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The question was submitted 09/10/2008

Subject: Prognosis of early onset of mental illness.

Hi,

I would like to ask if age of onset of mental illness affects the prognosis of the illness for that person. In this case, I am talking about being diagnosed with Bipolar 2 at 17 (and actually having suffered for years prior to formal diagnosis).

Also, I would like to ask if rapid cycling and tendency for occurence of mixed states means that the bipolar 2 is harder to treat and recover from. Because it seems as though even with medications and intensive followups with doctor and therapy with psychologist, the mood swings and sleep problems persist.

Thanks

Answer from DepNet

Bipolar Disorders include Bipolar I and Bipolar II. In Bipolar I, mania or mixed episode has occurred on at least one occasion. In Bipolar II, hypomania has occurred but mania has not.

Bipolar Disorder typically develops in late adolescence or early adulthood (ages 15 to 19); however, some people have their first symptoms during childhood. Also, people may suffer for years before obtaining an accurate diagnosis.

Both Bipolar I and Bipolar II are associated with the incidence of rapid cycling (10 to 20%). Patients experience four or more mood episodes within a 12-month period. Women are 2 to 9 times more likely to have a rapid cycling course than men. Rapid cycling may be due to or exacerbated by an associated medical condition. Although rapid cyclers are more difficult to treat, it does not mean that they have a worse outcome. It may be a temporary phase in the course of the illness, and after experiencing rapid cycling for a time, the person may return to having less frequent episodes.

Mixed symptoms are common in youths with bipolar disorder. Mixed episodes are often severe and would impair daily functioning. There are also high rates of mixed states in rapid-cyclers. The rates of mixed states range from 16 to 67%.

As you are still experiencing mood swings and sleep disturbances despite treatment, your psychiatrist and psychologist are in the better position to advise you on the overall management.

Best regards,

Depnet

The answer was published on DepNet 09/22/2008