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Anxiety and bipolar disorder

Most people feel anxious at times. And, it’s natural for a person’s mood or anxiety level to change when a stressful or difficult event occurs in his or her life. But, some people experience feelings of anxiety or depression, or suffer mood swings, that are so severe and overwhelming they interfere with their personal relationships, their work and their ability to function on a daily basis. These people may be suffering from an anxiety disorder, bipolar disorder or both.

It is not uncommon for someone with an anxiety disorder to also suffer from bipolar disorder or vice versa. In fact, the majority of people with bipolar disorder will suffer from at least one anxiety disorder at some point in their lives. The good news is that these disorders are both treatable – separately and together.

How can I tell if I have both an anxiety disorder and bipolar disorder?
According to Naomi Simon, MD, associate director of The Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital and assistant professor in psychiatry at Harvard Medical School, making a diagnosis of anxiety plus bipolar disorder can be confusing, and it is best to seek help from a mental health professional. But, Dr. Simon says, there are a few clues that may suggest the presence of both an anxiety disorder and bipolar disorder:

  • The presence of panic attacks and/or significant anxiety, nervousness or worry, or fearful avoidance of activities in addition to periods of depression and mania or hypomania.
  • The development of symptoms as a child or young adult (people with both disorders are more likely to report this, although it is not always the case).
  • Significant problems with sleep and persistent anxiety even when not in a manic state for those with bipolar disorder, and lack of response to initial treatment all may be clues that more than just an anxiety disorder or bipolar disorder alone are present.
  • Increased sensitivity to initial side effects of medication, and a sometimes longer time frame for finding the right medication combination and dosing (although, again, this is not always the case). (Sometimes starting at lower doses and increasing more gradually can help people get to the medication doses they need to get better.)

How is one affected by suffering from both disorders?
Suffering from both an anxiety disorder and bipolar disorder has been associated with poorer functioning, poorer quality of life, greater likelihood of substance abuse and greater likelihood of suicide attempts than suffering from one of the disorders alone. One of the common symptoms of an anxiety disorder, insomnia, is a major trigger for manic episodes and destabilization of bipolar disorder. This makes it essential for patients to be treated for both their anxiety disorder and bipolar disorder to fully achieve wellness.

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