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How Quickly Does Bipolar Disorder Get Worse Without Treatment?
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How Quickly Does Bipolar Disorder Get Worse Without Treatment?

Written by Seth Fletcher on May 29, 2024
Medical editor Dr. Karina Kowal
Last update: May 29, 2024

Bipolar disorder (BPD) is a mental health condition characterized by drastic mood swings, from emotional highs (mania or hypomania) to lows (depression). People may be genetically predisposed to suffering from this condition, but alcohol or drug abuse is one of the main reasons that bipolar disorder can be exacerbated. If left untreated, both the bipolar disorder and the substance abuse progressively worsen, potentially damaging one’s personal and professional life. In extreme cases, it may increase the risk of self-harm and impair cognitive functions. Fortunately, when treated properly and in time, affected individuals can recover. After recovery, there are a number of programs to prevent symptoms from appearing again, ensuring a stable and productive life. But to properly treat bipolar disorder, you need to understand all the risks and how to spot it early.

Key Takeaways

  • Progression Without Treatment: Untreated bipolar disorder worsens over time, leading to major disruptions in personal and professional life and an increased risk of self-harm and cognitive decline.
  • Substance Abuse Connection: Alcohol and drug abuse worsen bipolar disorder symptoms, creating a harmful cycle that complicates recovery.
  • Financial and Social Impact: Bipolar disorder can cause financial instability and social isolation due to reckless spending during manic episodes and withdrawal during depressive episodes.
  • Advanced Symptoms: Severe mood swings, hallucinations, and mixed episodes occur in advanced untreated bipolar disorder, significantly impairing daily functioning.
  • Effective Treatment: Medication, therapy, lifestyle changes, and support groups are essential for managing bipolar disorder and preventing relapse.

Impact of Bipolar Disorder

Bipolar disorder is characterized by alternating episodes of mania or hypomania and depression. Both affect energy levels and cognitive function, potentially leading to negative outcomes. The person’s judgment and awareness become clouded. In this condition, people may do or say things that lead to long-lasting consequences. It may affect personal relationships, social stability, financial status and physical health.

Bipolar Disorder and Alcohol

Individuals with bipolar disorder often turn to substance abuse, particularly alcohol. The mood swings may lead individuals to drink alcohol to cope with stress and depression. Conversely, during manic phases, the heightened sense of invincibility and poor judgment can lead to excessive alcohol consumption. It will not only worsen the symptoms but also lead to alcohol dependency. Alcohol use may seem like a temporary solution for BPD symptoms, but it only makes them worse.

Financial Impact of Bipolar Disorder

Bipolar disorder can lead to severe long-term financial problems. During manic episodes, individuals may lose impulse control, leading to reckless spending sprees and poor financial decisions. Both will result in going into debt or even bankruptcy. The depressive episodes, on the other hand, make regular employment difficult. Individuals may struggle with motivation, concentration, and the very act of getting out of bed and going to work. This leads to a cyclical pattern of financial distress, as they become unable to achieve and maintain economic stability.

Social Impacts of Bipolar Disorder

The most devastating impact of BPD is its ability to destroy relationships. Manic episodes cause people to act irrationally, which puts a strain on relationships. It’s not uncommon for people suffering from BPD to become social outcasts or break relationships with friends or even families. Mood swings make socializing exhausting and cause frequent misunderstandings. The depressive phases lead to withdrawal from social activities, further isolating the individual. Social networks are crucial for emotional support and mental health recovery, and BPD makes them erode quickly.

Symptoms of Bipolar Disorder

Bipolar disorder has distinct phases of emotional extremes, categorized broadly into manic or hypomanic episodes and depressive episodes. They vary in severity and duration and are separated by periods of normal mood and functioning. The manic phase is marked by abnormally high mood, energy, and activity levels. Individuals become hyper-productive, sleep less and have overly euphoric or irritable moods. In stark contrast, the depressive phase makes individuals irrationally sad and lethargic. They lose interest in activities they used to enjoy. The depressive phase makes sleep patterns become unstable. Affected individuals lose their appetite and find it hard to concentrate and remember things.

Symptoms of Bipolar Disorder in Men

BPD in men has distinct characteristics that make the timely diagnosis difficult. During manic episodes, men tend to be aggressive and take on risks. They show little concern for the consequences of their actions, which leads to substance abuse or acts of violence. These symptoms can be mistaken for personality traits rather than signs of a disorder. It delays diagnosis and prevents men from seeking treatment. Depression in men with bipolar disorder may not always come across as sadness. It often appears as fatigue, irritability, and withdrawal from social situations. This can be easily overlooked or mistaken for normal stress responses.

