Q:  Long-term aspects of Bipolar?

doctor phelps, 

i am bipolar II. i have been influenced by this disease since my preteens (about 11 to 12 years old). i successfully survived on my own by self medicating for over 30 years. i was hospitalized for the first time with a full blown manic episode in 1993. since that time my pdoc and i have experimented with most available medications; antidepressives, moodstabilizers and antipsychotics. i am treatment resistant and have had only moderate success. 

the question i would like to ask of you has to do with the longterm aspects of this condition. answers up to this point have been vague to say the least. i ask your help your help with the following questions: 

is this disease progressive, and if so, how is this manifested mentally? how about physical degradation? 

what is the morbidity rate? 

how and when in life do bpII people die? 

any facts on these questions? 

i hope you are able to read and answer some of my questions. willamette valley born and raised. 

thanks in advance 


Dear Howard -- 
Ok, here's a try: 

1. is this disease progressive, and if so, how is this manifested mentally?
In some folks, yes; women more than men, looks like so you might be lucky there.  Manifests by increased cycle frequency and intensity of symptoms, until for some folks, symptoms are continuous and severe. Mostly that's without treatment, which most experts seem to think can halt the progression for those who have it. 

2. how about physical degradation? 
Not much, but memory can really degrade with repeated episodes. 

3. what is the morbidity rate? 
Morbidity means loss of function (not death): almost everybody experiences some, at times; and some get better to "normal" for most of their lives, while others progressively lose function.   Mortality, on the other hand, is almost entirely through suicide.  The rate is variously quoted as 10% up to the highest I've heard, in a recent article by Kay Jamison, of 20%. 

4. how and when in life do bpII people die? 
Can be anytime from adolescence, where the rate is scary high, to geriatric age range -- by suicide. 

5. any facts on these questions? 
Try Kay Jamison's works, if you haven't read her yet: a great researcher and writer, who also has bipolar disorder -- now there's an example of how high functioning a person can be!

Dr. Phelps 

Published March, 2001