What Is Bipolar Disorder?

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by Dr Elizabeth Tyler

Older people have faced ageism in mental health services, including the belief that emotional difficulties are simply a part of ageing or that change is less possible later in life. This can delay appropriate assessment, diagnosis and support.

Common misconceptions are that bipolar disorder is a condition that only starts in younger people. However, there is a subset of people who have late-onset bipolar disorder and have their first episode after age 50.

The complexity of diagnosis in later life

Bipolar disorder can be difficult to recognise in older adults. It is not uncommon for someone to receive multiple diagnoses before they are diagnosed with bipolar. Late-life bipolar will often present primarily with depressive symptoms, and therefore may be diagnosed as depression.

Alongside this, people are often more likely to seek help when they feel low, rather than when their mood is elevated. In later life, symptoms such as impulsivity, irritability or agitation may be misattributed to other difficulties, including cognitive decline or dementia.

Older people are also more likely to have additional physical health comorbidities, which may complicate the clinical picture. They may also be less likely to seek help due to the perceived stigma of having a mental health condition.

Hormones and women’s mental health

For women, hormonal changes can add another layer of complexity. Hormonal shift may play a role in the development of........

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