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 Dysbindin, Neuregulin 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 of age.
- 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 country—about 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 year. [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 Source: BCSS (I believe the above Alzheimer’s information is outdated) Therefore, the approximate number of people in the United States suffering from:
- 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, 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 disorder) Where are the People with bipolar disorder? Approximately:
- 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 disorder)
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 America’s 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.
Source: Treatment Advocacy Center
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 million.
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)
- The 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.
- The 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. Source: Human Rights Watch
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 bipolar disorder
What Percentage of Individuals with sever mental illnesses are untreated, and why?
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 several reasons):
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”
Source: Treatment Advocacy Center
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.