Common co-occuring disorders with bipolar

In this blog, we will explore the various aspects of bipolar disorder and answer the query, “What are the common disorders occurring with bipolar disorder.”

What are the common disorders occurring with bipolar disorder?

Many comorbidities are occurring with bipolar disorder. Some of them are psychosis, eating disorders, anxiety disorder, ADHD, Substance abuse, etc.

What is bipolar disorder?

Bipolar disorder is a mood disorder in which a person experiences extreme moods that range from high to low. These mood swings fluctuate irregularly. A person with bipolar disorder can fluctuate back and forth from both extreme mania and intense depressive episodes in a short period. 

There are types of bipolar disorders.  Some of them are as follows. 

Bipolar I

In bipolar I disorder, the presence of mania is the most important factor. In this disorder, people go through episodes of mania and depression. But interestingly even if the depressive period does not reach or cross the threshold for a major depressive episode, the diagnosis of bipolar I disorder is still valid.  

Bipolar II

In contrast to Bipolar, I in Bipolar II disorder people experience hypomania(a milder form of mania) instead of episodes of mania and the symptoms are also below the threshold for full-blown mania. But the periods of depression pass the threshold and meet the criteria for major depression.

Factors and Causes of Bipolar Disorder

Genetics

People who have a history of bipolar disorder are at an elevated risk of developing this disorder. 

Chemical factors

Research has suggested that deficiency of neurotransmitters norepinephrine or serotonin can cause depression and excess of these can cause mania. 

Hormones

Studies have found that abnormality of thyroid function has been consistently found to be in association with mood changes.  

Sleeping pattern

Disturbances in the sleeping pattern which can have an impact on the biological functioning of our body may have some effect on causing mood disorder

Traumatic events

Sometimes our life events that are stressful or traumatic can trigger the development of mood disorders.

Social factors 

Sometimes social interaction and support can also play a major role in affecting the development of various mental health disorders as it has a major impact on a person’s psychological health. 

Symptoms of Bipolar Disorder.

It is not simple to classify the symptoms of bipolar disorder as each person has varied experiences, responses, and symptoms. Also, it is a very complex disorder with a lot of overlapping of different moods. Bipolar disorder consists of manic episodes, depressive episodes, or/and mixed episodes. When symptoms of both mania and depression are displayed then it is called a mixed episode. The duration of these episodes and symptoms can last a week or two or sometimes even longer. The symptoms for most of the day during the episode.

To simplify things, the symptoms have been broken down into two parts.

Symptoms displayed during manic episodes

• Extreme elation or even irritation 
• More sensitive, paranoid
• Active 
• Rapid, unsettled thoughts
• Decreased sleep
• Accelerated Speech 
• Increased appetite 
• Insatiable urges
• Feeling energized and hyped up
• Feeling adventurous 
• Delusional thoughts about oneself 

Symptoms displayed during depressive 

episodes

• Extreme sadness,
• Fatigue.
• Restless
• Unable to concentrate
• Insomnia or hypersomnia
• Sluggish
• Suicidal
• Feeling hopeless 
• Feeling worthless
• Losing interest in activities 
• Diminished appetite

When a person is suffering from mixed episodes, they experience the symptoms of both episodes.

Common disorders co-occurring with Bipolar disorder.

Psychosis

In psychosis, a person experiences hallucinations and delusions. It is one of the commonly co-occurring disorders with bipolar disorder, and they tend to have matching symptoms. 

Even in manic episodes, a person can have delusional thoughts about oneself just that they are rich or important.

On the other hand, during depressive episodes, the person can have delusional thoughts that they aren’t good enough or everybody will leave them.

Substance Abuse

Due to the fluctuations the unpredictability of the disorder, it is very difficult to manage this disorder. The sudden and constant mood swing tends to create great psychological distress among people. Hence some turn to substance abuse either to distract themselves or because of the decreased inhibitions caused by their disorder.

Eating disorders.

Eating disorders like bulimia or even binge eating is another common disorder that occurs with bipolar. As discussed earlier, both increased and diminished appetite are symptoms of bipolar disorder. This makes people more susceptible to eating disorders.

ADHD

Attention Deficit and Hyperactivity Disorder have a lot in common with Bipolar disorder.

Racing thoughts, restlessness, an abundance of energy, and decreased concentration are some of them.

Anxiety Disorders

Anxiety disorders can be developed due to stressful situations that the person undergoes during their episodes. 

There are also physical illnesses that occur due to bipolar disorder. People get obese, have diabetes, migraines, heart-related illnesses, etc.

Diagnosis Criteria Of Bipolar disorder.

Bipolar disorder is diagnosed according to the criteria in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

To meet the criteria of bipolar disorder, a person must have experienced at least one episode of mania or hypomania.

• Criteria for Mania

Experiencing elevated, expansive, or irritable mood for at least one week and throughout the day. 

• Criteria for Hypomania

The episode should last at least four consecutive days and it should be present throughout those days.

