The Course of Bipolar Disorder Over Time

For most people with bipolar disorder, strict adherence to medications is necessary to help keep episodes to a minimum.

If you have bipolar disorder, you may be wondering what the future will bring. Will your bipolar symptoms get worse or can this disorder go away? What happens if you stop taking your medications or seeing your psychiatrist?

Bipolar Disorder: Treatment Over Time

“Having bipolar disorder is very different than having a blood pressure problem ordiabetes,” says Gary Sachs, MD, founder and director of the Bipolar Clinic and Research Program at Massachusetts General Hospital, and associate professor of psychiatry at Harvard Medical School in Boston.

Dr. Sachs says that unlike other illnesses, in which patients accept the fact that they need to take medicine to control their disease, people with bipolar disorder often refuse to take their medications — an issue called treatment compliance. These patients often have trouble perceiving that they have a problem, even during a bipolar episode (a condition known as anosognosia, and therefore don’t believe they need treatment.

Avoiding treatment, however, is the worst thing you can do with bipolar disorder. Why? Because bipolar disorder tends to get worse if it’s not treated. So to improve your prognosis — your future with this condition — you need to follow your doctor’s prescribed treatments.

Bipolar Disorder: The Timeline

Bipolar symptoms usually appear during the late adolescent years, but they can emerge at any time from early childhood to your 50s. For a very few people diagnosed with bipolar disorder, symptoms will improve with medication to the point that medications will no longer be necessary.

But most people won’t be that lucky, since it is typical for manic and depressive episodes to recur later on.

“If you have a single episode of mania, the chances that you are going to have another one over your lifetime is virtually 100 percent,” says Sachs.

And there is a good chance that your manic and depressive episodes will become more frequent and severe over time. According to Sachs, most people can also expect more depressive episodes and fewer manic ones. “You will have fewer highs and more depression,” he says. Your illness may even progress to what is called rapid-cycling bipolar disorder, which is when you have four or more episodes a year.

And, Sach adds, “If you’ve had several [bipolar] episodes, there is probably a 60 to 80 percent chance that you will have one episode every year if untreated.” But with treatment, you can probably cut your risk of having an episode by half.

Bipolar Disorder: Remission

Most people who have bipolar disorder will have normal moods in between their manic and depressive episodes. However, in almost every case, bipolar disorder is a lifelong illness requiring treatment.

While there is no cure for bipolar disorder, there is every reason to believe that with proper treatment, you will get better. Proper treatment means taking all your medications and attending therapy sessions as recommended by your doctor. It is important to take the bipolar medications even between episodes of depression or mania. Consistency in taking the medications can stabilize your mood swings.

By learning to recognize the early signs of a manic or depressive episode, you will be empowered to take control of your bipolar disorder and deal with your symptoms before they become a full-blown episode.

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