Adult-Onset Bipolar Disorder. Bipolar disorder can also appear for the first time in people over the age of forty. In fact, age 40 is another peak of onset for women.
Onset Late in Life. Bipolar disorder that occurs late in life often either follows many years of repeated episodes of unipolar depression or it accompanies medical and neurological problems (particularly cerebrovascular disease, such as stroke). It is less likely to be associated with a family history of the disorder than earlier-onset bipolar disorder.
Accompanying Neurologic or Emotional Disorders
Patients with bipolar disorder, especially type II or cyclothymic disorder, have frequent episodes of major depression. Anxiety disorders also commonly coexist in these patients. For example, the occurrence of panic disorder in patients with bipolar disorder is 26 times that of the general population. Patients with bipolar disorder, particularly those with type II, are also subject to phobias. In one study, the presence of anxiety disorders was also associated with longer and more severe bipolar depressive episodes and with a higher risk for suicide.
Symptoms of bipolar disorder in children are often confused with attention-deficit hyperactivity disorder (ADHD). Furthermore, the two conditions can coincide. In one study, 65% of adolescents with bipolar disorder met criteria for ADHD. Yet another study indicated that close to 25% of children diagnosed with ADHD either already had bipolar disorder or go on to develop it. The risk for both diagnoses is highest in white males. Symptoms are also more severe in people with both conditions. Some experts believe that many of these disorders may actually be variations of a single disease.
Family History
Bipolar disorder frequently occurs within families, although genetic factors account for only about 60% of cases. Family members of patients with bipolar disorder also have a higher than average incidence of other psychiatric problems. They include schizophrenia, schizoaffective disorder, anxiety disorders, ADHD, and major depression.
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