Catching up on my reading, I came across an article on posing the argument that the Bipolar patient’s mania symptom profile changes with age.  The study found that compared with adults, adolescents (aged 10-17 years) with bipolar I disorder had significantly higher YMRS item scores – relative to the total score – for aggression and irritability.  Conversely, YMRS grandiosity and sexual interest item scores were higher in adults than adolescents.

Upon reflection it became clear that their findings mirror my experience with Bipolar Disorder.  While in my late teens and early 20’s, becoming agitated was something I dreaded.  Not only would I awake every morning wondering what kind of day my mood would allow me to have, I was always on edge waiting for the inevitable spark to set me off and bring with it bouts of screaming, china-smashing and risky-behavior I came to dread.  When I was young, my mania was a much more physical thing.  I’m amazed my family never tried to have me hospitalized.  I think my worst manic experience came when I was 21 or so.  I clearly remember driving like a lunatic in a 25 mph zone and daring myself to crash into a tree.  I almost did it, too.  I’ll never know what stopped me but that is the point where I decided I needed help and saw a doctor.

As I’ve aged, as the study points out, the manias haven’t mellowed, their dynamic has simply changed.  Grandiosity is really the main feature now – whether it is taking on a grand project that allows for no sleep until completed or believing in some grand life-circumstance that simply isn’t there. I would say the risky behavior has turned in on itself and become a form of grandiosity that a handful of times has bordered on psychosis.  The bottom line is if one were to diagram my journey through mania over the last two-and-one-half decades, today’s points of interest are not what they were twenty-five years ago.

I’m encouraged that the conclusion of the study states,

“Age-grouped differences in the assessment of bipolar manic disorder need to be taken into account to better understand the psychopathology of mania and to build consistent diagnostic criteria for community care.”

Keeping in mind another recent study that puts the average diagnosis time of Bipolar at 13.5 years from first onset of symptoms, I can’t help feel that one benefit of putting in place more granular, age-aware criteria for mania may make it possible for some individuals to be diagnosed sooner.

Another thing this study makes abundantly clear is that Bipolar is a very fluid disease.  Cycle time, wellness period length, episode features and the meds required for an effective cocktail are always changing.  Those of us living with Bipolar must be forever vigilant and be agile enough to react appropriately to whatever our disease throws at us in order to maintain optimum mental health.  Which, quite frankly, is pretty exhausting, but that is fodder for another post.