While everyone experiences mood swings at times, a person with bipolar disorder experiences extreme differences in mood that can affect their ability to think clearly and can interfere with their day-to-day life. It’s common for a person with bipolar disorder to wonder what will happen in the future, such as whether their symptoms will get worse with age and whether there is any hope of eventually coming off medication.
Bipolar disorder can change over time, and for some people, those changes can make symptoms feel different, or even more challenging to manage, as they get older. However, that doesn’t mean bipolar disorder always gets worse with age. In fact, many people maintain stability or even improve with consistent care and healthy habits.
Here’s what research shows about how bipolar symptoms can evolve later in life.
Symptoms of Bipolar Disorder
The severity of symptoms of bipolar can vary from one person to another. Mood swings include episodes of both mania and depression, which may occur in rapid sequence or may seem to go away for a period of time, sometimes for months or years.
Mania is a hallmark symptom of bipolar disorder, and a person must experience at least one episode of mania or hypomania in order to be diagnosed with this condition. Hypomania is a less intense form of mania.
Symptoms of mania include:
- Racing thoughts
- Talkativeness
- Decreased need for sleep
- Agitation
- Increased energy
- Sense of euphoria or exaggerated self-confidence
One or more episodes of mania may alternate with periods of depression, which include a lack of energy and loss of interest in activities. During a major depressive episode, a person may sleep too much, be unable to concentrate, and may consider suicide.
How Bipolar Disorder Symptoms Can Change with Age
While bipolar disorder affects each person differently, many people notice certain patterns as they get older. These changes don’t always mean the condition is getting worse—they can also reflect shifts in brain chemistry, life circumstances, and physical health. Understanding how bipolar can evolve helps people stay proactive about treatment and maintain long-term stability.
More Depressive Episodes
As people age, it’s common for depressive episodes to become more frequent or last longer. Research shows that across decades of living with bipolar disorder, depressive symptoms often become more dominant during a person’s third, fourth, and fifth decades of life. Those who experienced an earlier onset of bipolar disorder also tend to have a higher lifetime burden of depression.
These patterns suggest that the balance between depression and mania often stabilizes early in a person’s illness—meaning the tendency toward either depression or mania can remain consistent over time.
What this looks like: Feeling persistently low, losing motivation for daily activities, sleeping more than usual, or feeling drained even without much exertion. Because depression can also be tied to medical issues such as thyroid problems or vitamin deficiencies, regular checkups are essential to rule out other causes and adjust treatment as needed.
Milder or Fewer Manic Episodes
While depressive symptoms may intensify, manic episodes often become less frequent or less extreme with age. This can be partly due to lifestyle stability—many older adults have fewer major life disruptions, which can reduce triggers. It may also be a result of long-term treatment helping regulate mood more effectively.
What this looks like: Periods of high energy or euphoria that feel more muted than before, or a noticeable reduction in risky or impulsive behavior. Even so, hypomanic episodes can still interfere with sleep and decision-making, so monitoring subtle mood shifts remains important.
Cognitive Changes
Many older adults with bipolar notice changes in focus, memory, or processing speed. Some of this overlap is natural aging, but research also suggests that repeated mood episodes—especially untreated ones—can affect areas of the brain tied to attention and executive function. Medication side effects may also contribute.
What this looks like: Forgetting appointments, feeling mentally “slower,” or having trouble organizing thoughts. Practicing mental exercises, maintaining good sleep, and reviewing medications regularly can help support cognitive function.
Medication Sensitivity
As the body changes with age, medications may work differently than they once did. Liver and kidney function slow down over time, affecting how the body metabolizes prescriptions. This means a dosage that felt right in your 30s may cause side effects in your 60s.
What this looks like: Feeling dizzy, groggy, or unsteady after taking medication that previously felt fine. Because older adults often take multiple prescriptions, drug interactions can also play a role. Regular medication reviews with a psychiatrist or primary care doctor can help maintain balance and minimize side effects.
Health and Lifestyle Factors
Physical health plays a larger role in mental health as people age. Conditions like heart disease, diabetes, chronic pain, and hormonal imbalances can all influence mood stability and energy levels. Additionally, lifestyle changes—like retirement, loss, or reduced mobility—can affect daily structure and emotional wellbeing.
What this looks like: Mood changes that seem to follow shifts in physical health or daily routine. Staying active, maintaining a balanced diet, and keeping a consistent sleep schedule can all help regulate both physical and emotional health.
