Prognosis of Bipolar Disorder
Without treatment with medications, the risk of having a recurrence of a Bipolar mood episode (Major Depressive, Hypomanic, Manic or Mixed) after a previous one has resolved is as high as 85% in the first year [ref]. With medication, this risk is about 20-50% in the first year [ref] but up to 80% in five years [ref].
Furthermore, the chances of having a recurrence are higher when an individual:
- Has residual symptoms from their previous episode [ref, ref].
- Is having inadequate amounts of sleep [ref, ref].
- Is not taking their medications as prescribed [ref].
- Is abusing illicit drugs and/or alcohol.
- Is experiencing life stresses, such as problems at work, at school, in family, in relationships, etc. [ref, ref].
- Has experienced Rapid Cycling in the past [ref].
Although it is nearly impossible to predict with complete accuracy the course of a person's Bipolar Disorder, the following items are known to predict a more severe course that is more difficult to treat and that requires more intensive treatment efforts:
- Having any other concurrent psychiatric disorder, including:
- Anxiety Disorders [ref]
- Personality Disorders [ref]
- Substance Abuse or Dependence [ref]
- ADHD either concurrently or in the past [ref]
- The disorder started early in adolescence (before age 17 as a rough cut-off) [ref].
- Experiencing subsyndromal hypomanic or depressive symptoms in between bipolar mood episodes [ref].
- Having experienced physical or sexual abuse as a child [ref].
- Having mood-incongruent psychotic symptoms [ref].
- Experiencing Rapid Cycling [ref].
- The more Bipolar mood episodes (Major Depressive, Hypomanic, Manic or Mixed) that a person experiences, the more likely they are to experience future episodes, poorer response to treatments, longer hospitalizations and a decreased quality of life [ref]. For this reason, it is very important to treat Bipolar Disorder optimally so as to prevent the occurrence of multiple episodes.