B Bipolar Features: Depression With Short Duration Hypomania
Another area where we see this is short duration hypomania. About 1 in 20 patients with recurrent depression have brief hypomanias that are classic and recurrent but never last long enough to meet DSM criteria for bipolar they last less than 4 days. Jules Angst published a remarkable study where he showed the chance mood worsening on an antidepressant rises steadily with the duration of hypomania from 1% in patients with no history of hypomania, to 9% if theyve had it for less than a day, 14% for 2-3 days, and then we get into the real bipolar levels 4 days the cut off for bipolar II the risk is 27% and if theyve ever had hypomania for more than a week the risk of getting worse on an antidepressant is 38%. But, still, thats only 38% its not 100% none of this is absolute.
Depression: What You Need To Know As You Age
If youre one of the more than 14.8 million American adults who experiences major depression, you may feel so bad that you cant get out of bed, be around the people you love or participate in activities that you usually enjoy. Actually, there are more than 50 different symptoms of major depression, ranging from the well-knowncrying and sadnessto those you might never associate with depression, such as anger, workaholism and back pain.
Depression is a disease that affects every aspect of a persons life, not just mood, says Johns Hopkins expert Andrew Angelino, M.D., Chair of Psychiatry at Howard County General Hospital. The World Health Organization predicts that by 2020, depression will be the second-leading cause of disability in the world, just behind cardiovascular disease.
People who are depressed are far more likely to have other chronic medical conditions, including cardiovascular disease, back problems, arthritis, diabetes, and high blood pressure, and to have worse outcomes. Untreated depression can even affect your immune response to some vaccines.
Depression is not just debilitating it can be deadly. An estimated one out of five people with depression will attempt suicide at some point.
How You Can Support Seniors On The Spectrum
The following suggestions were compiled from various websites and publications. These ideas should not replace professional advice. However, they may prove helpful during times of transition.
- Create a safe environment. Make sure there aren’t too many distractions like TVs, radios, phones, computers, pets, etc. Also make sure everyone knows how to contact emergency services.
- Be patient. Seniors often need time to adjust to changes. Give them space to process things before asking questions.
- Be ready for an eventual loss of sight, hearing, balance, etc. You can search for a professional medical staff that can help guide your loved ones through this difficult period.
- Make plans ahead of time. Discussing future goals will give your loved ones something concrete to work toward. They’ll also feel less overwhelmed knowing where their priorities lie.
Seniors with autism experience life quite differently than people without the condition. While these strategies might seem obvious, they’re worth mentioning because they could save your loved one yearsof frustration and heartache down the road.
As the link between the severity of autistic traits and older age has been demonstrated, it is important to consider whether interventions aimed at improving cognitive abilities may benefit individuals with ASD across the lifespan.
In addition, some studies have suggested that early intervention may reduce the risk of developing dementia in late life.
Read Also: What Is The Difference Between Clinical Depression And Major Depression
Do The Symptoms Of Bipolar Get Worse With Age
Yes, it does, and I can attest to this. The symptoms of bipolar get worse with age, and studies back this up, I for one, have been experiencing this as I approach my fifth decade. In the space of five years, I have had several severe depressive episodes and two hypomanic spells. Im currently in my sixth depressive episode.
It has been shown via research that the depressive episodes are more prevalent the older you become and unlike other mental illnesses where the symptoms may improve with age, bipolar does not in fact, it can even age you based on studies of DNA telomeres, the longer the length of the telomere the better, but with bipolar they shorten quicker, and this can bring on earlier ageing than the average person.
Telomeres act as protective caps on the ends of DNA strands. Each time a cell divides, the telomere becomes shorter, until it is so short that the cell can no longer replicate.
With earlier ageing, this can make bipolar worse. It is an aspect of the illness that I find difficult and explains why I could have many spells of normality in my youth. Still, as I am middle-aged now, I fear I have a lot more to come in the way of mental instability, especially if my psychiatrist cannot balance my medication.
Trigger: Low Vitamin B12
If you’re feeling lethargic or depressed, too little vitamin B12 may be to blame. If you’re older, you’re more at risk for the B12 blues because you may not have enough stomach acid to release B12 from food.
Solution: Ask your doctor to measure levels of B12 in your blood. If it’s low, talk to your doctor about diet, oral supplements, or an injection to see what might be right for you.
Also Check: Denial Anger Bargaining Depression And Acceptance
Does Bipolar Disorder Get Worse With Age
Bipolar disorder may get worse with age if left untreated, as time passes a person will get signs bipolar is getting worse than it was in the beginning.
Furthermore, the symptoms continue for long without treatment, subsequently, a bipolar person taking treatments may also think that their illness has been cured but it may lead to the return of symptoms.
In like manner, the disorder also changes the thoughts of a person, like if we talk about how a person with bipolar thinks?
So, people with this disorder find it very hard to think, and even will not remember things.
However, sometimes they will also feel hallucinations and delusions and also fear getting things worse.