Symptoms of Bipolar Disorder in Women

Women with bipolar disorder have much more intense symptoms than men. They are also more likely to have depressive episodes than manic ones. Additionally, their symptoms are heavily influenced by hormonal changes. For instance, episodes may intensify before menstruation or during menopause. Women are also more susceptible to rapid cycling, which is having four or more episodes of depression, mania, hypomania, or mixed symptoms within a year. Manic episodes, rather than making women overly euphoric, simply make them more emotional. This is often mistaken for personality traits and disrupts personal relationships. During depressive episodes, women tend to experience anxiety disorders and eating disorders in addition to BPD.

Advanced Bipolar Disorder

When left untreated or poorly managed, bipolar disorder can lead to more severe symptoms. Advanced BPD increases the severity and frequency of mood episodes. Every symptom described previously becomes even worse, which can permanently change how individuals function. Without treatment at this stage, the damage may completely disrupt personal life and lead to extreme, life-threatening actions.

Does Bipolar Disorder Worsen with Age?

Surprisingly, bipolar disorder doesn’t always become worse with age. Some individuals reported that their symptoms became less severe over the years. However, we should note that these testimonies usually come from people receiving consistent treatment. For most people, BPD does indeed become worse with age. The symptoms may also worsen in case of recurrent episodes or inadequate treatment, as their effects will be felt down the line. As people age, their cognitive functions decline, which contributes to BPD severity. Affected individuals may also experience additional stresses, such as losing their loved ones to old age, which may trigger mood episodes.

Signs of Worsening Bipolar Disorder

The first sign that bipolar disorder is getting worse is mixed episodes where symptoms of mania and depression occur at the same time. It makes individuals very emotionally unstable and more likely to self-harm or become delusional. Such phases also can last for weeks or have no breather in between. Hallucinations also indicate that the disorder is escalating. Affected individuals report visual and auditory hallucinations, usually connected to traumatic experiences or emotional triggers.

End Stage Bipolar Disorder

If the condition has been left untreated or inadequately managed over an extended period, the symptoms become physically crippling or even life-threatening. Severe mood swings make individuals almost incapable of functioning independently. Memory loss and impaired problem-solving skills are also common. This often causes people to lose their jobs and become socially isolated.

Bipolar Disorder Treatment

Treating bipolar disorder involves a comprehensive approach tailored to the individual's specific symptoms and needs. Effective treatment requires a combination of medication, psychotherapy and lifestyle changes. BPD requires constant monitoring because treatment does not permanently cure it. The goal is to manage the symptoms and reduce the frequency and severity of mood episodes. Specialized treatment centres, such as the Canadian Centre for Addictions, help individuals maintain a good quality of life consistently.

Stages of Bipolar Disorder Treatment

The treatment of bipolar disorder is done in several stages, each crucial for managing the disorder over a person's lifetime. Understanding these stages helps both individuals and their caregivers in navigating the complexities of the treatment process.

Acute Treatment

The first stage focuses on dealing with current manic or depressive episodes. The goal is to reduce symptoms to a manageable level.  This is done mostly through medication, starting with mood stabilizers. These drugs help balance mood swings to prevent the highs of mania and the lows of depression. Lithium, one of the most well-known mood stabilizers, has been used for decades. It’s particularly good at managing mania. However, lithium medicine must be taken under supervision to prevent side effects such as thyroid and kidney issues.

Another class of medications often used for BPD are anticonvulsants. They were originally developed to treat epilepsy symptoms but have proven themselves very effective in stabilizing mood disorders. Valproate and lamotrigine are anticonvulsants often prescribed for bipolar disorder. They are particularly useful for individuals who experience rapid cycling in their mood swings or in case they don’t respond well to lithium.

Antipsychotic medications help people who experience delusions or hallucinations during manic and depressive episodes. These medications, which include olanzapine, risperidone, and quetiapine, can be used alone or in combination with other drugs to manage symptoms.

Antidepressants seem like an obvious choice for depressive episodes, but they must be used with caution. Sometimes they may have an adverse effect and trigger manic episodes. Antidepressants are often prescribed in combination with mood stabilizers or antipsychotics to balance their effects. 

Individuals suffering from BPD should bear in mind that these medications may have their own side effects. They range from minor nuisances like weight gain and drowsiness to more severe issues such as cognitive impairment or long-term metabolic changes. Because of this, acute treatment is a careful balancing act that must be managed by healthcare professionals. They will do their best to minimize the possible side effects and make sure that it improves the patient’s condition.

