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Senior Correspondent

Q. Is it possible for bipolar disorder to first appear when you’re older?

Bipolar disorder can strike anyone at any age, but it isn’t likely to start when you are old. However, it is possible that a person could suffer from bipolar disorder for many years and not be diagnosed until late in life.

It's not known what causes bipolar disorder, but a variety of biochemical, genetic and environmental factors seem to be involved in causing and triggering bipolar episodes.

Bipolar disorder — also called manic-depressive illness — causes extreme mood swings. When people with bipolar disorder are happy and energetic, they are in the mania phase of the illness. When they are sad and listless, they are in the depression phase.

The shifts from mania to depression and back again can occur quickly. The deep mood swings of bipolar disorder may last for weeks or months. Often, there are periods of normal mood in between.

Sometimes, severe episodes of mania or depression include symptoms of psychosis such as hallucinations. Some people with bipolar disorder become suicidal.

The cause of bipolar disorder is not known. A variety of forces seem to be involved in bipolar disorder. Some studies indicate that people with bipolar disorder have physical changes in their brains. And researchers are trying to find genes that may be involved in the condition.

As people get older, symptoms of bipolar disorder may change in nature and severity. Because of this, treatments may need to be adjusted.

Bipolar disorder is treated with medicines to stop the mood swings. Mood stabilizers are used to even out highs and lows. Antidepressant medicine can help reduce the symptoms of depression. Counseling is an important adjunct to drug treatment of bipolar disorder.

People with bipolar disorder can lead healthy and productive lives when the illness is treated effectively. Without treatment, however, the natural course of bipolar disorder tends to worsen.

Bipolar disorder runs in families. If you have a parent who has bipolar disorder, you have a greater chance of having it.

Alcohol and drug abuse are very common among people with bipolar disorder. Anxiety disorders, such as post-traumatic stress disorder and obsessive-compulsive disorder, also may be common in people with bipolar disorder.

Some specific symptoms of mania include: irritability, anger, rapid speech, decreased need for sleep, difficulty concentrating, spending sprees, inflated ego, substance abuse, increased sex drive, high energy level, restlessness, poor judgment, aggression, denial that anything is wrong, increased physical activity and risky behavior.

Some specific symptoms of depression include: no interest in pleasure, anxiety, hopelessness, loss of sex drive, unprovoked crying, low energy level, feeling unworthy and guilty, thoughts about death and suicide, appetite change, insomnia or oversleeping, forgetfulness, body aches, restlessness, weight loss or gain.

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