Bipolar and Anxiety:(A Comprehensive Guide)

Bipolar and Anxiety

Bipolar and anxiety are both common disorders these days.

However, due to lack of knowledge mostly people are unaware of their In this article we will discuss  Bipolar and Anxiety.  

Bipolar and Anxiety Disorder

Bipolar disorder or manic depression is a psychological illness which is manifested by extremely high and low moods.

The state in which a person has a high mood is known as Mania and the low mood state is called Depression.

Actually there are two (high and low) poles of mood that is why this disorder is named as Bipolar disorder.

When people with bipolar disorder have manic episodes they tend to feel extreme happiness, liveliness, energy, excitement, confidence and when they have depressive episodes they feel extreme sadness, hopelessness, and lethargy.

During manic episodes some people may have hallucinations (false perception) or delusions (false and rigid belief).

Bipolar and Anxiety:(A Comprehensive Guide)

Types of Bipolar Disorder

  • Bipolar I: In this disorder there is at least one manic episode and often depressive episodes. 
  • Bipolar II: In this disorder there is at least one hypomanic (less severe form of mania) episode and often depressive episodes.
  • Cyclothymic Disorder (Cyclothymia): In this disorder there are periods of hypomanic and depressive episodes for at least 2 years. 

Symptoms of Bipolar Disorder

In Bipolar disorder there are different patterns of symptoms and vary from person to person. 

Symptoms of Manic episode

  • Extreme happiness
  • Increased energy
  • Hopefulness
  • Over Excitement
  • Impatience or Impulsiveness
  • Flight of  ideas or thoughts
  • Poor attention
  • Less sleep time
  • Talkativeness 

Symptoms of Depressive episode

  • Extreme sadness
  • Less energetic
  • Feelings of worthlessness
  • Hopelessness 
  • Loss of interest 
  • Insomnia or hypersomnia 
  • Weight gain or weight loss
  • Suicidal ideation
  • Feelings of loneliness

Symptoms of Hypomanic episode

The symptoms of hypomanic episodes are the same as mania but their intensity is less than manic episodes and more than depressive episodes. 

Causes of Bipolar Disorder

Bipolar disorder usually starts during early adulthood and it can also appear in childhood.

It equally affects men and women but women are more likely to get bipolar disorder than men.

There is not a single cause of bipolar disorder. There are numerous risk factors which are involved in causing bipolar disorder.

For example,

Bipolar and Anxiety:(A Comprehensive Guide)

Alcohol or drug abuse: Use of drugs or alcohol addiction leads to developing bipolar disorder.

People, who are in extreme depression, use drugs as a source of relaxation but it becomes an addiction for them. 

Genetics: Bipolar disorder runs in families. Several researches have proved that people having family history (parent or sibling) of bipolar disorders are more prone to develop bipolar disorder than people who don’t have family history of bipolar disorders. 

Brain structure: Studies have shown that people with bipolar disorder have different brain structures or abnormalities than people who don’t have bipolar disorder.

Stressful or traumatic experiences: Studies have suggested that people who go through any stressful or traumatic experience (i.e., death of any family member or loved one, physical or psychological abuse etc.) are likely to have bipolar disorder.

Anxiety

Anxiety is defined as a feeling of uneasiness, extreme worry and fear. It’s a natural reaction of the body during stressful situations.

Anxiety disorder is an umbrella term for a number of anxiety disorders. 

Types of Anxiety Disorders

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) anxiety disorders include disorders which have common features of intense fear, anxiousness and behavioral disturbances. 

Phobia

It is defined as excessive or intense distress or fear of certain places, objects or situations.

A person experiences an extreme level of distress in a phobic situation. It has three types: Social phobia (fear of social gatherings), Specific phobia (fear of specific objects such as mountains, water, animals etc.) and Agoraphobia (fear of open places). 

Generalized Anxiety Disorder

It is a less severe form of anxiety disorder. The person generally feels anxiety in everyday life situations.

It is a chronic condition and a person experiences distress and persistent worry about some objects, situations or places.

Bipolar and Anxiety:(A Comprehensive Guide)

Obsessive Compulsive Disorder

This disorder is characterized by persistent or recurrent thoughts and repetitive behaviors.

The person suffering from obsessive compulsive disorder realizes his or her actions are illogical but he or she doesn’t have control on these thoughts and behaviors.

It has many forms such as cleaning objects, washing hands, checking doors or locks, ordering or sequencing objects etc. 

Post traumatic Stress Disorder

It occurs after experiencing or witnessing stressful or traumatic life events. The stressors which can trigger post traumatic stress disorder include: death of a family member or a loved one, environmental disasters, physical or psychological abuse etc.

Acute Stress Disorder

It is a less severe form of post traumatic stress disorder.

If a person experiences symptoms of anxiety after a stressful or traumatic event within days and symptoms disappear after at least a month, then this is called acute stress disorder. 

Separation Anxiety Disorder

It is an anxiety disorder which is characterized by excessive fear or distress about separating from home or from the people (e.g. parents, siblings, friends etc.) with whom the person has strong emotional bonding or attachment.  

Illness Anxiety Disorder

In this disorder a person fears about getting sick or having an illness.

A person perceives that the minor symptoms or bodily changes are signs of a disease.

Symptoms of Anxiety Disorders

Most common symptoms of anxiety include:

  • Irritability
  • Intense fear
  • Rapid heartbeat
  • Shortness of breath
  • Sweating
  • Muscle tension
  • Sleep disturbance
  • Numbness 

Causes of Anxiety Disorder

Studies have found both environmental and biological factors for anxiety disorders. The risk factors may vary from person to person.

