Bipolar Disorder: Prognosis and Life Expectancy
Close to 3% of Americans—nearly 10 million people—have bipolar disorder, a mental illness characterized by periods of depression and mania. This serious, chronic illness often requires lifelong treatment, including medication. The disorder has a positive prognosis with proper treatment, Unfortunately, due to a variety of factors, those suffering from it may be at a higher risk of dying younger than those who don't have the condition.
Bipolar disorder is often diagnosed in young people, typically first appearing in the late teen years or early adulthood. It is a lifelong, incurable condition, but symptoms can usually be successfully managed with medication, such as antidepressants, mood stabilizers, and antipsychotics, as well as therapy or some form of counseling.
The prognosis for bipolar disorder varies depending on which type of bipolar disorder you have.
- Bipolar I is considered more severe, with episodes of mania or depression that can require hospitalization. About 70 to 80% of people with Bipolar I are treated successfully. However, 20 to 30% will continue to have symptoms, including mood swings, and may have more trouble maintaining relationships and keeping jobs.
- Bipolar II is considered less severe, with no full-blown manic episodes. Treatment is about 85% effective for this condition. However, about 15% of affected individuals continue to have symptoms. About 5 to 15% of bipolar II patients may experience rapid cycling between mania and depression. This bipolar disorder complication results in a poorer prognosis.
Also affecting prognosis: having another mental health disorder along with bipolar disorder, such as an anxiety or eating disorder. Such patients have a higher likelihood of relapse than individuals without co-occurring conditions.
People with bipolar disorders are at a relatively high risk for suicide. Annually, about 10 to 17% percent of those with a bipolar disorder diagnosis commit suicide. Many more attempt it.
Psychiatrists often recommend medication even when symptoms have abated, in order to prevent recurrence. However, some people with bipolar disorder prefer no medication, especially when they are feeling well. Some treatments that don’t involve medication are available as an alternative, such as transcranial magnetic stimulation (a noninvasive procedure that stimulates nerve cells in the brain).
In general, experts say those who are able to follow a long-term treatment plan, usually including medication, therapy and a healthy lifestyle, can live well.
Unfortunately, studies show that people with bipolar disorder are more likely to die early than people without the condition, by anywhere from 10 to 25 years earlier. Experts point to several possible reasons for this shorter life expectancy:
- Reckless behavior: People with uncontrolled bipolar illness—especially during manic episodes—can behave more recklessly, resulting in more fatal accidents and health-harming behavior, such as taking illegal substances.
- Poor healthcare: Bipolar patients who have trouble maintaining a job may have less access to quality healthcare.
- Suicide: Suicide takes the lives of thousands of people with bipolar disorder each year. People with bipolar disorder have about a 10-fold higher risk of suicide compared to people without the condition.
- Medication side effects: Bipolar medications, especially antipsychotics, can have serious side effects. While such medications can save lives by keeping the disorder at bay, some drugs (and combinations of drugs) are linked to higher risks of obesity, diabetes, heart problems, thyroid disorders, kidney problems, and other chronic illnesses, all of which can shorten lifespan when left untreated.
- Co-existing diseases: Studies show people with bipolar disorder are 1.7 times more likely to be obese than the general population, with double to triple the risk of diabetes and heart disease, as well as higher risks of stroke and cancer. People with bipolar disorder are also more likely to die from illnesses like the flu or pneumonia.
A good support system will help counter some of these risk factors of a poor prognosis. That system includes your doctor, usually a psychiatrist. You can ask your doctor to adjust your medicines, especially if the ones you are taking seem to cause weight gain or other serious side effects. Alternatives, including newer medications, may be available that don't cause these side effects.
Doctors also advise being vigilant about physical health. This means watching your weight, exercising regularly, keeping a good sleep regimen, and avoiding cigarette smoking and excess alcohol intake, as well as seeing a health provider on a consistent basis.
If you have concerns, your doctor can help explore ways to help improve your bipolar disorder prognosis and avoid long-term complications. The National Alliance on Mental Illness (NAMI) is also a good resource, even if you (or your loved one) is doing well with bipolar disorder. You can connect with other people and families coping with bipolar disorder and its effects.