A person can have bipolar disorder and anxiety at the same time. When someone has both conditions, one may affect the other, and this will influence their treatment.

Bipolar disorder and anxiety disorders have high comorbidity. This means that they commonly occur at the same time.

According to one 2019 review, more than 50% of people with bipolar disorder will likely develop an anxiety disorder at some point in their lives. This can cause complications, including more severe illness, delayed diagnosis, and increased suicide risk.

Therefore, it is important for doctors to screen people regularly for both conditions.

Read on to learn more about the connection between anxiety and bipolar disorder.

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Anxiety disorders often occur alongside other mental health conditions. However, they are particularly common in people with bipolar disorder.

People with bipolar disorder are three to seven times more likely to receive an anxiety disorder diagnosis than the rest of the population.

People with bipolar disorder tend to have the following types of anxiety disorders:

Experts are not entirely sure why bipolar disorder and anxiety are connected. As the causes of many psychiatric conditions are not fully understood, and their respective diagnostic criteria can overlap, it may be difficult to distinguish between a person’s anxiety and bipolar disorder.

Some researchers theorize that certain anxiety disorders are overdiagnosed in people with bipolar disorder.

A 2014 study of people with comorbid bipolar disorder and OCD showed spurious comorbidity. This is when one condition only appears at certain times, indicating the two conditions do not exist independently.

For 78% of participants, OCD symptoms worsened during their depressive episodes. The study indicates that 64% saw symptoms improve or disappear during periods of mania or hypomania.

Although the link between bipolar disorder and anxiety disorders is not well understood, it is clear that it is prevalent.

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 lead to:

  • more mixed manic and depressive episodes
  • an increase in the severity of mood episodes
  • medication resistance
  • a greater risk of substance use
  • medication side effects
  • more psychological distress
  • poorer quality of life

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.

Treating one condition and not the other can be potentially harmful. For example, antidepressants are commonly prescribed as a first-line (first choice) treatment for anxiety. However, some antidepressants can destabilize the mood of a person with bipolar disorder and cause manic episodes.

When a doctor, psychiatrist, or psychologist is developing a person’s treatment plan, they will take multiple factors into consideration. Usually, medication and therapy form the basis of the treatment plan.

Medication

Initially, a doctor will likely prescribe a mood stabilizer or antipsychotic medication. These medications treat the symptoms of bipolar disorder.

They will assess the impact of the medication over several weeks and then decide if additional medication is needed.

Because antidepressants are an effective anti-anxiety medication, a doctor may prescribe a very low dose. They will do this carefully to avoid triggering a manic episode.

Therapy

There are several types of therapy that can help someone with bipolar disorder and anxiety. They include:

Cognitive behavioral therapy (CBT)

CBT teaches people to recognize patterns that can affect their behaviors and moods. Then, it gives them the psychological tools they need to deal with difficult situations.

Family therapy

The goal of family therapy is to reduce stress within a family unit. Stress can worsen anxiety and bipolar disorder symptoms, so it is important that people try to alleviate stressors as much as possible. Family therapy can help both the individual and their family members.

Interpersonal and social rhythm therapy

A person with bipolar disorder can have changes in mood that prevent them from completing day-to-day tasks and socializing. However, keeping steady social rhythms and habits helps stabilize mood. Interpersonal and social rhythm therapy teaches people to record their moods and activities, so they can plan for, and effectively manage, disruptions to their routine.

There are several support options for people with bipolar disorder and anxiety.

The Depression and Bipolar Support Alliance (DBSA)

DBSA is an organization that empowers people with bipolar disorder and anxiety. It has a range of free resources, including podcasts and videos, to help people and their loved ones.

Learn more about DBSA here.

MoodNetwork

MoodNetwork is a team of psychologists, researchers, and mental health advocates. They all have experience, either personal or professional, with bipolar disorder and anxiety.

They gather information and feedback from people with mood disorders and use it to research new treatment methods.

Learn more about MoodNetwork here.

People living with bipolar disorder are three to seven times more likely to experience an anxiety disorder. It is important that a healthcare professional recognizes when a person has both conditions to ensure a safe and effective course of treatment.

A person usually receives medication and therapy as part of their treatment plan. Support groups, such as DBSA and MoodNetwork, have excellent resources and provide a sense of community for people living with bipolar disorder and anxiety.