combination for me and it turned my life around.  Since then, the medication has gradually lost its effectiveness.  Now I have to continually up a dose there, or lower a dose there or swap something out completely to stay stable.  Lithium was wonderful...until i started loosing my hair. :( Recently my GP told me that my current cocktail of meds is doing the best it will ever do for me. This is as good as it gets.  So now, at age 51, I have to force myself to become an adult and tackle the other areas of my life.  Eating well, regular exercise, getting up at the same time every morning, keeping my house clean,  properly managing my income, etc, etc.

I used to wait to do anything until i had high energy and clear thinking.  Now i have to push myself to do "life" even when i don't have the drive within me. The meds keep me from sinking into a deep depression but that's about it. My goal now is to take control of my diet, exercise, sleep routine and anything else that effects my moods.  I've been in cognitive therapy forever and it doesn't seem to help much.

 I'm trying to accept things for the way they are and make the best of it, rather than wishing i could go back in time to re-experience the breakthrough of '07. 

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I'm 36 and was just diagnosed with BPII.  Before that was 11 years of an MDD dx.  I think it's really impossible to say how your illness will progress, because it depends on a lot of factors.  I think I worsened my own condition and prognosis by refusing meds through several severe episodes, including several consecutive *years* of severe depression (which, along with begging from family members and therapists, was FINALLY what convinced me I needed medical tx).  I (thank GOD) have not experienced any depressive episodes like the ones I had before meds.  Yes, I've gotten depressed again since then, but the episodes have been much shorter and not as intense.  Since I got into a DBT program a couple months ago my condition has improved dramatically.  I finally have motivation and interest in life again.

As far as mania goes, as far as I know I didn't experience my first proper hypomanic episode until last year.  Since then, I have had a couple more episodes, which introduced me to what I call "angry hypo" and "anxious hypo".

Overall: Depression has gotten better.  Hypo is more of the issue for me now.

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No, I don't think it gets better at all. I think that how your bipolar hits you changes every few years. If anything gets better it's that you've been dealing with your illness consciously, awarely, for years, and you know better what to do when shit starts heading for the fan.

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I'm 37 and I've definitely gotten worse over time though I'm still functional mostly.  But I'm not as resilient as I used to be.  I don't know though, courses of illness are so individual, you might improve with meds and be fine.  I have hope, my life is good, but I struggle with depression lately and psychosis historically.  Some mixed states in there.  I am most likely SZA though so maybe don't listen to me (I meet the dx criteria for SZA, but my pdoc feels a working dx of bipolar is more suited to the way my thought patterns work, though he wouldn't argue with someone who dx'd me with SZA).  

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Thank you to all who replied. I really appreciate you sharing your experiences. Not as comforting as I'd hoped... but about as realistic as I expected.

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I am 44 years old.  In my case, the bipolar symptoms have gotten worse as I get older.  I have a harder time getting over my depressions, fight self-harming, increased suicidal ideation, am much more easily fatigued (I have to really limit my schedule in order to have energy for work), and have strange things happen that did not in my 20s.  My pdoc and I are exploring right now, but it looks like I may be having episodes of dissasociation which I do not think happened when I was younger.  LIving with bipolar has become more difficult with time and I often struggle to keep going.  I had one suicide attempt at age 42.  I had my first major episode (depression/suicidal ideation) at age 18.  Diagnosed at 27.  Medicated until early 30s then went off meds.  I went back on meds at age 40.  I don't plan to ever go without meds again.

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I'm 50 and I don't know if it gets better I do think you get a greater perception of things you used to think we're so damn important that really aren't 

I also think your focus changes 

for me I have a really good bad attitude " everything can be solved with time and a glass of wine"

 

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Better over time, for me. In a nutshell: I'm 48, diagnosed BP1 when I was 29. Struggled hard for four years, then stabilized (mostly) after finding the right combination of meds + changes of attitude and behaviors (still needed PRN Zyprexa). Next couple of years, stabilized more with the same meds and slightly adjusted dosages, learning more all the time about how to take care of myself. I haven't had anything resembling a real episode in maybe twelve years. Who knows what's around the bend, but so far so good, and it's been a while.

I hope your path is a positive one, too! Very best wishes.

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I was dx at 24 and I'm 36 now. Sadly for me it has gotten worse. Not the phases so much but my inability to bounce back quicker. I'm more fatigued, my depressive episodes are quieter and more pronounced, and my breakthrough manic phases can be more disruptive since I'm supposed to be an adult with self control. 

Ive been hospitalized 4 times in the past 4 years but I also didn't know that option existed. 

We keep trying to tweak my meds but they are only effective so long. Or maybe so long as I'm med compliant. 

I don't say any of this to worry you. It's just my personal experience. 

