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Financial Impact of Bipolar Disorder

Reviewed by: HU Medical Review Board | Last reviewed: September 2023

The financial burden of bipolar disorder can be steep. High medical costs paired with lost wages are common, and this combination can be devastating.1,2

People in an episode of mania also may spend money recklessly. Spending sprees, inappropriate business investments, or large gifts can lead to financial ruin. And dealing with the aftermath of such behavior can trigger more mood swings.1,2

Direct versus indirect costs

Experts divide the costs of bipolar disorder into 2 categories: direct and indirect. Direct costs refer to the costs of bipolar care, which may include:1

Indirect costs may include:1

  • Lost wages due to absences, unemployment, or underemployment
  • Caregivers’ lost wages
  • Treatment for substance use disorder
  • Legal costs

Research shows that bipolar disorder costs the United States up to $219 billion per year in direct and indirect costs. This equates to an average of $52,413 to $88,443 per person per year. About one-fourth of those total costs are direct costs. The cost per person gets higher the more often they have mood swings that require intervention and the more co-occurring health conditions they have.1

Even if a person with bipolar disorder has health insurance, it is rare that it covers all expenses.1

Direct costs

Studies show that a single manic episode can cost $11,720. A case of bipolar disorder that does not respond to treatment can cost $624,785 over a lifetime. As a comparison, a person without a mental health condition spends an average of $4,706 per year on health care.1

The things that drive up healthcare costs for people with bipolar disorder include:1

  • Frequent ER visits or hospital stays to get symptoms under control
  • Co-occurring health conditions like substance use disorder, heart disease, diabetes, or other mental health conditions
  • Not taking prescription drugs as directed
  • Receiving the incorrect combination or doses of prescription drugs
  • Misdiagnosis leading to incorrect and ineffective treatments

Indirect costs

There are many possible indirect costs linked to bipolar disorder. For example, a person who is arrested or is the victim of a crime may have legal costs. Compared to people without the condition, people with bipolar disorder are more likely to:1

  • Be involved in a crime
  • Miss work
  • Work fewer hours due to medical or mental health issues
  • Be fired or laid off
  • Go on disability benefits

Unemployment is a common problem for people with bipolar disorder. They might miss more work or have behavior issues that lead to being fired. During episodes of bipolar depression, they are more likely to have problems thinking at work. This often leads to lower quality work and less pleasure in working.1

In turn, a job loss is one of the key stresses that leads to more mania or depression. The more episodes of mania and depression a person has, the more likely they are to be unemployed or go on permanent disability. Also, having bipolar disorder is associated with lower overall lifetime earnings.1,2

For all of these reasons, finding stable and affordable housing can be a major challenge. Coming up with a first month’s rent and deposit may be impossible if a person is cycling in and out of hospitals or between jobs.3

Tips to manage impulse spending

There are things you can do to reduce the stress of constantly having too little money to live on. It is important to limit the damage you do to your finances during an episode. While it may take some time to find the solutions that work best for you, here are some suggestions.4,5

  • Make a budget that includes saving for a rainy day fund.
  • Set low spending limits on credit and debit cards, or consider not using credit and debit cards at all.
  • Separate assets such as a house and bank accounts to protect your partner’s credit and your joint assets.
  • Set up email or text notifications that alert someone to unusual bank activity.
  • Lock your credit reporting accounts so you cannot apply for new credit cards or loans without someone being alerted.
  • Make a budget and keep good records so someone can step in and pay your expenses for you if needed.
  • Use a prepaid debit card loaded with a specific amount of money.
  • Create an emergency plan with someone you trust who knows your financial limits and has permission to manage your money in a crisis.
  • Avoid places you tend to overspend, such as a favorite online retailer.
  • Distract yourself by going for a walk or watching a movie before buying things online.

Reach out to your therapist and support group for other solutions to control spending. But forgive yourself if you overspend during a manic episode. Practicing self-care and following your treatment plan can help you have less severe and fewer episodes. This can reduce your direct and indirect costs.

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