Bipolar Disorder And Anxiety As Co
It is not uncommon for someone with bipolar disorder to have a co-existing anxiety disorder. For a person with these co-occurring conditions, it is crucial they get the correct diagnosis so that they are able to access the right treatment for both disorders, and manage them effectively.
If you are uncertain about whether you have an anxiety disorder and bipolar disorder, we have outlined the symptoms of these co-occurring conditions, and the steps to take if you believe that you have both. We have also looked at the type of treatment recommended for those with the co-existing disorders, as well as self-care techniques to help better manage these conditions.
In Bipolar Disorder Anxiety Often Follows Mania
NEW YORK, NY –Adults with bipolar disorder are just as likely to develop anxiety as depression following an episode of mania, according to data from a national survey of more than 34,000 adults. This finding, published today in Molecular Psychiatry, may expand our understanding of bipolar disorder to include anxiety.
An estimated 5.7 million Americans have bipolar disorder, a serious mental illness that has been characterized by recurrent periods of mania and depression. Because mania, which involves having an elevated or irritable mood, and depression are mood disturbances, bipolar disorder is considered a type of mood disorder.
Study participants were interviewed to determine the incidence of manic episodes. A second interview was conducted three years later to determine the subsequent incidence of depression or anxiety. Participants with mania had an approximately equal risk of developing depression or anxiety . Both conditions were significantly more common among participants with mania than without. In addition, participants with depression had a significantly higher risk of developing mania or anxiety compared with those without depression.
A broader clinical definition of bipolar disorder that includes episodes of mania along with anxiety or depression might lead to earlier identification of individuals with bipolar disorder and different approaches to treatment.
Patients Who Progressed To Mania During The Follow
Subjects who met the criteria in inclusion criteria and displayed manic symptoms during the follow-up period, as assessed by Young Mania Rating Scale scores and the duration of symptoms , were considered new BD patients.
Exclusion criteria
Anxiety patients with any of the following features were excluded:
suffering from non-anxiety mental disorders, such as BD, depression, or schizophrenia, or from severe physical illness that might make the patient unable to complete the questionnaires
unable to read or comprehend the questionnaires
unwilling to participate or uncooperative.
Patients with typical BD who met any of the following exclusion criteria were not enrolled:
suffering from other mental disorders in addition to BD or from neurological diseases or severe physical illness that might make them unable to complete the questionnaires
Unable to read or comprehend the questionnaires
unwilling to participate or uncooperative.
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What Are The Long
Bipolar disorder is a life-long and often recurring illness. You may need long term support to help manage your condition.
What medication options are there?
Your doctor will look at what medication worked for you during episodes of mania or depression. They should ask you whether you want to continue this treatment or if you want to change to lithium.
Lithium usually works better than other types of medication for long-term treatment. Your doctor should give you information about how to take lithium safely. If lithium doesn’t work well enough or causes you problems, you may be offered:
- Valproate,
- Olanzapine, or
- Quetiapine.
Your doctor should monitor your health. Physical health checks should be done at least once a year. These checks will include:
- measuring your weight,
- checking your liver and heart, and
- checking your pulse and blood pressure.
What psychological treatments are recommended?
You should be offered a psychological therapy that is specially designed for bipolar disorder. You could have individual or group therapy.
The aim of your therapy is to stop you from becoming unwell again. This is known as relapse. Your therapy should help you to:
If you live with your family or are in close contact with them, you should also be offered family intervention.
Family intervention is where you and your family work with mental health professionals to help to manage relationships. This should be offered to people who you live with or who you are in close contact with.
How Is Bipolar Disorder Diagnosed
Most people with bipolar disorder can be helped â but a psychiatrist or psychologist must first diagnose the disorder. Sadly, many people with the condition are never diagnosed or are not diagnosed properly. Without proper diagnosis and treatment, the disorder can become worse. Some teens with undiagnosed bipolar disorder can end up in a psychiatric hospital or residential treatment center, in the juvenile justice system, abusing drugs, or committing suicide.
