Prognosis and Duration of disabling effects

Although recovery from an individual episode of mania or depression can be expected, the long-term prognosis for people with bipolar disorders is poorer than might be anticipated. Long - term studies (25 years) show that on average a person with bipolar disorder will have ten further episodes of mood disturbance. The time interval between episodes tends to shorten with increasing numbers of episodes and increasing age. Although treatment of an individual episode of mania or depression symptoms may be relatively effective, people continue to have disabling symptoms affecting daily life, social interaction and ability to work.

For a person who is making a reasonable recovery from a single episode of hypomania or severe depression it may be appropriate to make a limited award. Those people who relapse infrequently, perhaps every 3 to 5 years, and in whom the evidence shows that the mental state is normal between relapses might also be eligible for a limited award.

People who have a history of recurrent episodes and in whom symptoms of abnormal mood exist most of the time, despite treatment with appropriate medication, should be considered for an indefinite award.

The following features are likely to indicate long - term disability -:

• Recurrent episodes of mania and depression.
• Decreasing interval between episodes of relapse.
• History of multiple hospital admissions.
• History of admission under the Mental Health Act.
• In sheltered or supervised accommodation.
• Long - term prescription of mood stabilising drugs such as lithium.
• Treated with ECT.
• Rapid cycling disorder.

All information must be taken into account when considering the duration of disabling effects and the duration of disabling effects must be based on the particular circumstances of the individual claimant.

Click on the links for details:

• Course and variants of Bipolar disorder
• Frequency of relapses

Amended March 2012