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Early Signs of BP Mood Elevation or Depression

Hi there, Just wondering if anyone may be able to suggest warning signs family & friends need to be aware of with our ongoing monitoring of my frail 77 year old Mum who was very recently diagnosed with Late Onset Bipolar? She is only a very low nightly dose of an antipsychotic drug, no other meds such as mood stabilisers have been deemed necessary by the psychiatrist nor has he suggested any follow up visits to him for ongoing monitoring. She has just been discharged from a voluntary admission to a mental health ward in a local hospital & is living independently. Many thanks for any insights or advice. 🙂


Re: Early Signs of BP Mood Elevation or Depression

Hi @BPMum

Welcome to the forums! I'm one of the moderators, I hope you find the forums really helpful Smiley Happy


I'm sorry to hear that your mum has been recently diagnosed with Bipolar, that must be a huge change for her and for you. I hope forum members can give you some ideas as to early warning signs. Were you in contact with your mum when she became unwell recently? Were there things you noticed in her behaviour? 


I'm sure some forums members will jump in soon, here are some informative websites around Bipolar as well: Bipolar Australia and

And the Sane factsheet/guide on Bipolar


Take care and I hope to see you more on the forums,


Re: Early Signs of BP Mood Elevation or Depression

Thank you @Tortoiseshell. We did notice signs but things had unravelled quite a bit before the penny dropped. Initially, we thought it was some sort of cognitive decline due to Mum having so many issues using familiar things - it turned out to be doing things too quickly & inattentively due to hypomania. There were also poor sleeping habits, over eating, flirtatious behaviour, poor risk assessment ( sharing personal details on Facebook, replying to scam emails & providing her mobile number, walking along busy roads & trying to negotiate stairs unsafely with her wheeler walker, escalating out of character spending, overtalking, frequent very lengthy phone calls, repetitive multiple email & texts etc. Mum’s frailty & physical health issues coupled with her BP diagnosis may prove to be too much for her to be able to live independently, which saddens all the family.

Re: Early Signs of BP Mood Elevation or Depression

Hi @BPMum 

Late onset diagnosis = yikes.


I gather that patients have their own signs as to the things they do when they start ramping up and one goal of treatment is that patients will recognise these signs and present for treatment before things get out of hand. Collaboration with family members is thought best practice.


An already aging body does add to treatment complexity and factors considered with medication would include your Mum's general health and any other meds she is taking,  when looking at treatment algorithms (such as the RANZCP guidelines to the treatment of affective disorders)  there is mention of APs; these guidelines are readily accessible on line. The pdoc should have explained any risk vs benefit and addressed any concerns and why an AP was offered rather than a different MS. Has Mum given permission for you to be involved in her care or are you her enduring guardian?  If so it would be appropriate for you to ask the pdoc about choice of drug/risks-benefits.


It seems unusual to me that no follow up appt has been made as most pdocs would ensure stability before handing back ongoing care to GP and it might be worthwhile checking this. 


Re: Early Signs of BP Mood Elevation or Depression

Hi @BPMum, sounds like it's been a busy and confusing time for both you and your mum. We echo the comments that have been made in seeing if you can talk to your mum's GP (or accompanying her to visit them) and talking through the diagnosis.

Re: Early Signs of BP Mood Elevation or Depression

Thanks for your feedback, I greatly appreciate it given I am navigating unfamiliar territory. Today Mum attended her GP, with me - I have medical & financial power of attorney. He had received her psychiatrist’s report. I do not know what was stated, it wasn’t disclosed but he looked concerned or questioning as I observed him reading it. He examined my Mum re: her physical complaints, prescribed antibiotics for her recurring cellulitis, asked for post consult’ blood tests to be done as he had no current info’ from her hospitalisation & discussed her ‘take’ on her mental state to see if her opinion differed from her earlier more elevated state. Mum maintains the psychiatrist believes “I may have a mild case of bipolar but probably nothing is wrong with me.” The GP asked her, “Is this the psych’ who put you on a dose of *name of med*? ” Mum said it was but couldn’t make the connection between a diagnosis & receiving medication. On her GP’s advice, she has agreed to re-enter the local Aged Care for Respite where he will undertake ongoing care & assessment of her multiple medical issues & medication requirements to ensure the best possible outcome for her health, safety & wellbeing. At present, it seems likely we will need to find a permanent placement in an Aged Care facility. 

Re: Early Signs of BP Mood Elevation or Depression

Thanks @Ali11. Please see my response under @Darcy

Re: Early Signs of BP Mood Elevation or Depression

Are you able to discuss concerns with GP @BPMum  as it seems like getting some clarification around what is happening might be helpful. 

Re: Early Signs of BP Mood Elevation or Depression

Sounds like you have a very supportive GP @BPMum and it is great that they are going to closely monitor all of her symptoms and concerns. Have you been able to get in touch with the relevant people in the aged care facilities?

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