Q. A good friend of mine has been diagnosed with bipolar II (Hypomania). He is 39 years old and currently receives treatment from a psychiatrist and psychologist. He is on several medications. He has had good medical care for about 3 years. He has a good, high paying job and does well for the most part.

Before proper diagnosis and treatment, he was hospitalized over 4 times in a 6 year period for severe depression and also has a history of alcohol and drug abuse (no longer abusing).

Question: Does bipolar get worse with age, even if someone is getting proper treatment?

  A. Good question with no clear answer. What seems to happen is that people get ill for longer periods, and depression predominates where hypomania use to be. Not everyone follows this course. Data by Joe Calabrese suggests that effective treatment may result in fewer episodes down the road, so it makes sense to take the medications. Since most biological illnesses worsen with time, it is reasonable to assume that psychiatric ones do too.