Additionally three or more of the following symptoms is required to be present and represent a significant change from usual behavior:

• Inflated self-esteem or grandiosity
• Decreased need for sleep
• Increased talkativeness
• Racing thoughts
• Distracted easily
• Increase in goal-directed activity or psychomotor agitation
• Engaging in activities that hold the potential for painful consequences, e.g., unrestrained buying sprees

• Criteria for Depressive

According to DSM-5 a person needs to experience five or more of the following symptoms in two weeks to be diagnosed with a major depressive episode:

• Depressed mood most of the day, nearly every day
• Loss of interest or pleasure in all, or almost all, activities
• Significant weight loss or decrease or increase in appetite
• Engaging in purposeless movements, such as pacing the room
• Fatigue or loss of energy
• Feelings of worthlessness or guilt
• Diminished ability to think or concentrate, or indecisiveness
• Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt

Treatment of Bipolar Disorder

For the treatment of bipolar disorder, we have various options. As it is a clinical mental disorder and can be diagnosed only by either clinical psychologists or psychiatrists, it needs more than just regular counseling. 

Medications are often prescribed to patients to control the symptoms.

Following are the treatment options that have proven to be effective in the treatment helpful in bringing the  

Pharmacotherapy

Drugs such as antipsychotics, mood stabilizers, and antidepressants are utilized in the treatment. These drugs prove to be very effective in bringing the symptoms under control and giving the patient relief until the medications are in effect.

But medications can only be used for the treatments of the symptoms and not the disorder. For the treatment of the disorder, we need the help of psychotherapy. 

Electroconvulsive therapy 

For patients displaying immediate suicidal risk due to severely depressed mood then electroconvulsive therapy is used instead of antidepressants as they take 3 to 4 weeks to take effect. 

This treatment includes induced seizures that are administered under general anesthesia and muscle relaxants. ECT also works well for manic episodes. 

Transcranial Magnetic Stimulation (TMS)

This treatment technique is noninvasive and allows focal stimulation of the brain in wide-awake patients. But this procedure is not all painful, instead, it is painless even though thousands of stimulation are delivered in each treatment session.

Therapeutic Treatment

• Cognitive Behavior therapy 

Cognitive-behavioral therapy resolves dysfunctional behavior by altering negative thought processes and emotions.

Bipolar disorder is a mood disorder exhibiting dysfunctional behavior, CBT works very well for its treatment.

CBT works on it by breaking down the negative automatic thoughts and replacing them with positive, helpful thoughts. Thus by challenging those negative beliefs CBT manages to bring about changes in behavior. 

• Behavioral Activation Treatment

As in this disorder patients sometimes lose the motivation to engage in activities or their environment it is necessary to generate that motivation once again. This treatment method focuses on scheduling daily activities and asks the patients to rate these activities in terms of pleasure and mastery. This treatment is very action-based and requires the active participation of the patient. It also utilizes role play and encourages patients to think of alternative behaviors to achieve their goals.

• Interpersonal Therapy 

Though interpersonal therapy (IPT) has proven to be very effective with unipolar depression, it has been adapted for the treatment of bipolar disorder as well. This new, adapted version is called interpersonal and social rhythm therapy.

This therapy teaches patients to recognize the effects of interpersonal events on their social and circadian (sleep-wake cycle) rhythms and regularize them.

• Family and marital therapy

Our environment affects our mental health. If any distressing situations or events happen in our lives, those events can cause great psychological harm to our minds. Studies have proven that relapse in bipolar disorder can occur through stressful events happening in family life. This is very essential to deal with these negative aspects related to preventing the relapse of bipolar disorder.

Hence family and marital therapy are also one of the many treatment methods for bipolar disorder that helps by resolving family issues. 

Thus there are many treatment options available for helping with Bipolar disorder and people can lead a normal life with the right treatment and proper follow ups. 

Conclusion

We answered the query, “What are the common disorders occurring with bipolar disorder” and explored the various aspects of bipolar disorder.

Frequently asked Questions

What diseases are related to bipolar disorder?

People with bipolar disorder have an increased chance of having the following diseases

thyroid

migraine

headaches,

heart disease,

diabetes,

obesity, and other physical illnesses.

What is soft bipolar disorder?

Bipolar spectrum disorder—also known as “subthreshold bipolar disorder” or “soft bipolar disorder”—is diagnosed with many symptoms of bipolar disorder. Still, not all criteria fit the scientific definition of the illness.

What is atypical bipolar disorder?

Atypical bipolar comes under the bipolar spectrum and is characterized by mixed states, rapid cycling, and a lack of full recovery between episodes. These patients are more responsive to anticonvulsants and atypical antipsychotics, but lithium should not be ruled out as it may work for them as well.

What is a bipolar spectrum?

The bipolar spectrum is a term used to refer to conditions that include bipolar disorder as described traditionally (that is, clear episodes of mania or hypomania and depressive syndromes) and other types of mental conditions that can involve depression or mood swings without manic or hypomanic.

Is bipolar a part of autism?

Research suggests that bipolar disorder may be relatively common among children and adults with autism, as many other psychiatric disorders. Some studies have found that as many as 27 percent of those with autism also have symptoms of bipolar disorder.

References

NIMH » bipolar disorder. (n.d.). NIMH » Home. https://www.nimh.nih.gov/health/publications/bipolar-disorder

7 of the most common co-occurring disorders. (n.d.). On Demand Counseling. https://ondemandcounseling.com/blog/7-most-common-co-occurring-disorders/

Bipolar disorder – Symptoms and causes. (2021, February 16). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955