Post-traumatic stress disorder (PTSD) and bipolar disorder (BD) commonly occur together, which may indicate a link. However, experts do not know whether one causes the other.
Researchers theorize that one condition may predispose a person to the other. They also believe that certain physiological changes may contribute to the development of both conditions.
Read on to learn more about the possible link between PTSD and bipolar disorder.
PTSD is an anxiety disorder in people who have experienced a shocking or dangerous event. It involves flashbacks and recurring memories of the event, along with distressing thoughts and physical signs of stress.
In contrast, BD involves marked shifts in a person’s activity, mood, energy, and concentration.
One explanation is that there is a pathophysiological link. This means atypical effects in the body cause the conditions. Anxiety disorders may be predisposing factors to BD or vice versa.
Another theory is that rather than a factor that increases the risk, pathophysiology contributes to the development of both BD and anxiety disorders.
The pathophysiology may involve:
- disturbances in neurotransmitters, which are chemicals that transmit messages between nerve cells
- changes in synaptic plasticity, which is the ability of junctions between nerve cells to weaken or strengthen in response to alterations in their activity
- functional and structural brain changes
The study authors cite several studies suggesting that early childhood trauma may underlie both conditions.
Below are the symptoms of PTSD and BD.
PTSD symptoms typically start within
- avoidance symptoms, such as staying away from places that are reminders of the event or avoiding thoughts about the trauma
- arousal and reactivity symptoms, such as:
- being easily startled
- having difficulty concentrating
- having angry outbursts
- feeling tense
- having difficulty going to sleep
- engaging in potentially harmful behavior
- cognition (thinking) and mood symptoms, such as
- having negative thoughts about self or the world
- losing interest in enjoyable activities
- having trouble remembering key features of the event
Bipolar disorder symptoms
Mania symptoms include:
- feeling joy or irritability
- having a reduced need for sleep
- racing thoughts
- talking fast
- feeling wired or unusually active
Depression symptoms include:
- feeling sad
- having sleep difficulties
- having difficulty concentrating
- feeling slowed down or talking very slowly
- having a lack of interest in activities
The following are the risk factors of PTSD and BD:
PTSD risk factors
- having a previous traumatic event, particularly in childhood
- having little social support following the event
- getting hurt or seeing people hurt or killed
- having a personal or family history of mental illness or use of harmful substances
Bipolar disorder risk factors
Inheriting one of many genes
Another risk factor is the possibility that the brain structure and function of someone with BD differs from that of a person who does not have the condition.
Diagnosing co-occurring mental health conditions poses a challenge, so recognizing that both conditions are present may cause delays. Because of the significant frequency of co-occurrence,
A hierarchical method means identifying which condition is primary and then comprehensively treating it before addressing the secondary condition.
However, it is more common to use the sequential method. In this strategy, the initial focus is on mood stabilization. It involves the step-by-step addition of medication and psychosocial treatments that a person needs.
People with PTSD who believe they may also have BD should ask if they need screening for it. The reverse is also true.
If someone receives a diagnosis of both conditions, they may consider asking:
- Which condition is the primary one?
- What treatment do I need?
- How long may treatment be necessary?
- What benefits and side effects may I expect from treatment?
There may be an association between PTSD and bipolar because it is not unusual for people with one condition to have the other.
Despite the potential link, research
Since diagnosing the co-occurrence poses a challenge, if a person has PTSD, they should undergo screening for BD, and someone with BD should have screening for PTSD.