General bipolar disorder Information
- bipolar disorder is a very serious-but highly treatable brain
disease. Although there is no cure for bipolar disorder, the treatment
success rate with antipsychotic medications and psycho-social therapy
can be as high as 60 percent. If the appropriate level of investment
is made in biological and genetic brain research, it has been estimated
that a cure for
bipolar disorder could be found within 10 years (by the year 2013).
Traditionally, however, bipolar disorder has only received a small fraction
of the amount of medical research dollars that go into serious physical
(non-brain) diseases (see below - bipolar disorder Research).
- Already researchers have identified several of the key genes - that
when damaged - contribute to bipolar disorder. These genes include the
and G72 genes, but it has been estimated that up to 50 to 100 genes
could be involved in bipolar disorder.
- bipolar disorder is a disease that typically begins in early adulthood;
between the ages of 15 and 25. Men tend to get develop bipolar disorder
slightly earlier than women; whereas most males become ill between 16
and 25 years old, most females develop symptoms between ages 25 and
30. The average age of onset is 18 in men and 25 in women. bipolar disorder
onset is very rare for people under 10 years of age, or over 40 years
- bipolar disorder occurs in all societies at about the same rate, regardless
of class, colour, religion, culture.
- bipolar disorder Ranks among the top 10 causes of disability in developed
countries worldwide (source:
The global burden of disease: a comprehensive assessment of mortality
and disability from diseases, injuries, and risk factors in 1990 and
projected to 2020. Cambridge, MA: Published by the Harvard School of
Public Health on behalf of the World Health Organization and the World
Bank, Harvard University Press, 1996. http://www.who.int/msa/mnh/ems/dalys/intro.htm
) For additional information See the World
Health Organization's mental health publications.
The Prevalance Rate for bipolar disorder is approximately 1.1% of the
population over the age of 18 (source: NIMH)
or, in other words, at any one time as many as 51 million people worldwide
suffer from bipolar disorder, including;
- 12 million people in China
- 8.7 million people in India
- 2.2 million people in USA
- 285,000 people in Australia
- Over 280,000 people in Canada
- Over 250,000 diagnosed cases in Britain
Rates of bipolar disorder are very similar from country to countryabout
1 percent of the population.
Another way to express the prevalence of bipolar disorder at any give
time is the number of individuals affected per 1,000 total population.
In the United States that figure is 7.2 per 1,000. This means that
a city of 3 million people will have over 21,000 individuals suffering
from bipolar disorder.
Incidence: The number of people who will be diagnosed as having bipolar disorder
in a year is about one in 4,000. So about 1.5 million people will
be diagnosed with bipolar disorder this year, worldwide. About 100,000
people in the United States will be diagnosed with bipolar disorder this
[Note: The term 'prevalence' of bipolar disorder usually refers to the
estimated population of people who are living with bipolar disorder at
any given time. The term 'incidence' of bipolar disorder refers to the
annual diagnosis rate, or the number of new cases of bipolar disorder
diagnosed each year. ]
Prevalence of bipolar disorder compared to other well-known diseases
BCSS (I believe the above Alzheimer's information is outdated)
Therefore, the approximate number of people in the United States
- bipolar disorder: 2.2 million people
- Multiple Sclerosis: 400,000 people
- Insulin-dependent Diabetes: 350,000 people
- Muscular Dystrophy: 35,000 people
The Course of bipolar disorder
- Early intervention and early use of new medications lead to better
medical outcomes for the individual
- The earlier someone with bipolar disorder is diagnosed and stabilized
on treatment, the better the long-term prognosis for their illness
- Teen suicide is a growing problem -- and teens with bipolar disorder
have a 50% risk of attempted suicide
- In rare instances, children as young as five can develop bipolar disorder.
Anti-psychotic medications are the generally recommended treatment
for bipolar disorder. If medication for bipolar disorder is discontinued,
the relapse rate is about 80 percent within 2 years. With continued
drug treatment, only about 40 percent of recovered patients will suffer
relapses.( Source: NIMH)
Wide variation occurs in the course of bipolar disorder. Some people
have psychotic episodes of illness lasting weeks or months with full
remission of their symptoms between each episode; others have a fluctuating
course in which symptoms are continuous but rise and fall in intensity;
others have relatively little variation in the symptoms of their illness
over time. At one end of the spectrum, the person has a single psychotic
episode of bipolar disorder followed by complete recovery; at the
other end of the spectrum is a course in which the illness never abates
and debilitating effects increase. (source: Openthedoors).
