Untreated bipolar disorder: Signs, effects, and more - Medical News Today

Untreated bipolar disorder can become severe, and may have a range of effects on a person's work, relationships, mental and physical health, and decision-making.

Without effective treatment, the bipolar disorder can cause episodes of mania, depression, or both. Symptoms of a manic episode can include intense excitement, excessive energy, anxiety, or racing thoughts. A depressive episode can cause sadness, hopelessness, or low energy.

An effective treatment regimen typically involves a combination of medications and psychotherapy.

This article discusses untreated bipolar disorder, including the effects it may have on work, relationships, and mental and physical health. It also explains treatment options, outlook, and support resources.

Treatment can help manage the symptoms of bipolar disorder. Without treatment, symptoms may affect a person's life in various ways, including their:

Personal life

Bipolar disorder can lead to difficulties with daily tasks, such as personal hygiene, getting dressed, or going to school or work. A person may struggle with self-care and eating enough, or may find they eat more than they need.

In manic episodes, people may also make impulsive decisions about their finances, such as spending large amounts of money or making risky investments.

In some cases, the extreme shifts in mood that the condition causes can lead people to consider suicide.

Work

According to a 2022 study, research indicates a link between cognitive challenges that untreated bipolar disorder can pose and work difficulties. These include temporary difficulty with:

• attention
• memory
• learning

In manic episodes, people may also make impulsive decisions about their career that have long-term consequences. For example, they may suddenly decide to quit their job.

Relationships ­­­­

The effects bipolar disorder can have on an individual can subsequently affect their relationships, including:

Romantic relationships

A 2021 review evaluated 27 research articles to gauge the potential effects of bipolar episodes on marital relationships and couples. It suggests there may be a link between the condition and higher divorce rates.

According to the review, potential effects on romantic relationships during periods of illness can include:

• increased levels of self-sacrifice and caregiving from partners
• volatility in the relationship
• sexual dissatisfaction

Depressive episodes can result in a low sex drive, while manic episodes may cause a high sex drive, or risky decisions about sex. Either could affect a romantic relationship.

Childrearing

The 2021 review notes that some research suggests having bipolar disorder may lead to a lower rate of childbearing. However, the authors point out that these findings may be controversial due to methodological flaws in the studies in question.

It also states that some research suggests certain behaviors that can occur during bipolar episodes may lead to adverse effects on parent-child interactions, or contribute to the development of psychiatric conditions in children.

However, the authors state that the illness may sometimes have positive impacts, such as personal evolution, strengthening relationships, and introducing new perspectives.

Learn more about bipolar disorder and relationships.

Mental health

Untreated bipolar disorder usually becomes more severe. A 2016 study cites older research that found a link between extended durations without treatment and:

• more frequent mood episodes
• more frequent suicidal behavior
• a tendency toward a higher rate of lifetime mood instability, which involves rapid cycling of episodes and possible antidepressant-induced mania

People with the condition also commonly have co-occurring psychiatric conditions, which may be harder to manage when their bipolar disorder is untreated.

Physical health

A 2021 study featuring 118 individuals with bipolar disorder and 215 people without the condition indicated that it may affect physical health. The results suggest a statistically significant link to:

• higher rates of weight gain
• decreased physical activity
• increased physical health conditions

However, it is worth noting that some of these physical effects may stem from bipolar treatment, rather than the condition. An older 2013 review notes that antipsychotic medications may play a role.

The authors urge early intervention to enhance treatment outcomes, along with educating people in ways to minimize the development of these physical conditions.

Bipolar disorder involves both manic and depressive episodes. However, some people mostly have depressive episodes, with only mild episodes of mania. This is known as hypomania.

Manic episodes

Signs of a manic episode include:

• intense feelings of:
  • excitement
  • euphoria
  • happiness
• excessive energy
• being unusually talkative or speaking fast
• distractibility
• doing uncharacteristic or impulsive things, such as spending a lot of money
• appearing atypically wired or jumpy
• restlessness or insomnia
• jumbled or racing thoughts
• inflated self-esteem
• increased irritability and agitation

Depressive episodes

Signs of a depressive episode include:

Learn more about bipolar disorder.

Bipolar disorder is a lifelong condition, but treatment can help with managing symptoms, even with the most severe form of the condition.

Treatment options include:

• medications
• psychotherapy
• other interventions

Effective treatment typically involves a combination of medications and psychotherapy.

Medications for bipolar disorder

People may need to try different medications before they and their doctor determine which works best.

The most common types are atypical antipsychotics and mood stabilizers, such as lithium (Eskalith, Eskalith-CR, Lithobid). Such drugs may prevent mood episodes or decrease their severity.

Antidepressants are often a treatment for bipolar depression. However, a person with bipolar disorder will need to take mood stabilizers with antidepressants to avoid triggering a manic episode.

Learn more about medications for bipolar disorder.

Psychotherapy for bipolar disorder

Psychotherapy, or talk therapy, refers to techniques that aim to help someone identify and adapt certain thoughts, emotions, and behaviors. It can help people with bipolar disorder with symptom management.

Cognitive behavioral therapy (CBT) is a type of psychotherapy that can help treat depression. CBT that focuses on insomnia may be particularly beneficial for people experiencing issues falling or staying asleep.

Other types of psychotherapy may include family-focused therapy, which helps families learn skills around communicating and resolving conflicts, or interpersonal and social rhythm therapy, which may help with managing symptoms such as low mood and anxiety.

Other treatments

Other forms of treatment include:

Episodes of mania and depression usually recur in those with bipolar disorder. Between episodes, many people do not have mood changes. However, some experience lingering symptoms. Continuous treatment can help reduce mood alterations.

Despite the potential for effective symptom management, some research suggests bipolar disorder may reduce life expectancy compared with the general population.

A 2023 article cites an earlier research review that found having the condition may reduce life expectancy by approximately 13 years. It also states that a 2015 analysis suggests the all-cause death rate of people with bipolar disorder may be twice that of the general population.

Additionally, a 2018 meta-analysis found a significantly elevated risk of suicide among individuals with bipolar disorder. The rates were 20–30 times higher than the general population.

However, long-term, ongoing treatment can help people with the condition manage their symptoms and live a full life.

People with bipolar and their loved ones can access support resources through the following organizations:

Untreated bipolar disorder can have a wide range of effects on a person's life. As well as affecting mental and physical health, it can lead to challenges in relationships and at work or school. Without treatment, the condition usually becomes more severe.

Signs of untreated manic episodes include insomnia, speaking more quickly than usual, and feelings of euphoria. Symptoms of untreated depression include indecisiveness, feelings of hopelessness, and thoughts of suicide.

Effective treatment frequently consists of medications and psychotherapy. Other options, such as brain stimulation procedures, are also available. Continuous treatment can help people manage their symptoms and live a full, long life.

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