What conditions are similar to bipolar disorder

Delirium, schizophrenia, mania

Mental illness in old age (page 9/10)

and related mental disorders


Delirium is a state of confusion that leads to disorders of consciousness, attention, orientation and memory. The consciousness can either be reduced or changed. In the case of reduced awareness, the wakefulness of the person concerned is reduced, so that thinking, acting and processing stimuli are restricted. When consciousness changes, thinking and acting are confused or restricted to a partial aspect of the experience. Sleep disorders and movement disorders can also occur. Symptoms can be traced back to an organic cause or exposure to a substance such as alcohol or certain medications.

Delirium can occur at any age, but is much more common in older people. The incidence of delirium in older people is around one to 16 percent. One reason for this is that older people often suffer from a variety of diseases that can contribute to the development of delirium. They can also develop delirium after an operation, during internal medical treatment or as a result of malnutrition and insufficient fluid intake.

One of the most important things about treating delirium is to find out what is causing the symptoms of confusion and how to treat it accordingly. At the same time, neuroleptics or benzodiazepines are used to alleviate the symptoms of confusion.

Schizophrenia and Delusional Disorders

Schizophrenic diseases rarely appear for the first time after the age of 60. Such late forms of the disease are more common in women than in men.

The symptoms of schizophrenia are similar in old age as in younger years. In the elderly, however, it is important to rule out possible organic diseases and drugs as the cause of delusions or other schizophrenic symptoms. The symptoms can also occur in the context of dementia, delirium, another organic disease of the brain or the nervous system (e.g. stroke, brain tumor) or an internal illness (e.g. heart attack, thyroid dysfunction). Medications that can trigger schizophrenia-like symptoms include anti-epileptic drugs, Parkinson's drugs, and high blood pressure drugs.

Even in older people, neuroleptics are the first choice medication for schizophrenia or delusional disorders. It must be carefully checked whether there are physical risk factors that make taking these drugs problematic. Both the so-called older and the newer neuroleptics can increase the risk of a stroke. If risk factors are present, the benefits and risks of the medication must be carefully weighed and the intake must be closely monitored.

After the acute symptoms have subsided, psychotherapeutic and sociotherapeutic measures can help to further stabilize the symptoms. Similar to younger patients, the aim of therapy is to offer the patient support and relief through discussions, to motivate him to take the medication regularly and to support him in structuring his everyday life. Adapted to the age and the possibilities of the patient, attempts are also made to build up activities and improve social skills.

Mania and bipolar disorder

Manic episodes - i.e. phases with an extremely elated or irritable mood and greatly increased drive - rarely occur in older people. The likelihood that someone with bipolar disorder will develop mania for the first time at an advanced age is less than one percent.

It should be noted in older people that physical illnesses or medication can often trigger manic symptoms. When mania occurs, complications can quickly develop in the elderly. Manic states often lead to a reduced need for sleep and to reduced fluid and food intake - factors that can quickly lead to severe physical disorders in the elderly.

Treatment for a manic episode is usually carried out in an inpatient setting, with the symptoms being treated with psychotropic drugs. At the same time, physical illnesses and medication that could have triggered the mania must also be treated during therapy.