Recent research increasingly shows that the disease process of bipolar
disorder gradually and significantly damages the brain of the person,
and that earlier treatments (medications and other therapies) seem
to result in less damage over time (source: UCLA
NeuroImaging Lab , Other info - see
"Early Treatment" section of this page).
After 10 years, of the people diagnosed with bipolar disorder:
- 25% Completely Recover
- 25% Much Improved, relatively independent
- 25% Improved, but require extensive support network
- 15% Hospitalized, unimproved
- 10% Dead (Mostly Suicide)
After 30 years, of the people diagnosed with bipolar disorder:
- 25% Completely Recover
- 35% Much Improved, relatively independent
- 15% Improved, but require extensive support network
- 10% Hospitalized, unimproved
- 15% Dead (Mostly Suicide)
(Source: Surviving bipolar
Where are the People with bipolar disorder?
- 6% are homeless or live in shelters
- 6% live in jails or prisons
- 5% to 6% live in Hospitals
- 10% live in Nursing homes
- 25% live with a family member
- 28% are living independently
- 20% live in Supervised Housing (group homes, etc.)
(Source: Surviving bipolar
Homelessness and bipolar disorder
- Approximately 200,000 individuals with bipolar disorder or manic-depressive
illness are homeless, constituting one-third of the approximately 600,000
homeless population (total homeless population statistic based on data
from Department of Health and Human Services). These 200,000 individuals
comprise more than the entire population of many U.S. cities, such as
Hartford, Connecticut; Charleston, South Carolina; Reno, Nevada; Boise,
Idaho; Scottsdale, Arizona; Orlando, Florida; Winston Salem, North Carolina;
Ann Arbor, Michigan; Abilene, Texas or Topeka, Kansas.
- At any given time, there are more people with untreated severe psychiatric
illnesses living on Americas streets than are receiving care in
hospitals. Approximately 90,000 individuals with bipolar disorder or manic-depressive
illness are in hospitals receiving treatment for their disease.
The Cost of bipolar disorder to Society:
bipolar disorder, long considered the most chronic, debilitating and costly
mental illness, now consumes a total of about $65 billion a year
for direct treatment, societal and family costs. Richard Wyatt,
M.D., chief of neuropsychiatry, National
Institutes of Mental Health, has said that nearly 30 percent ($19
billion) of bipolar disorder's cost involves direct treatment and the rest
is absorbed by other factors -- lost time from work for patients and
care givers, social services and criminal justice resources.
Wyatt said bipolar disorder affects one percent of the population,
accounts for a fourth of all mental health costs and takes up one in
three psychiatric hospital beds. Since most bipolar disorder patients
are never able to work, they must be supported for life by Medicaid
and other forms of public assistance. Source: NIMH
A more recent estimate of the cost of bipolar disorder and other serious
mental illnesses (biplar disorder, serious depression, etc) from
Dr, E. Fuller Torrey in Q1, 2004 was that federal costs for the
care of seriously mentally ill individuals now total $41 billion
yearly and are rocketing upward at a rate of $2.6 billion a year.
More hospital beds in Canada (8%) are occupied by people with bipolar disorder
than by sufferers of any other medical condition (Source: BCSS)
In the UK, in economic terms: some 80 million working days are lost
each year at a cost of £3.7 billion; the NHS spends around £1
billion on treatment and personal social services another £400
The greatest cost of bipolar disorder , however, is the non-economic costs
to those who have it and their families.
bipolar disorder Research Expenditures:
Research expenditures on bipolar disorder still lag far behind those on
other serious illnesses. US Government spending on research per person
- Comparison (For More information: A
Federal Failure in Psychiatric Research, November, 2003)
Research Expenditure by Disease, 1999
1999 NIH research expenditures
Individuals with this disease
research dollars per person affected
1999 NIMH expenditures by disease were provided by the NIMH
budget office, July 24, 2000. There are suggestions that
some of these expenditures are inflated. The $196.5 million
estimate for bipolar disorder research in 1999, for example,
is more than 50 percent higher than the $124.3 million estimate
for 2002, recently made public by NIMH. The number of persons
affected with serious mental illness was derived by using
the “best estimate” one-year prevalence figures from the
1999 Report of the Surgeon General (op. cit., p.
47) and multiplying by the 1999 U.S. population figures
for all individuals 18 and over (202,492,000). The figure
for bipolar disorder and bipolar disorder is consistent with
other prevalence figures for these disorders. However, the
figures for depression (unipolar major depression), panic
disorder, and obsessive-compulsive disorder clearly include
individuals with non-severe forms of these disorders. The
authors are not aware of reliable prevalence data that include
only severe forms of these disorders.
