Bipolar disorder is a lifelong mental condition that causes extreme shifts in mood. A person’s moods can change very quickly, and they may experience everything from high highs to low lows.
These shifts in mood can cause major changes in their energy and activity levels. The shifts can also interfere with their quality of life and daily activities.
Everyone experiences some anxiety from time to time, such as before taking a test or making a big decision. However, some people have anxiety disorders that cause them to experience more than short-term worries.
Anxiety disorders aren’t limited to specific life events and may worsen over time. Sometimes people with anxiety disorders have worries so severe that they interfere with their ability to carry out their everyday activities.
The various types of anxiety disorders include:
Anxiety disorders often occur alongside other mental health conditions, such as:
Most people with bipolar disorder have a coexisting mental health condition of some sort.
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A 2018 study found that anxiety disorder rates among people with bipolar disorder are 3 to 7 times higher than anxiety disorder rates among the general population.
Both conditions are treatable, but they’re long-term conditions that can sometimes be challenging to live with.
Some of the symptoms of bipolar disorder can be associated with an anxiety disorder. For that reason, it’s not always easy to separate an anxiety disorder diagnosis from a bipolar disorder diagnosis.
When an anxiety disorder and bipolar disorder co-occur, symptoms may worsen. According to experts, the impact of having both disorders may include:
- having an increased number of mood episodes
- seeing an increased rate of first episodes that are depressive episodes
- having an increased rate of episodes with mixed features (which are characterized by simultaneous symptoms of mania and depression)
- having an increased rate of rapid cycling (in rapid cycling, a person has at least four mood episodes a year)
- seeing an increase in the frequency and severity of mood episodes
- undergoing longer periods of untreated illness
- undergoing longer periods of time between remission
- having increased suicidal thoughts and making plans to die by suicide
- having an increased risk of substance use disorder
- experiencing an increase in severe negative events after taking medication
- experiencing an increased use of healthcare
- experiencing increased amounts of psychological distress
- having a poorer response to treatment
- having a more difficult time adhering to a treatment plan
- experiencing a decrease in functioning and quality of life
Both conditions can negatively affect a person’s quality of life and functioning.
People with both conditions have an increased chance of:
- manic episodes triggered by insomnia (insomnia is a symptom of the anxiety disorder)
- substance misuse
- suicidal thoughts and behaviors
Suicide prevention
If you think someone is at immediate risk of self-harm or hurting another person:
- Call 911 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline.
Try the National Suicide Prevention Lifeline at 800-273-8255.
Bipolar disorder and anxiety disorder are challenging to treat individually. Treating both kinds of disorders together is even more of a challenge.
Your primary care physician and mental healthcare provider will often work together to ensure you receive the best possible care.
Bipolar and anxiety disorders are typically treated with a combination of:
- medications
- individual psychotherapy
- couples therapy, depending on your individual situation
Doctors usually treat co-occurring bipolar and anxiety disorders with medication first. They may initially prescribe a mood stabilizer to address your bipolar disorder.
Medications
Medications used to treat anxiety may be part of your treatment.
This may include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac, Sarafem) and sertraline (Zoloft).
However, these medications can worsen manic symptoms. Your prescriber will monitor you very carefully for any signs of problems.
Often benzodiazepines will be prescribed. These drugs are commonly used to treat anxiety disorders, and they don’t appear to worsen bipolar disorder symptoms.
However, they may cause physical dependence and tolerance, increasing a person’s risk for substance misuse.
If benzodiazepines are recommended, they may only be used for a limited duration (such as 2 weeks).
Therapy
Therapy can be a safer way to treat anxiety in people who are already taking mood-stabilizing medications. It gives a person an alternative to using antidepressants, which may cause negative effects.
Some common types of therapy used to treat anxiety co-occurring with bipolar disorder include:
- Cognitive behavioral therapy (CBT). Cognitive behavioral therapy (CBT) is a short-term form of psychotherapy focused on changing behaviors to diminish anxiety.
- Family therapy. Family therapy can be used to reduce levels of distress within a family that may contribute to or be caused by a person’s symptoms.
- Relaxation techniques. Relaxation techniques can help a person develop ways of coping with stressors that affect anxiety and mood.
- Interpersonal and social rhythm therapy. This type of therapy involves scheduling and record-keeping. It may help a person with both conditions maintain stability and avoid changes in anxiety and mood.
Living with bipolar disorder is tough, but it can be even more challenging if you’re also living with an anxiety disorder. While these are lifelong conditions, it’s possible to treat both and increase your quality of life.
Once you begin treatment, make sure to communicate regularly with your healthcare providers.
Let them know if your medication or therapy seems less effective than usual or is causing any unpleasant or severe side effects.
Your healthcare team will help you find and adhere to an effective treatment plan that works best for you.