What Is The Prognosis for Bipolar Disorder?

Bipolar Disorder is a very distressing condition to suffer from. Periods of depression can be difficult enough to deal with, but when combined with feelings of mania or hypomania, a toxic mix is created.

But fortunately, treatment is available, which means that any individual with Bipolar Disorder should be able to lead a quality life, with their condition not proving too disruptive.

Unfortunately, Bipolar Disorder is normally a lifelong condition, which may involve periods of remission in between episodes. In this article, we look at the prognosis for Bipolar Disorder.

What is Bipolar Disorder?

Bipolar Disorder (once known as Manic Depression) is a serious mental health condition characterised by intense mood swings. Someone with Bipolar Disorder will experience both highs – known as mania, and lows – known as depression. These periods will often last for weeks, and can cause significant distress. Sometimes, Bipolar Disorder can start as Depression, before exacerbating. The depressive periods of Bipolar feature long-term periods of low moods. During the manic phase, an individual will feel happy, energetic and ambitious – and often act recklessly, or exhibit signs of psychosis. There are different sub-types of Bipolar Disorder, based around the differing characteristics of each. Bipolar Disorder is normally a chronic condition. However, with treatment, the symptoms can be controlled far more, which should result in an improvement in quality of life.

The impact of different types of Bipolar Disorder

It is important to state at first that the prognosis for each different type of Bipolar Disorder can vary. For instance, Cyclothymia – the most ‘mild’ of the disorders, has a better prognosis than Bipolar I Disorder – which features at least one episode of mania.

But in any case, each Bipolar Disorder can cause problems, and may lead to a lifetime of issues.

In terms of the individual disorders associated with Bipolar Disorder, those who have Rapid Cycling features as part of their diagnosis are at the highest mortality risk. This is due to its high rate of self-harm and suicide attempts [1].

A Mixed Bipolar State also carries significant risks – due to the potentially toxic mix of low mood and impulsivity – something that can end in destructive or impulsive acts – including self-harm. But any of the different Bipolar Disorder’s can lead to distress.

This, unfortunately leads us on to the difficult topic of suicide. Bipolar Disorder has high rates of suicide, with it believed around 10-15% of people with the condition go on to commit suicide. Moreover, about 50% of people with Bipolar Disorder will attempt suicide at least once in their life time [2].

The average suicide rate is around 10-15 times higher than the general population [3]. These statistics suggest a bleak prognosis for those with Bipolar Disorder.

Some people only ever have one manic or hypomanic episode. The periods of Depression tend to last longer, and may be more of a concern as time passes by. But between episodes, functioning can be at a positive level.

Remission in between episodes is a very real possibility. The combination of talking therapy and medication can lead to an individual attaining a good quality of life.

They may find episodes shorten in length and severity, while in rare cases, symptoms may completely disappear.

Effect of comorbidities

Bipolar Disorder often co-exists with other psychiatric conditions, which can further complicate treatment outcomes.

Research has showed a strong connection between Bipolar Disorder and Substance-Related Disorders, Eating Disorders, Personality Disorders, Trauma-based conditions and Anxiety [4].

Therefore, treatment may be complex for a patient, as it is likely to involve many different facets. For example, instead of medication being the primary treatment – as would be the case in Bipolar Disorder – talking therapy may also be needed due to the other conditions.

Reaction to medication

The prognosis of Bipolar Disorder can be partially dependent on how an affected individual reacts to medication.

Medication is such a crucial aspect of treatment, but Lithium – the main medication used – is known for its side effects, meaning that some people may not be able to access effective medication.

Anticonvulsants like Lamotrigine, Valproate or Carbamazepine, along with antipsychotics like Quetiapine – may be able to step in to provide relief instead.

High possibility of misdiagnosis

A big issue with Bipolar Disorder is its high rate of misdiagnosis. This can impact the prognosis of this condition, as patients may not get the correct treatment.

Patients often seek treatment when they are in the depressive phase, and may not realise that their manic/hypomanic symptoms exist – especially if they don’t have others around to notice.

Bipolar Disorder is commonly misdiagnosed as either Clinical Depression or a Personality Disorder. This may lead an individual to not receive sufficient treatment, and at the very least, adds a frustrating delay.

Other factors

The prognosis of Bipolar Disorder can also be impacted by the level of disruption caused. Typically, Bipolar Disorder causes impaired functioning – such as in areas like relationships, employment, and finance.

The symptoms of the condition typically wreak havoc on the life of the individual. Bipolar I Disorder is most associated with manic episodes, which have the potential to cause chaos.

This can lead to several personal problems, which can worsen states of depression. Similar to the above, this is why there is such a high suicide rate for those with Bipolar Disorder.

But, accessing help early can prove helpful. By receiving treatment early, an individual will see their chances of recovery become much higher.

Summary

Seeking treatment is very important. This is a good starting point, and can lead to improvements in quality of life.

The aim is always for recovery, but improving a patient’s mental wellbeing – whether through medication, therapy, or a mix of both – is the most important result.

See Also

1. Bipolar Disorder: Everything You Need To Know
2. What Are The Different Types of Bipolar Disorder?
3. What Are The Symptoms of Bipolar Disorder?
4. What Are The Causes of Bipolar Disorder?
5. How is Bipolar Disorder Diagnosed?
6. How Can Bipolar Disorder be Treated?
7. What is the Prognosis for Bipolar Disorder?
8. 10 Tips for Living With Bipolar Disorder