Shifts in Episode Frequency or Pattern
Over time, some people experience changes in how often or how intensely their mood episodes occur. For example, someone who once had long, distinct manic and depressive phases may begin to experience shorter, more mixed episodes where symptoms overlap. Others may find their mood stabilizes for longer stretches.
What this looks like: A less predictable pattern of ups and downs or an overall sense that mood shifts are different than they used to be. Tracking these changes can help your provider adjust your treatment plan early—before patterns become harder to manage.
Why Treated Bipolar Disorder Doesn’t Always Get Worse with Age
Even though bipolar symptoms can shift, “worsening” isn’t guaranteed. Many people live stable, fulfilling lives with proper treatment and self-awareness.
Here’s why:
- Effective management matters: Regular medication, therapy, and healthy routines can help maintain long-term stability.
- Everyone’s course is different: Bipolar disorder is highly individual—some people improve with age as they learn their triggers and coping strategies.
- Symptoms often evolve, not intensify: It’s common for the balance between manic and depressive symptoms to change rather than worsen.
In other words, bipolar disorder tends to change with time, not necessarily deteriorate.
How People With Bipolar Disorder Maintain Stability as They Age
All types of bipolar disorder can be well-managed at any age with the right strategies and support. Here are some practical steps that can make a difference:
- Stay consistent with psychiatric care and medication management.
- Prioritize sleep and maintain a steady daily routine.
- Take care of your physical health through regular exercise and a balanced diet.
- Watch for early warning signs of mood changes and act quickly.
- Keep your brain active through reading, puzzles, or learning new skills.
- Stay connected to friends, family, or support groups for accountability and encouragement.
Small, consistent habits can help you stay grounded and reduce the chance of relapse over time.
How Untreated Bipolar Disorder Can Get Worse Over Time
Bipolar disorder may worsen with age or over time if the condition is left untreated. As time goes on, a person may experience episodes that are more severe and more frequent than when symptoms first appeared. The longer the symptoms continue without treatment, the more likely a person is to experience problems in personal relationships or daily responsibilities.
Understanding what happens if bipolar disorder is left untreated reveals the full scope of potential consequences, from deteriorating relationships and career setbacks to increased risk of hospitalization and suicidal behavior. These outcomes underscore why early intervention and consistent treatment are so crucial for long-term stability.
Avoiding or Discontinuing Treatment
Refusing to believe that treatment is necessary can also lead to the worsening of symptoms. It’s not uncommon for a person with bipolar disorder to believe they’re cured if their symptoms start to improve. They may attempt to discontinue taking their medication, which can lead to a quick return of symptoms.
Substance Abuse and Unhealthy Coping
Untreated bipolar disorder may also lead to unhealthy coping mechanisms like substance abuse. Misuse of substances can exaggerate or prolong symptoms of both mania and depression. Symptoms of mania can lead to difficulty controlling reckless behavior, including drinking too much, driving too fast, or behaving aggressively toward others.
Destructive or Risky Behavior During Mania
With or without substance abuse, episodes of mania can cause destructive actions that may not have occurred if the bipolar symptoms were under control. These actions can ultimately lead to legal problems because of acts like road rage, domestic violence, stealing money to support compulsive spending behavior, or a drug addiction.
How Consistent, Ongoing Treatment Helps Manage Bipolar Systems
Long-term engagement with treatment breaks the cycle of worsening symptoms. Maintaining medication and therapy over time is linked with fewer relapses, reduced episode severity, and better overall functioning.
For example, psychosocial therapies (like psychoeducation or cognitive-behavioral approaches) used alongside medications have been shown to help prevent relapse in bipolar disorder.
Similarly, medications that are continued beyond acute recovery help extend periods between mood episodes and strengthen stability in the long run. When treatment is consistent and tailored, it’s building a foundation that resists them going forward.
Find Lasting Stability with Bipolar Treatment
Bipolar disorder can evolve as you age, but with the right care and support, it doesn’t have to get worse. Effective treatment helps you manage mood changes, maintain balance, and build a life that feels steady and fulfilling.
At Clearview Treatment Programs, we offer specialized care for people living with bipolar disorder. Our programs combine evidence-based therapies, medication management, and compassionate guidance to help clients gain insight, strengthen coping skills, and find long-term stability.
Because every person’s experience with bipolar disorder is different, we tailor treatment plans to meet each client’s unique needs and goals. With the right approach, you can move beyond symptom management and build a healthier, more grounded future.
To learn more about our bipolar treatment programs and take the next step, please call us or reach out to one of our locations.
