Bipolar Disorder: Prognosis

A good prognosis results from good treatment, which, in turn, results from an . Because disorder continues to have a high rate of both under-diagnosis and misdiagnosis, it is often difficult for individuals with the condition to receive timely and competent treatment.

disorder can be a severely disabling . However, with appropriate treatment, many individuals with disorder can live full and satisfying lives. Persons with disorder are likely to have periods of normal or near normal functioning between episodes.

Ultimately one’s prognosis depends on many factors, which are, in fact, under the individual’s control: the right medicines; the right dose of each; a very informed patient; a good working relationship with a competent medical doctor; a competent, supportive and warm therapist; a supportive family or significant other; and a balanced lifestyle including a regulated stress level, regular exercise and regular sleep and wake times.

There are obviously other factors that lead to a good prognosis as well, such as being very aware of small changes in one’s energy, mood, sleep and eating behaviors, as well as having a plan in conjunction with one’s doctor for how to manage subtle changes that might indicate the beginning of a . Some people find that keeping a log of their can assist them in predicting changes.[80]

Recurrence

Even when on medication, some people may still experience weaker episodes, or have a complete manic or . In fact, a recent study found disorder to be “characterized by a low rate of recovery, a high rate of recurrence, and poor interepisodic functioning.” Worse, the study confirmed the seriousness of the disorder as “the standardized all-cause mortality ratio among patients with BD is increased approximately 2-fold.” disorder is currently regarded “as possibly the most costly category of mental disorders in the United States.”[81]

The following behaviors can lead to depressive or manic recurrence:

Recurrence can be managed by the sufferer with the help of a close friend, based on the occurrence of idiosyncratic prodromal events.[83] This theorizes that a close friend could notice which , activities, behaviours, thinking processes, or thoughts typically occur at the outset of episodes. They can then take planned steps to slow or reverse the onset of illness, or take action to prevent the episode from being damaging.[84] These sensitivity triggers show some similarity to traits of a highly sensitive person.

Mortality

“Mortality studies have documented an increase in all-cause mortality in patients with BD. A newly established and rapidly growing database indicates that mortality due to chronic medical disorders (eg, cardiovascular disease) is the single largest cause of premature and excess deaths in BD. The standardized mortality ratio from suicide in BD is estimated to be approximately 18 to 25, further emphasizing the lethality of the disorder.”[85]

Although many people with disorder who attempt suicide never actually complete it, the annual average suicide rate in males and females with diagnosed disorder (0.4%) is 10 to more than 20 times that in the general population.[86]

Individuals with disorder may become suicidal, especially during mixed states such as dysphoric mania and agitated depression.[87] Persons suffering from II have high rates of suicide compared to persons suffering from other mental health conditions, including Major Depression. Major Depressive episodes are part of the II experience, and there is evidence that sufferers of this disorder spend proportionally much more of their life in the depressive phase of the illness than their counterparts with I Disorder (Akiskal & Kessler, 2007).

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June 7, 2008 | Filed Under Mental Disorders 

Comments

One Response to “Bipolar Disorder: Prognosis”

  1. David Moyer on June 7th, 2008 8:00 pm

    This article is good as far as it goes. However, it excludes recent data showing the effectiveness of nutritional supplements for those diagnosed with bipolar disorder. Also it fails to discuss factors such as infections that impact those with the same diagnosis. Approprite nutritional supplemenation has proven to be more effective for a greater number of patients(Kaplan et. al.) Immunotherapy is as effective as medications for psychosis according to German physician Dr Barbara Fellerhoff.

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