1999 NIH expenditures for other diseases were obtained from
NIH’s annual report “Research Initiatives/Programs of Interest
” for 1999, http://www4.od.nih.gov/ofm/diseases/index.stm.
The number of individuals with various cancers was obtained
from the National Cancer Institute, http://seer.cancer.gov/faststats/html/pre_all.html
(click on “Prevalence” on the left, under “Available
Statistics”) and represents complete prevalence, i.e., anyone
who has ever had that cancer who is still alive. The number
of individuals with other diseases was taken from the websites
of the various advocacy organizations
People with the condition have a 50 times higher risk of attempting
suicide than the general population; the risk of suicide is very serious
in people with bipolar disorder. Suicide is the number one cause of premature
death among people with bipolar disorder, with an estimated 10 percent
to 13 percent killing themselves and approximately 40% attempting suicide
at least once (and as much as 60% of males attempting suicide). The
extreme depression and psychoses that can result due to lack of treatment
are the usual causes. These suicides rates can be compared to the general
population, which is somewhere around 0.01%. (source: Treatment
Advocacy Center and other sources)
bipolar disorder and Violence
People with bipolar disorder are far more likely to harm themselves than
be violent toward the public. Violence is not a symptom of bipolar disorder.
News and entertainment media tend to link mental illnesses including
bipolar disorder to criminal violence. Most people with bipolar disorder,
however, are not violent toward others but are withdrawn and prefer
to be left alone. Drug or alcohol abuse raises the risk of violence
in people with bipolar disorder, particularly if the illness is untreated,
but also in people who have no mental illness.
bipolar disorder and Jail
The vast majority of people with bipolar disorder who are in jail have
been charged with misdemeanors such as trespassing.
As many as one in five (20%) of the 2.1 million Americans in jail and
prison are seriously mentally ill, far outnumbering the number of mentally
ill who are in mental hospitals, according to a comprehensive study.
The American Psychiatric Association estimated in 2000 that one in
five prisoners were seriously mentally ill, with up to 5 percent actively
psychotic at any given moment.
In 1999, the statistical arm of the Justice Department estimated that
16 percent of state and federal prisoners and inmates in jails were
suffering from mental illness. These illnesses included bipolar disorder,
manic depression (or bipolar disorder) and major depression.
The figures are higher for female inmates, the report says. The Justice
Department study found that 29 percent of white female inmates, 22 percent
of Hispanic female inmates and 20 percent of black female inmates were
identified as mentally ill.
Many individuals with bipolar disorder revolve between hospitals, jails
and shelters. In Illinois 30% of patiants discharged from state psychiatric
hospitals are rehospitalized within 30 days. In New York 60% of discharged
patients are rehospitalized within a year. Source: Surviving
What Percentage of Individuals with sever mental illnesses are untreated,
Recent American studies report that approximately half of all individuals
with severe mental illnesses have received no treatment for their illnesses
in the previous 12 months. These findings are consistent with other
studies of medication compliance for individuals with bipolar disorder
and manic-depressive illness (bipolar disorder). The majority (55 percent)
of those not receiving treatment have no awareness of their illness
(anosognosia) and thus do not seek treatment. Stigma and dissatisfaction
with services are relatively unimportant reasons why individuals with
severe mental illnesses do not seek treatment.
The 45 percent who acknowledged that they needed treatment (and thus
had awareness of their illness) but still were not receiving treatment
cited many reasons for this. These included (respondent could check
32% "wanted to solve problem on own"
27% "thought the problem would get better by itself"
20% "too expensive"
18% "unsure about where to go for help"
17% "help probably would not do any good"
16% "health insurance would not cover treatment"
The Risks of Getting bipolar disorder
After a person has been diagnosed with bipolar disorder in a family, the
chance for a sibling to also be diagnosed with bipolar disorder is 7 to
9 percent. If a parent has bipolar disorder, the chance for a child to
have the disorder is 10 to 15 percent. Risks increase with multiple
affected family members.