Bipolar Disorder

Bipolar Disorder

Bipolar disorder, formerly known as manic depression, was named for the two emotional poles of the syndrome. People with bipolar disorder cycle back and forth between between periods of mania (see the following description), normal functioning, and depression. Some people with bipolar disorder return to their regular level of functioning following a manic episode, while others fall into a major depressive episode. The latter is more common, particularly among older adults. Some older adults also experience psychiatric episodes with both depressive and manic symptoms (a mixed episode). Onset of the disorder usually comes when people are between 18 and 22 years of age, although the disorder may appear later in life (Almeida & Fenner, 2002). Treatment for bipolar disorder includes mood-stabilizing medications (e.g., lithium, valproate [Depakote], or carbemazepine [Tegretold]). Psychotherapy may also be beneficial in helping people cope with the interpersonal and practical consequences of bipolar disorder.


It is estimated that 5 to 19 percent of older adults who are treated for a mood disorder experience an episode of mania (van Gerpen, Johnson & Wistead, 1999). Manic symptoms are relatively rare among older adults who do not have a history of this syndrome, however (Weissman et al., 1991). For most older adults, manic symptoms are the result of a medication (such as toxic levels of a steroid like prednisone), medical illness, or drug abuse. Periods of mania are characterized by the following symptoms (not already accounted for by another illness):  

  • extremely elevated mood (feeling overly joyful for no particular reason) or very irritable mood for a distinct period of time)
  • at least three of the following symptoms:
    • inflated self-esteem-feelings of invincibility, to the point being out of touch with reality
    • decreased need for sleep
    • extreme talkativeness
    • racing thoughts of shifting ideas
    • high distractibility
    • increased level of activity
    • engaging in behaviors with potentially serious consequences, such as being in dangerous places, spending a great deal of money, or increasing sexual activity  
  • impairment in daily functioning or interpersonal relationship

 The above information was provided by the Society of Certified Senior Advisors (SCSA)