Almost Nothing Sparks Your Interest
Depression commonly involves a decrease in your energy levels and a loss of pleasure in your favorite hobbies and other things you usually enjoy. As you work toward recovery, youll usually find your interest in these activities slowly begins to return, along with your energy.
With worsening depression, you might notice the opposite.
It may not just seem difficult to find the motivation for exercise, socializing, and other hobbies. Anhedonia, or difficulty experiencing joy and pleasure, is a core symptom of depression.
You might also have trouble mustering up enough energy to go to work or take care of basic responsibilities, like paying bills or preparing meals. Even necessary self-care, like showering and brushing your teeth, might feel beyond your current abilities.
Also Check: F Code Major Depressive Disorder
Depression In Older Adults
- Guides & Publications
- Depression in Older Adults
If you have a sad, despairing mood that lasts for more than two weeks, it may be depression. Depression is not the same as sadness, though it can be triggered by the sadness caused by loss , stress or major life change . Depression can also be caused by some medical conditions, such as chronic pain, thyroid problems, stroke or Alzheimers disease. Certain medications and alcohol use can cause depression as well. Depression may also develop for no apparent reason.
People who are depressed cannot just get over it. Depression is a biological illness caused by a chemical imbalance in the brain. It affects thoughts, feelings, behaviour and physical health. Older adults who are depressed may have had episodes of depression throughout their lives, or they may have their first episode late in life. Depression can affect anyone at any age, but is often not recognized in older adults. This is because some signs of depression can be mistaken for signs of aging, and also because older adults who are depressed may not complain about feeling low. When left untreated, depression may continue for weeks, months or even years. Untreated depression is the main cause of suicide in older adults.
What are the signs of depression?
What can I do about depression?
Where can I get help or get more information?
Studying How Depression Affects Dna
Han and colleagues examined the DNA of 811 people with depression and 319 people without. The participants were enrolled in the Netherlands Study of Depression and Anxiety.
Using blood samples, the researchers examined how the participants DNA changed with age. The study revealed that epigenetic changes took place more quickly in people with depression.
Epigenetics is the study of the changes in gene expression that do not affect the DNA sequence. Such changes can occur as a result of many factors, including environment and lifestyle.
One of the mechanisms through which epigenetic change occurs is called DNA methylation that is, when a methyl group is transferred and added to the DNA.
Overall, the scientists saw that people with major depressive disorder had a degree of methylation and epigenetic change that was indicative of an older age. More specifically, this means that those with depression were biologically older, by 8 months, than people without depression.
In some severe depression cases, this biological age was 1015 years older than the chronological age.
The study also found that those who had had childhood trauma were biologically 1.06 years older, on average, than people who had not experienced trauma.
The researchers replicated their findings by examining brain tissue samples.
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Bipolar Disorder Treatment For Older Adults
To address the complicated issue of does bipolar get worse with age or not, we need to keep some things in mind. Primarily, as we already discussed, bipolar disorder can affect people very differently. Still, its important to acknowledge that untreated bipolar disorder can cause symptoms to become progressively worse. Treatment approaches will vary on a case-by-case basis however, an effective treatment plan often involves a combination of psychotherapy and pharmaceuticals.
Therapy is used to minimize the negative behavioral symptoms associated with bipolar disorder. Effective and helpful techniques include:
- Family-focused therapy
Prescription drugs can help reduce both short- and long-term symptoms of bipolar disorder. Several types of medication may be prescribed, including:
- 2nd-generation antipsychotic medications
Its very important to point out that when someone with bipolar makes great progress through therapy and self-care, they might not need to rely as heavily on prescription medications. All meds are associated with at least some adverse side effects. However, its best to make that choice with guidance from your therapist and other healthcare providers.
Who Struggles With Major Depression
The Centers for Disease Control estimates that only between 1 and 5% of older adults living in the community struggle with major depression. Those estimates rise to 13.5% for people who require more constant care and 11.5% for older hospital patients.
Older women are more likely to suffer from mood and anxiety disorders. Older men tend to develop more substance abuse problems, Dr. Havemann says.
However, the CDC reports that less than 30% of older adults who need treatment actually receive it.
Also Check: Symptoms Of Depression In Autism
Myths And Realities About Bipolar Disorder
Five questions for bipolar disorder expert Eric Youngstrom, PhD
Myths and realities about bipolar disorder
Reporters/editors/producers note: The following feature was produced by the American Psychological Association. You may reprint it in its entirety or in part. We only request that you credit APA as the source.
Media coverage of people who have been diagnosed with bipolar disorder usually does not fully explain this serious mental illness, how best to treat it and how it can affect those who have it, as well as their families, friends and coworkers. To explain what bipolar disorder is and psychologys role in identifying and treating it, APA asked Eric A. Youngstrom, PhD, to share his knowledge about this mental illness.
APA: What is bipolar disorder and how is it different from the general mood swings that many people experience?
APA: Is bipolar disorder on the rise or does it just seem that way because of frequent media coverage?
APA: How prevalent is bipolar disorder? Is it more common among certain demographic or geographic groups?
APA: What causes bipolar disorder? Are there differences in how the disorder affects children, adolescents and adults?
