I’ll be 67-years-old next August 7. I think I’m still 17 until I look in the mirror each morning, splash cold water on my face, brush my gray hair and discover more wrinkles on my face that were not there the day before.
My psychiatrist did not tell me what to expect in recovery when he diagnosed me with bipolar disorder II nearly 25 years ago. I thought that if I just took the medication all would be well. I didn’t know about maintaining a healthy sleep schedule, how to manage stress, eating balanced meals, exercise and psychotherapy to start living as normal a life as possible.
BP affects all age groups — and the number of seniors with bipolar disorder is expected to increase as the population ages.
Now that I am an “older adult,” I have challenges each day other than keeping mood swings at bay. According to a study by the National Institute of Health, bipolar disorder often involves disabling and enduring cognitive impairments in older patients. A cognitive impairment is when a person has trouble remembering, learning new skills, concentrating, or making decisions that affect their everyday life. Cognitive impairment ranges from mild to severe. I had to retire and go on disability when I was 60 after giving up trying to hold a job. I could not remember directions necessary for whatever I was supposed to do in my position. I went from being a college professor and Ph.D. candidate in the 1980’s to a night janitor in a hospital emergency room and onto several unsuccessful telemarketing jobs.
I married an Egyptian woman in 2010 who assured me I would be speaking Arabic in a year. Our dog understands more Arabic than I do. His favorite phrase is “yalla bye bye” which means “let’s go” when it is time for a walk. I can only remember that one and few other words.
In contrast to younger individuals with bipolar disorder, studies have determined that older adults are more likely to be hospitalized for manic symptoms and experience more disability related to the depressive symptoms. Older adults are more likely to be “rapid cyclers” meaning they experience more than four episodes of depression or mania over the course of a single year. That requires psychiatric treatment. Some older adults with BP look forward to the upswings in mood despite the problems they cause. That’s because it is the only time they feel energetic and motivated to pursue something enjoyable. This makes the lows all the worse, however, due to the contrast between the depression and the positive feelings experienced during the manic phase. Mood changes can be complicated because of feelings of agitation, irritability or frustration that seem to be more common among older people. The over-expression of these feelings, a common symptom among all ages of people with bipolar, can complicate intimate relationships with the non-bipolar spouse and children.
Here’s the unsettling news: patients with bipolar disorder life expectancy is reduced by about 10 years relative to the general population, according to Danish researchers. This is due to a higher suicide rate and poor lifestyle choices such as smoking (31% of all cigarettes are smoked by adults with a mental illness because nicotine lifts one’s mood). We are at increased risk for developing dementia, too, a nationwide study in Taiwan confirms.
My general practitioner now refers me to a “geriatric psychiatrist”. “Geropsychiatry” is a sub-specialty of psychiatry dealing with the study, prevention, and treatment of mental disorders in older people.
All the news about having bipolar disorder when you are older may be discouraging to all of us Baby Boomers and older. Don’t give in. Our brains are just different from everyone else’s. Bipolar disorder is incurable and this pattern of deterioration occurs in all of us with the disease, whether we are un-medicated, under-medicated, or medicated.
If I give in to the illness, I am finished. Instead, I help someone else. I’ve gone to work on behalf of other people who live with bipolar disorder or other mental illnesses and educate those who do not in my volunteer work for the National Alliance on Mental Illness (NAMI) speaking on college campuses about my experience with bipolar. My mission is to end stigma, which prevents many people from getting help who need it, and telling people with bipolar disorder how I learned to manage it.
Nineteenth Century American statesman Daniel Webster said, “Wisdom begins at the end”. I guess at nearly 67 I am now a “sage”. Well, probably not a “sage” because I always have more to learn.
Since the suicide rate for people with bipolar disorder is 15-17%, every day above ground is a good day.