Because children and teens with bipolar disorder do not usually show the same patterns of behavior as adults who have the condition, a mental health professional will observe a teen’s behavior carefully before making a diagnosis. This includes getting a complete history of the person’s past and present experiences. Family members and friends can also provide helpful insights into the person’s behavior. The doctor may also want a teen to have a medical exam to rule out other conditions.
Diagnosing bipolar disorder can be difficult. As yet, there aren’t any laboratory tests like a brain scan or blood test that will diagnose it. In teens, bipolar disorder can sometimes be mistaken for illnesses like schizophrenia and posttraumatic stress disorder, attention deficit hyperactivity disorder , and other depressive disorders. That’s why a complete, detailed history is so important.
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How Does Anxiety Affect Bipolar Disorder
Both bipolar disorder and anxiety are treatable, manageable conditions. However, it is important to distinguish between the two, as this will affect the type of medication and therapy a healthcare professional will prescribe.
When a person has both conditions, they may find their anxiety affects the symptoms of bipolar disorder. This could
Although anxiety and bipolar disorders have some similarities, they have distinct sets of symptoms and diagnostic criteria.
However, some symptoms suggest a person may have co-occurring anxiety. They include:
- A persistent, intense feeling of nervousness: This can include worrying, anxiety, and panic attacks. A person may also avoid taking part in activities. These symptoms persist during manic and depressive episodes.
- Sleep and anxiety problems: People may find they have issues sleeping even when they are not in a manic state. They may feel persistently anxious despite receiving treatment.
- History of symptoms: Some people may have lived with anxiety and bipolar disorder symptoms from childhood and adolescence.
Learn more about the symptoms of anxiety and bipolar disorder here.
If someone has an anxiety disorder in addition to bipolar disorder, a doctor should diagnose and treat the conditions together.
When a doctor, psychiatrist, or psychologist is developing a persons treatment plan, they will take multiple factors into consideration. Usually, medication and therapy form the basis of the treatment plan.
Anxiety As A Separate Condition
Now well have to be more specific about what kind of anxiety are we talking about?. There are several specific forms of anxiety which appear to be clearly separate from bipolar disorder . Heres a list, and then well look at specific symptoms that identify each one. After that well look at the treatment implications of having one of these. Jump to each by the link below.
Most of these have been shown to occur more often than you would expect in people with bipolar disorder . Well look at each one or you can use the link above to jump to the one youre interested in.
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Clinically Speaking: How Bipolar Disorder And Gad Differ
Sleep issues, mind-racing, and irritability are only a few symptoms in which bipolar disorder and anxiety overlap. How are they different?
For many people, symptoms associated with bipolar disorder and generalized anxiety disorder can feel similar.
Learning the difference between bipolar disorder and GAD can help you find treatment options to address your specific concerns.
At first glance, the two can look similar. After a deeper dive, though, you can see several distinctions:
| Symptom | ||
|---|---|---|
| Feeling decreased need and thus little to no sleep | Dissatisfied on little to no sleep | |
| Energy | Supercharged or functional energy levels, sometimes feeling euphoric | Fatigued, sometimes feeling groggy |
| Creative, innovative, goal-oriented , agitated | Lack of concentration, all-consuming worry, ever mentally replaying interactions | |
| Psyche | ||
| More talkative and gregarious than usual | More avoidant of social situations than usual | |
| Risk Assessment | High due to fear of the unknown | |
| Duration of episode | 2-4 months for mania/ hypomania, 2 years for cyclothymia | Chronic |
While anxiety can be ongoing, mania will ebb and is usually followed by an episode of depression.
A person with anxiety often dreads the hypothetical worst-case scenario event. Those managing bipolar II, cyclothymia, or mixed episodes of depression often dread the looming depression bookending an episode of charging full steam ahead.