Edited by Sapphireburst

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I mentioned in an earlier post how (for me) things seem to gradually get better around 40+/- .  FWIW My mom learned about this at NAMI.  For some people this is true, for some people it is not.  For me I gradually did get "better" (my behaviors got better) around high 30's to low 40's.

However, I wanted to add that my MI got worse before getting better.  It was a gradual thing like I said, but more like 1 step forward 2 steps back for awhile.  Then slowly things started improving to 2 steps forward and one step back.

If this makes sense.

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Is it age or is it number of episodes, especially untreated episodes, that progressively worsen?

 

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Maybe clarify your question. This thread is about aging and bipolar. Age is definitely progressing.  

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I'm 38 and was undiagnosed bipolar until I was 36.  I do feel that things have worsened over time, and I'm experiencing more mixed episodes and rapid cycling.  But I don't know if that's a result of misdiagnosis (I was diagnosed with depression at 22) or a result of aging.  I have read about and seen videos about untreated episodes causing a worsening of the illness.  Or am I just getting older and so beginning to see the effects of aging?  I had such a difficult time being taken seriously until I was 36.

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13 hours ago, Iowella said:

I'm 38 and was undiagnosed bipolar until I was 36.  I do feel that things have worsened over time, and I'm experiencing more mixed episodes and rapid cycling.  But I don't know if that's a result of misdiagnosis (I was diagnosed with depression at 22) or a result of aging.  I have read about and seen videos about untreated episodes causing a worsening of the illness.  Or am I just getting older and so beginning to see the effects of aging?  I had such a difficult time being taken seriously until I was 36.

(in bold)  I agree with this, from personal experience.  Had I not kept hearing voices to myself for as long as I did, I think I would be a lot better off today.  Had I been treated earlier on, a lot of the voices/hallucinations/delusions wouldn't be so ingrained like they are now, even with medication.

I don't think it is aging, but that is my opinion.  Others may have other experiences.

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I am 47, going on 48. I can tell you, I've always known something wasn't right. It got hard and unbearable in my twenties, but towards the last part of my late twenties I got in with a tdoc and a pdoc and started meds. Slowly things became much more stable for me. I still struggle and what not, but 40's are starkly different from the overwhelming hopelessness I felt in my early 20's and as a teen. Meds are only part of it, a lot of the work is on us, to like work on developing tools and strategies to manage our bipolar symptoms. Not easy. I know. But I'm doing a bit better now. Hope you get relief too. 

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22 hours ago, Iowella said:

I'm 38 and was undiagnosed bipolar until I was 36.  I do feel that things have worsened over time, and I'm experiencing more mixed episodes and rapid cycling.  But I don't know if that's a result of misdiagnosis (I was diagnosed with depression at 22) or a result of aging.  I have read about and seen videos about untreated episodes causing a worsening of the illness.  Or am I just getting older and so beginning to see the effects of aging?  I had such a difficult time being taken seriously until I was 36.

In bold ... IMO I think it all develops over time (the effects of aging), as well as other things like meds.

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My psychologist told me that the "kindling theory" that was in vogue around 10 years ago has been shown to be false in studies (kindling = the idea that each mood episode increases the likelihood and severity of more mood episodes over time). He's seen it be false in most but not all of his patients. 

At 42, I still struggle with mood episodes and am currently depressed. But I had two hospitalizations within a year when I was in my 20s, then no hospitalizations at all until I was 40, and then none since. So it does seem to have gotten less severe, caveat being that I am meticulous about taking all my meds as prescribed and go to therapy every single week without fail. By "less severe"  I don't mean I never have ups and downs...I believe that I will struggle with depression in particular for the rest of my life. But serious enough for hospitalization? I don't expect to have to deal with that too much. Probably another time or two, but I don't see myself going in and out of inpatient treatment like I thought I would be doing when I was in my 20s. 

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I am 52, well almost 53.  I was misdiagnosed and not med complaint till my late 40's. I can see myself suffering in my mid teens with depression and the first and only suicide attempt. 20s were painted with depression, 30s by mania.  I was drunk during my 40"s.  All the while i sought help and was given AD's and i would end up not taking them after a bit, they made me worse. By then i was addicted to opiates and booze.  My choice of self medicating.  Maybe if i started to get serious a bit earlier the two year mixed episode from hell would not have happened.   

So to answer your original question, yes it has gotten worse as i have aged.  But on the bright side i am now med compliant, sober and am in therapy and attend a group regularly.  Be it worse or better at any age  i think working closely with a Pdoc and Tdoc and really digging into what you can do to help yourself makes all the difference in the world no matter how old you are or how long you have been in the game so to speak.

 

 

Edited by dragonfly23

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