Do Bipolar Episodes Increase With Age?

In measuring whether or not the occurrence of bipolar episodes increases with age, the age the disorder first appears is more important than the effects of aging.

A study that looked at outcomes 20 years after the age of onset for bipolar disorder found that the frequency of depressive episodes increases over time, while the frequency of manic episodes does not.

However, the amount of time spent in episodes of depression has more to do with the age of onset of BP then the current age of the individual with BP.

The implication is that while depressive episodes may increase with time, the contributing factor may be age of onset of a person’s struggles with bipolar disorder, not the physical effects of aging.

People with an onset of BP under 30 years of age saw an increase in the amount of time spent in depression during the third, fourth and fifth decades after onset.  People first hit with BP over the age of 45 had rates of depression that remained stable.

At 20 years after onset the people who were struck with BP under the age of 30 spent 30% of their time depressed.  The people with an age of onset over 45 faced depression 22% of the time.

There was no indication that severity or duration of episodes of depression increased.  They just occurred more often in people with an earlier age of onset.

The amount of time spent manic or hypomanic remained stable despite age of onset or number of years after onset, even in individuals with bipolar disorder 1.

While it seems obvious that the longer one has bipolar disorder the greater the number of depressive episodes, the researchers suggest that people with an earlier onset of the disease suffer from more depression because their BP developed concurrent with the stress of the enormous life changes of early adulthood.

Simply put, the brain develops until age 25.  Mental illness that emerges in a brain that is still developing will result in a more challenging prognosis than illness that begins in a mature brain.  And the impact will be multiplied as years pass.

Work and Meditation

I haven’t written about meditation for the past few newsletters because I’ve been refocusing my practice to emphasize the benefits of work over just sitting. The way society deals with mental illness - the low expectations, the prison of disability insurance, the struggle to obtain health insurance - leads to an awful lot of unemployment in our community, and this inactivity, whether forced or chosen, leads to a lot of inertia and depression. Work and productivity add meaning and purpose to life, and if you’re not doing it you’re keeping yourself locked into life defined by an illness instead of by your own effort.

Whether it’s a full-time job or a hobby, find work that is meaningful and pursue it with everything you’ve got. I’ve attached a video of Henry Rollins discussing making and seizing opportunities and finding direction and meaning through work. He says a line that is crucial to making work meditation: Application, discipline, focus, repetition.

That can be enough. Brought to any effort, application, discipline, focus and repetition can help you express all the benefits of meditation through work. Work that will add meaning to your life, give you a reason to get out and contribute to your community, and help you find independence.

Work is a key path to positive mental health. Enjoy a few minutes with Henry:

Please consider helping me support the work of this newsletter by purchasing a copy of my book Resilience: Handling Anxiety in a Time of Crisis for yourself or someone close to you. Click here to buy a copy.