Warning Signs And Symptoms Of Bipolar Disorder
Disclaimer: Results are not guaranteed*** and may vary from person to person***.
The signs and symptoms of bipolar disorder can have a major impact on a persons life. It is common to go through challenges in life, and we all experience highs and lows. That said, people with bipolar disorder have a much tougher time coping during manic highs and depressive lows.
As a result, bipolar disorder symptoms can hurt your performance at work or school and damage your relationships. Often family and friends dont understand mental illnesses like bipolar disorder, which causes further stress and damage to those with the condition.
I know first hand how hard bipolar disorder can affect a person and the people around them. My mom was diagnosed with bipolar disorder 2008 at the age of 48. She has gotten help for the condition, but she quite possibly had bipolar disorder for years without realizing it. It took years before we understood the warning signs and symptoms of the condition. Knowing the symptoms is very important, and it is the first step on the road to recovery.
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What Are The Symptoms Of Bipolar Disorder
Bipolar disorder symptoms can make it difficult to deal with day-to-day life. It can have a bad effect on your relationships and work. The different types of symptoms are described below.
Mania
Symptoms of mania can include:
- feeling happy or excited, even if things arent going well for you,
- being full of new and exciting ideas,
- moving quickly from one idea to another,
- racing thoughts,
- sleeping too much or not being able to sleep,
- eating less or over eating,
- losing or gaining weight, when you dont mean to, and
- thoughts of death or suicide, or suicide attempts.
Psychosis
Sometimes you can have psychotic symptoms during a severe episode of mania or depression. Symptoms of psychosis can be:
- hallucinations. This means that you may hear, see, or feel things that are not there, and
- delusions. This means you may believe things that arent true. Other people will usually find your beliefs unusual.
Psychotic symptoms in bipolar disorder can reflect your mood. For example, if you have a manic episode you may believe that you have special powers or are being monitored by the government. If you have depressive episode, you may feel very guilty about something you think you have done. You may feel that you are worse than anybody else or feel that you don’t exist.
You can find more information about:
- Depression by clicking here.
The Basic Demographic Questionnaire
The graphic questionnaire was designed by members of our research team to collect data regarding the participants demographic features and the clinical features of their diseases. . The item on suicidal ideation was adapted from the 10th item of the Montgomery-Asberg Depression Rating Scale and was scored on a 6-point scale. The higher the score was, the more severe the symptom.
Table 1 Demographic characteristics
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What Risks And Complications Can Bipolar Disorder Cause
There can be complications and risks for people who live with bipolar disorder. But these risks can be lessened with the right support and treatment.
What about suicide and self-harm?
You might have an illness where you experience psychosis, such as schizophrenia or bipolar disorder. Your risk of suicide is estimated to be between 5% and 6% higher than the general population.
You are more likely to try to take your own life if you have a history of attempted suicide and depression. It is important that you get the right treatment for your symptoms of depression and have an up to date crisis plan.
There is also research that suggests you are 30% – 40% more likely to self-harm if you live with bipolar disorder.
What about financial risk?
If you have mania or hypomania you may struggle to manage your finances. You may spend lots of money without thinking about the effect that it may have on your life.
You could make a Lasting Power of Attorney. This is a legal process. This means that you pick someone that you trust to manage your finances if you lack mental capacity to manage them by yourself.
You can work with your carer and mental health team. You can form an action plan. This can say what they can do if you have a period of mania or hypomania and you start to make poor financial decisions.
What about physical health risk?
What about alcohol and drugs risk?
If you want advice or help with alcohol or drug use contact your GP.
What about driving risk?
Bipolar Disorder And Anxiety
Anxiety is a common symptom of bipolar disorder, but about half of those with the condition have co-existing anxiety disorder. Find out more about the link between the two.
