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Bipolar disorder and anxiety as co-occurring conditions

It is not uncommon for someone with bipolar disorder to have a co-existing anxiety disorder. For a person with these co-occurring conditions, it is crucial they get the correct diagnosis so that they are able to access the right treatment for both disorders, and manage them effectively.

If you are uncertain about whether you have an anxiety disorder and bipolar disorder, we have outlined the symptoms of these co-occurring conditions, and the steps to take if you believe that you have both. We have also looked at the type of treatment recommended for those with the co-existing disorders, as well as self-care techniques to help better manage these conditions.

Possible symptoms of co-occurring bipolar disorder and anxiety disorder

If you have a bipolar disorder and experience symptoms of anxiety, do not ignore them. Discuss them with your doctor or psychiatrist, as co-occurring anxiety symptoms in those with bipolar disorder can have a substantial impact on the course of the illness. The presence of co-morbid anxiety in people with bipolar disorder can also affect treatment options, so an accurate diagnosis is important.

If you are concerned that you have co-existing anxiety and bipolar disorders, you are likely to experience the following symptoms:

  • Panic attacks and significant anxiety
  • Avoidance of certain experiences due to intense fear
  • Periods of depression and mania or hypomania
  • Problems with sleep and anxiety, even when you’re not in a manic state

A person with both conditions may also suffer from low confidence and self-esteem due the severe effect that their conditions can have on their quality of life. They may have even started to abuse substances in an attempt to mask or dull how they feel, which is very dangerous.

Treatment options for co-occurring bipolar and anxiety disorders

When receiving treatment for bipolar and anxiety disorders, it is important that any medication and therapy is suitable for both conditions.

Antidepressants, which are a mainstay pharmacological treatment for anxiety disorders, can adversely affect the course of bipolar disorder. They can destabilise the mood of the person with bipolar disorder and cause hypomanic or manic episodes. Therefore antidepressants are better avoided.

For a person with bipolar disorder and co-occurring anxiety, a doctor is likely to use the most appropriate mood stabiliser, alongside suitable treatment for their co-morbid anxiety which may include utilising appropriate medication or treating anxiety with psychotherapy. Cognitive behavioural therapy (CBT) and relaxation training can be useful for those with bipolar disorder looking to manage their anxiety.

Self-care tips for managing bipolar and anxiety disorders

Self-care can also be a big part in managing bipolar and anxiety disorders simultaneously, helping you to better understand and reduce your symptoms. Try incorporating the following recommendations into your weekly routine.

  • Meet up with family and friends – your anxiety may leave you feeling as though you want to isolate yourself, but it is important to get out of the house and speak to others. You could meet up with someone you trust to talk about your worries and work out solutions together. A good catch-up can also distract you from your symptoms and boost your mood
  • Exercising regularly – the chemicals released into your brain as you exercise can be a great mood stabiliser. Try to get outside and do some form of exercise that you enjoy for 30 minutes, 3 times a week
  • Establish a good sleep routine – insomnia can be a trigger for manic episodes so it’s important to establish a good sleep routine. Wake up and go to sleep at similar times every day, even at weekends, and try not to nap during the day. Also, avoid using electronic devices in the hours before you go to sleep, or when you are in bed
  • Avoid alcohol and drugs – you may try to self-medicate using drugs and alcohol. But this can aggravate your symptoms, worsen mood disorders and lead to addiction issues

Treatment and support at Priory Hospitals and Wellbeing Centres

At Priory, we support people with bipolar and anxiety disorders in many ways. Our outpatient services give you the opportunity to set up a series of hourly sessions with an experienced consultant, psychologist or therapist to help you better manage your symptoms in everyday life.

Our inpatient options are also available for those finding their co-morbid bipolar and anxiety symptoms particularly debilitating. During a hospital stay, you take part in a psychological group programme and attend regular sessions with an experienced consultant to help you learn ways to better manage the co-occurring disorders going forward.


Blog reviewed by Dr Ashraf Nasr (MBChB, MRCPsych, FRCPsych), Consultant Psychiatrist at Priory Hospital Woodbourne

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