Over the Hill, but Still Above the Ground: Aging with Bipolar Disorder

August is my birthday month. I turned 66 on the 7th, but as a typical Leo, I think of myself as 16. The illusion is shattered the moment I look in the mirror after I wake up each morning. I splash cold water on my face, see my messed-up grey hair and, if I get close enough to the mirror, I see a couple of wrinkles I did not notice before.  

Progressive multiple sclerosis has taken its toll on my body leaving me legally blind and needing to use a cane sometimes. MS is a disease of the central nervous system, but there is something else going on inside my brain. It is bipolar disorder, which ruined relationships and my career until I finally learned how to manage it the year I turned 60. It took nearly 20 years after my diagnosis to get to that point.

My psychiatrist did not tell me what to expect in recovery. I thought that if I just took the medication all would be well. I didn’t know about maintaining a healthy sleep schedule, stress management, nutrition, exercise and psychotherapy to start living as normal a life as possible.

This disorder 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 reported in The Journal of Affective Disorders, 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 technical writer and instructor at the University of California-Berkeley Extension and finally to 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 a greater degree of 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. The over-expression of these feelings, a common symptom among all ages of people with BP, can complicate intimate relationships with the non-bipolar spouse and children.

Here’s the chilling news: patients with bipolar disorder have a life expectancy that 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.

I now am referred 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 of 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. 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 66 I am now a “sage”. Well, probably not a “sage” because I have more to learn.

Happy birthday to me. Every day above ground is a good day.

To see more of Tom’s work, visit his website, read his posts on MVP seminarsTumblr, and Stigma Fighters, or check out the rest of his posts for IBPF here

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