Bipolar disorder in later life: A mixed-methods, experiential sampling study of health and well-being over time

Bipolar disorder (BD) is a chronic mental health condition characterized by extreme shifts in mood, behaviour and judgment (onset usually by age 25). More than half with untreated BD abuse alcohol and/or drugs and 60% will have marriages that end in divorce. Suicide by those with BD is greater than unipolar depression. Although (almost) everyone experiences mood variability, people with BD experience profound shifts in mood (e.g., clinical depression, mild elation [hypomania] or extreme elation or irritability). It is estimated that there are today 75,000 Canadians 50+ years of age with BD; moreover, the number of older Canadians with BD will triple over the next 10 years. Despite these growing numbers, psychosocial research focussing on older adults with BD is virtually nonexistent. This proposed 5-year study will include intensive periods of data collection; these 2-week periods will each separated by 8-months. Participants will be prompted at 2-times per day (12 hour window) to report current mood, medication adherence and recent life events. We envision use of a GPS located electronically connected to an iPad or similar tablet-type device. The GPS information (recorded every 20 seconds) will allow us to determine if periods of mania are heralded by expanding geographic range, rapid movement between points or, novelty seeking; conversely, contraction of movements may be a precursor to major depression episodes. Two-hundred and five participants will be recruited from both urban and rural communities with a 10+ year BD diagnosis; medical information will be obtained during regular psychiatric assessments. We will use a range of contemporary research methods with emphasis on BD in later life (e.g., retirement, bereavement, concurrent physical illness). This study will provide a wealth of information to increase our understanding of BD in older adults where little information currently exists.