People with bipolar disorder often experience anxiety as a symptom of their condition. Anxiety accompanies the deep depressions and the manic highs, prompting symptoms that include:
- Compulsive behavior
- Physical distress such as shortness of breath, racing heart, nausea, sweating, shaking
- Having a hard time concentrating
However, many people with bipolar disorder also have a distinct anxiety disorder. Anxiety disorders occur when your worries or fears go on for months or even years. They continue whether or not there is any logical or sensible reason for them. You can become anxious just thinking about ordinary daily responsibilities and how youre going to get through the day.
Links Between Bipolar Disorder and Anxiety
Its well known that both bipolar disorder and anxiety disorder often occur together. Studies have found that around half of people with bipolar disorder also have some sort of anxiety disorder.
Diagnosing Bipolar Disorder and Anxiety Disorder
An accurate diagnosis of both bipolar disorder and anxiety disorder is needed to pursue the best treatment possible for the patient. Some clues that might indicate the presence of both disorders include:
Treating Bipolar Disorder and Anxiety Disorder
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When To Be Concerned
Garden-variety irritability can be a sign of bipolar depression if a relatively “little thing” such as a minor interruption explodes into a major annoyance for no obvious reason. In other words, the response is out of proportion to what appears to be the trigger. Depression can also cause persistent irritability that lasts for days or weeks at a time.
Can Bipolar Disorder Be Prevented
There is no known method to prevent bipolar disorder. Because its exact cause has not yet been determined, it is especially important to know its symptoms and seek early intervention. Regular and continued use of medication can help reduce episodes or mania and depression. Some people who experience bipolar disorder may become suicidal. By knowing how to recognize these symptoms, there is a better chance for effective treatment and finding coping methods that may prevent long periods of illness, extended hospital stays, and suicide.
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How Do I Get Help If I Think I Have Bipolar Disorder
The usual first step to getting help is to speak to your GP.
It can help to keep a record of your moods. This can help you and your GP to understand your mood swings. Bipolar UK have a mood diary and a mood scale on their website. You can find their details in the Useful contacts section at the bottom of this page.
Your GP cant diagnose bipolar disorder. Only a psychiatrist can make a formal diagnosis. Your GP may arrange an appointment with a psychiatrist if you have:
- depression, and
- ever felt very excited or not in control of your mood or behaviour for at least 4 days in a row.
They might refer you to a psychiatrist at your local NHS community mental health team .
Your GP should make an urgent referral to the CMHT if they think that you might have mania or severe depression. Or there is a chance that you are a danger to yourself or someone else.
Your GP should refer you to your local NHS early intervention team if you have an episode of psychosis and its your first one.
Bipolar disorder can be difficult to diagnose because it affects everyone differently. Also, the symptoms of bipolar disorder can be experienced by people who have other mental illness diagnoses. It can take a long time to get a diagnosis of bipolar disorder.
You can find more information about:
- NHS mental health teams by clicking here.
Do These Symptoms Sound Familiar
Generalized Anxiety Disorder symptoms include worrying very much about everyday things, knowing you worry much more than you should, having trouble controlling the constant worries, not being able to relax, having trouble concentrating, being easily startled, having trouble falling asleep or staying asleep, feeling tired all the time, having a hard time swallowing, trembling or twitching, having to go to the bathroom a lot, being irritable, sweating a lot, feeling light-headed or out of breath and having headaches, muscle aches, stomach aches or unexplained pains.
Phobias are strong, irrational fear of something that poses little or no actual danger. Being anxious and extremely self-conscious in everyday social situationssuch as eating or drinking in front of peopleare signs of a social phobia. People with phobias try to avoid what theyre afraid of, such as heights, public places, water or flying if they cant, they may experience panic, fear, rapid heartbeat, shortness of breath, trembling and a strong desire to get away.
Panic disorder is indicated by sudden and repeated attacks of fear that last for several minutes or longer. These panic attacks bring a fear of disaster or of losing control even when there is no real danger. A person may also have a pounding or racing heart, breathing problems, weakness or dizziness, tingly or numb hands, chest pain, stomach pain or feel hot or a cold chill. Panic attacks can occur at any time.
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