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Bipolar Disorder: Age of Onset and Associated Risk factors

Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include cycling of moods associated with extreme emotional highs (mania or hypomania) and lows (depression). Persons that struggle with mood instability may experience intense feelings of sadness, helplessness, or hopeless and lose interest or pleasure in most activities. However, when mood shifts to mania or hypomania (less extreme than mania), the sufferer may feel euphoric, full of energy or unusually irritable or creative. Mood instability can affect the way in which the sufferer engages and relates to others, process information, behavior, judgment, eating/sleeping patterns, energy level, etc.

Bipolar disorder is often characterized by episodic disturbances in mood and behavior. Changes in mood not directly influenced by external stimuli may occur rarely or multiple times over the course of a year. Although, some people may experience symptoms related to bipolar disorder between episodes, others may not experience any.

Unfortunately, bipolar disorder is a lifelong mental health condition, however, those with the disorder can manage mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).

It should be noted, familial history of psychiatric disorders and adverse experiences during childhood have been positively correlated to risk factors for earlier age at bipolar disorder (BD) onset. Previous studies conducted on bipolar disorder confirmed the significance of both heredity and vulnerability factors, suggesting an even stronger correlation between early age at onset and vulnerability factors when both factors were combined.

The average age at bipolar disorder onset among many individuals reporting both a high familial burden of psychiatric difficulties and a high frequency/severity of childhood abuse was 20 years earlier than those with no familial history and no experience of childhood abuse. Many people with bipolar disorder often display signs and symptoms of the disorder in adolescence, however, formal diagnosis is usually delayed until after puberty has ended.

Adversity during childhood and familial history of bipolar disorder or other significant psychiatric disorders have been previously reported as risk factors for earlier age at onset. However, the combined effect of these two factors has not been examined in detail or conclusively confirmed. Adversity during childhood play a significant role in understanding the role of exposure during childhood, and grandparental and parental loading for Bipolar disorder and other mental illnesses, as risk factors for younger age onset of the disorder. Because early-onset bipolar disorder predicts poorer long-term outcomes, it is reasonable to assume these variables should be considered in risk assessments for early-onset bipolar disorder in different populations and preventions.

Several strategies as well as a combination of techniques have been identified as effective in improving adherence, increasing social and familial support, including psychoeducation, medication (typically those that are preferred by the patient), motivational interviewing, cognitive behavioral therapy, and simplified dosing.