The possible causes of anxiety disorders are given below:

Genetic factors: Anxiety disorder is more common in people who have a parent or a sibling with this condition.

A person with a family history of anxiety disorder or other psychological disorders are more prone to anxiety disorder. 

Environmental Factors:  People who experience stressful or traumatic life experiences in any phase of life tend to develop anxiety disorder later in life.

Physical illness: Some physical diseases such as heart arrhythmias or thyroid problems can cause anxiety symptoms.

Drug addiction: Drug or substance abuse lead to anxiety disorder.

Bipolar and Anxiety

Bipolar and Anxiety disorder are related with each other. There are usually two possibilities.

Firstly anxiety itself can be a symptom of bipolar disorder. Secondly a person can have both bipolar and anxiety disorder.

In medical terms, this is called comorbidity.

It means both disorders are present independently i.e., anxiety disorder is separate which is not triggered by bipolar disorder.

During manic episodes a person becomes, irritable or anxious than in a depressive episode. 

Manic episodes activate the autonomic nervous system causing rapid heartbeat, increased breathing or high muscle tension which indicates that the bipolar and anxiety disorder are related.

The researches have shown that people with bipolar disorder are likely to have anxiety disorder.

The most common anxiety disorders which are associated with bipolar disorder are Generalized Anxiety Disorder, Post traumatic Stress Disorder and Separation Anxiety.

People with Bipolar and Anxiety disorder have greater functional dysfunction, increased risk of suicide and decreased quality of life.

Patients with Bipolar disorders and anxiety disorder can also develop other medical or psychological illnesses such as: Heart diseases, Migraine, Thyroid problems, Obesity, Diabetes, Anxiety disorder, ADHD, Substance abuse disorder, Eating disorders etc.

A study reported that most of the people having bipolar disorder also experience anxiety disorder during their life.

There are treatments for both of these disorders but sometimes they get worse to be treated.  

Sometimes it gets difficult to distinguish between bipolar and anxiety disorder because some of the anxiety symptoms are related with bipolar disorder.

The following symptoms are the same in both bipolar and anxiety disorder.

  • Irritability 
  • Panic attacks 
  • Uneasiness
  • Avoiding situations or places which can cause anxiety by showing hypomanic, manic or depressive symptoms. 
  • Difficulty in sleeping
Bipolar and Anxiety:(A Comprehensive Guide)

Treatment and Prevention

Treatment of both Bipolar and anxiety disorder is a great challenge.

The general practitioner and psychologist often work together to make sure that the patient gets the best possible treatment for bipolar  and anxiety disorder.

To cure bipolar and anxiety disorder, a combination of treatments are used. 

Medications: The patients with bipolar and anxiety disorder mainly get medications first.

They are prescribed with mood stabilizers to treat bipolar disorder. The medications include: lithium, Tegretol, Zyprexa etc. 

Cognitive Behavior Therapy (CBT): It is a type of psychotherapy which focuses on changing cognitions and behaviors to treat bipolar and anxiety disorder.

Family therapy: This form of psychotherapy is used when there is distress in the family members or a person with bipolar disorder has developed symptoms because of family issues.

Relaxation Techniques: The patients with bipolar and anxiety disorder are recommended to perform deep breathing or other relaxation techniques.

These techniques help a person to cope with stressors.

Conclusion

Bipolar disorder or manic depression is a psychological illness which is manifested by extremely high and low moods.

Bipolar disorders are related with Anxiety disorder. There are usually two possibilities. Firstly anxiety itself can be a symptom of bipolar disorder.

Secondly a person can have both bipolar and anxiety disorder. If a person shows symptoms of bipolar and anxiety disorder, he or she must consult a doctor, a psychiatrist or a psychologist.

They will inquire about psychological illnesses.

The person should also get a complete medical or psychological examination to confirm if he or she has a bipolar disorder or any other medical or psychological illness.

FAQs about Bipolar and Anxiety

How do bipolar people act?

When people with bipolar disorder have manic episodes they tend to feel extreme happiness, liveliness, energy, excitement, confidence and when they have depressive episodes they feel extreme sadness, hopelessness, and lethargy.

Is anxiety part of mania?

During manic episodes a person becomes agitated, irritable or anxious than in a depressive episode. 

Manic episode activates the autonomic nervous system causing rapid heartbeat, increased breathing or high muscle tension.

The research has shown that people with bipolar disorder are likely to have anxiety but there is also some evidence which suggests that anxiety disorders are the risk factors of bipolar disorder. 

Can a person become bipolar later in life?

However, several people with bipolar disorder don’t accept or apprehend they have developed bipolar disorder.

They don’t get treatment for that.

Some studies have suggested that if bipolar disorder doesn’t get treated, it gets worse with the passage of time.

Moreover, anyone can develop bipolar disorder with time.

References

webmd.com/bipolar-disorder/mental-health-bipolar-disorder#3

mayoclinic.org/diseases-conditions/bipolar-disorder/symptomscauses/syc-20355955

nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

healthline.com/health/bipolar-and-anxiety

nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

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Daniela Paez is a Clinical Psychologist with an MSc. In Clinical Neuropsychology from Bangor University. She has vast experience in working with children with disabilities, adolescents and their families, in extreme conditions of poverty and vulnerability. Additionally, she owns a private practice where she provides neuropsychological evaluation for children and adults, and treatment for mood disorders, anxiety, couple therapy, among other conditions.