Continuation Treatment

After the individual’s mood has been stabilized, the next goal is to prevent a relapse. During this stage, the patients must maintain the previous treatment regimen for several months. Medical professionals also observe the effects of the prescribed medications and make adjustments to dosages if necessary. Psychotherapy is particularly helpful at this stage as individuals are adjusting to the new routine. Psychiatrists also help them understand their condition, identify the onset of episodes, and develop strategies to manage their symptoms.

Maintenance Treatment

The long-term goal of BPD treatment is to prevent future episodes and sustain a stable emotional state. In addition to medication and psychotherapy, individuals should also change their lifestyle. For starters, BPD patients should adhere to a strict sleep schedule to stabilize sleep patterns. A healthy diet improves well-being and mood. Exercise strengthens the body and serves as a good outlet for stress. These adjustments will help cement all the positive changes from medication and therapy and maintain a steady mood level.

Support Groups

Just like with many psychological disorders, support groups play a vital role in helping individuals with BPD find an outlet for their emotions. They provide a safe space where individuals can share experiences, challenges, and successes related to their condition. Here, bipolar disorder patients can finally feel a sense of belonging and understanding that is often missing in their wider social networks.

Participating in a support group is a great opportunity to connect with others who are facing similar struggles. This connection helps reduce the isolation and stigma faced by many people with bipolar disorder. Members can discuss personal experiences with symptoms, and treatment plans, and develop coping strategies together. 

Support groups help affected individuals better understand their condition. Instead of seeing BPD as an intrinsic part of their personality, they begin to see it as a manageable condition. The groups can also serve as educational platforms. Members can learn more about the disorder and stay informed about new therapy methods. It helps members actively manage their physical and mental health as well as make informed decisions about their treatment options.

Peer support serves as a great source of motivation and hope. Seeing others who successfully manage their condition can inspire members to keep going, too. The support network is built on mutual help. The members never feel alone and isolated, which alone helps them cope with the disorder. 

Bipolar Disorder Treatment Centres

Nobody can manage bipolar disorder symptoms on their own, let alone maintain the results and prevent relapse. This is where treatment centres are indispensable. Canadian Centre for Addictions offers specialized care programs for individuals dealing with complex or severe bipolar symptoms. We offer a range of services including psychiatric assessment, medication management, individual therapy, group therapy, and family therapy. Our staff consists of professionals in mental health disorders to ensure that patients receive the best treatment possible. We carefully monitor our patients in a controlled environment to adjust treatment plans as needed in a timely manner.

Bipolar disorder requires a diligent and comprehensive treatment approach. Medical professionals need to properly diagnose affected individuals and tailor the treatment to their specific circumstances. Even though there is no way to cure the disorder at the moment completely, the symptoms can be kept in check. A combination of medication, lifestyle changes and support groups helps maintain a stable mood and better manage manic and depressive episodes. If you or your loved ones seek professional BPD treatment, the Canadian Centre for Addictions is happy to help. Our trained staff will help affected individuals develop effective treatment plans and stick to them.


How quickly does bipolar disorder worsen without treatment?

Untreated bipolar disorder progressively worsens over time, which can lead to severe personal and professional disruptions and an increased risk of self-harm and cognitive decline.

What role does alcohol play in bipolar disorder?

Alcohol abuse is a major contributor to worsening bipolar disorder symptoms, creating a harmful cycle that exacerbates mood swings and complicates recovery.

What are the financial and social impacts of untreated bipolar disorder?

Untreated bipolar disorder can lead to financial instability due to reckless spending during manic episodes and difficulty maintaining employment during depressive episodes. It also strains personal relationships, often resulting in social isolation.

What are the signs of advanced bipolar disorder?

Advanced bipolar disorder features severe mood swings, hallucinations, and mixed episodes of mania and depression, significantly impairing daily functioning and increasing the likelihood of life-threatening actions.

How is bipolar disorder treated effectively?

Effective treatment involves medication, psychotherapy, lifestyle changes and support groups, all of which are essential for managing bipolar disorder and preventing relapse.

Certified Addiction Counsellor

Seth brings many years of professional experience working the front lines of addiction in both the government and privatized sectors.

Medicolegal Litigation Strategist/ Mediator

Dr. Karina Kowal is a Board Certified Physician specializing in insurance medicine and medicolegal expertise, holding certifications from the American Medical Association as a Certified Independent Medical Examiner. 

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