APA: What are the most effective treatments for the disorder?
Key Messages To Take Away:
- Depression isnt a normal part of aging, but it can affect older adults and lead to serious consequences if left untreated.
- Depression diagnosis involves a careful review of an older persons complete medical history, medications, and lifestyle, as well as talking to those close to the older adult and using a screening tool, like the GDS.
- Depression is treatable and has a high rate of remission, although it often takes a few different treatment approaches and maybe more than one trial of a medication.
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Elderly Depression As A Side Effect Of Medication
Symptoms of depression can also occur as a side effect of many commonly prescribed drugs. Youre particularly at risk if youre taking multiple medications. While the mood-related side effects of prescription medication can affect anyone, older adults are more sensitive because, as we age, our bodies become less efficient at metabolizing and processing drugs.
If you feel depressed after starting a new medication, talk to your doctor. You may be able to lower your dose or switch to another medication that doesnt impact your mood.
Medications that can cause or worsen depression include:
|Language and motor skills are slow, but normal||Writing, speaking, and motor skills are impaired|
|You notice or worry about memory problems||You dont notice memory problems or seem to care|
Whether cognitive decline is caused by dementia or depression, its important to see a doctor right away. If its depression, memory, concentration, and energy will bounce back with treatment. Treatment for dementia will also improve your quality of life. And in some types of dementia, symptoms can be reversed, halted, or slowed.
Medications To Treat Depression In Later Life:
Antidepressants are effective in the treatment of depression in cognitively intact older adults.
Anti-depressants do sometimes cause side-effects, and have also been associated with an increase in fall risk. For these reasons, it is sometimes reasonable to try to first treat depression with non-pharmacological approaches, such as psychotherapy . That said, the likely benefits of antidepressants often outweigh the risks.
There have been many scientific clinical trials of antidepressants. A systematic review of 51 well-designed studies, which included over 2600 patients over age 55, showed that antidepressants were better than a placebo to produce a remission from depression. Response rates are around 30-50%. More analysis of the systematic review did show that with older age , the effectiveness of an antidepressant goes down, and potential for side effects goes up.
Although its not clear that any one class of antidepressant is more effective than another, some are less likely to cause side-effects or drug interactions, and those are the medications that geriatricians often use. An analysis of 12 newer antidepressants showed that sertraline and citalopram were the ones that were easy to take and seemed to work well, and are ones that Ive used in many of my patients.
Important to know when starting an antidepressant:
This table has a summary of some of the most commonly used antidepressants in older adults.
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How Depression In Older Adults Can Be Treated
Untreated depression in later life is a serious problem. It can worsen many medical conditions, it affects quality of life, and it can lead to more use of alcohol and illicit drugs.
Depression has also been found to increase the risk of death in those moving to nursing homes, recovering from stroke or heart attack, or in hospital for any reason. And, it can result in suicide, which is tragic and should be prevented if at all possible.
So its essential to help older adults get treated for depression. Depression treatment may consist of one or more of:
- Physical Exercise
- Other treatments
The goal of treatment is to induce a remission from symptoms and maintain this response for as long as possible.
Treatment For Bipolar Disorder
If you spot the symptoms of bipolar disorder in yourself or someone else, dont wait to get help. Ignoring the problem wont make it go away in fact, it will almost certainly get worse. Living with untreated bipolar disorder can lead to problems in everything from your career to your relationships to your health. But bipolar disorder is highly treatable, so diagnosing the problem and starting treatment as early as possible can help prevent these complications.
If youre reluctant to seek treatment because you like the way you feel when youre manic, remember that the energy and euphoria come with a price. Mania and hypomania often turn destructive, hurting you and the people around you.
Read Also: How Can You Be Diagnosed With Depression
Small Changes Big Impact
Take a close look at the choices and habits you make and consider how they may be contributing to your depressive symptoms. Change isnt easy but if youre willing to try some simple tweaks , you may start feeling better. And when you feel better, youre more likely to be motivated to make more changes in other areas. A small change can be the crack that lets some hope seep in.
Here are some ideas.
So Does Bipolar Get Worse With Age
Unfortunately, for most people, bipolar disorder is a mental health condition that can progress with time and age. Complicating matters is that as we age, we can also simultaneously become less able to metabolize the medications that are prescribed to treat symptoms.
Therefore, its essential to get everything you can from all forms of bipolar disorder treatment. This might include routine psychotherapy as well as an effort to stay mindful and make healthy lifestyle choices that help reduce your symptoms.
Finding a therapist who specializes in treating bipolar disorder is always important for long-term symptom management. Working with a therapist who is experienced in either in-person or online therapy can help you develop and implement effective coping skills into your daily routine. While medication is often used as a frontline defense for bipolar, its smart to use several techniques for symptom management.
Living with bipolar disorder isnt simple, and it might be easy to feel like its cruel to not be able to control your own emotions. However, bipolar is a treatable condition. You can still live a rewarding, contented life. It takes some deep work but armed with information and support, its possible.
Reviewed On: May 24, 2022
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