Many individuals who suffer from PTSD or bipolar disorder experience symptoms of the other condition as well. The prevalence of bipolar disorder among individuals with PTSD ranges from 6% to 55%, while the prevalence of PTSD among those with bipolar disorder is 4% to 40%.
For those dealing with PTSD or bipolar disorder, the existence of one of these conditions can exacerbate the symptoms of the other. Find out how comorbid PTSD and bipolar disorder affect each other.
The Relationship Between PTSD and Bipolar Disorder
Studies suggest that early childhood trauma may be an underlying factor in both conditions. PTSD occurs, on average, in about 16% of people with bipolar disorder, compared to just under 8% of the general population.
While research hasn’t shown that PTSD causes bipolar disorder, a genetic condition, it has shown that trauma may be a risk factor. According to a 2020 study, experiencing a traumatic event in childhood can increase the risk of developing bipolar disorder.
Though there is no evidence for either of the two conditions to directly cause the other, symptoms of bipolar disorder during episodes of mania–such as impulsivity, self-destructive and risk-taking behaviors, and poor judgment–can lead individuals to engage in potentially traumatic activities.
Another study revealed that patients with both PTSD and bipolar disorder are shown to have more severe symptoms, an increased number of hospitalizations, and a worsening in quality of life.
Risk Factors for Developing Either Condition
Several risk factors increase the odds of an individual developing either PTSD or bipolar disorder, with some of these factors influencing both conditions. The risk factors for developing bipolar disorder cover a range of biological, psychological, and environmental markers.
Genetics play a significant role in determining the risk of bipolar disorder–individuals whose parents have been diagnosed with a psychiatric disorder such as bipolar disorder, schizophrenia, or depression have an enhanced risk of developing bipolar disorder themselves.
In addition, the experience of childhood trauma is positively related to the occurrence and severity of symptoms of bipolar disorder. Cognitive deficits, altered brain structure, and irregular neural activity are also linked to an increased risk of bipolar disorder.
PTSD shares some of these risk factors, namely the experience of childhood trauma and a genetic predisposition to psychiatric disorders. Other risk factors include a family history of substance abuse, experiencing a harmful event or witnessing harm toward others, and having little social support following a traumatic event.
Symptoms of PTSD
PTSD develops after an individual experiences a traumatic event. Symptoms typically begin within 3 months of the event that triggered the disorder. Symptoms of PTSD include avoidant behaviors, such as staying away from places that trigger memories of the event or avoiding thoughts about the trauma experienced.
PTSD symptoms also include increased reactivity, which can manifest as being easily startled, having frequent outbursts, and consistently feeling tense. Individuals with PTSD may also face difficulty concentrating, difficulty falling asleep, and may engage in potentially harmful behavior.
PTSD may also affect an individual’s cognition and mood. This can cause them to lose interest in enjoyable activities, have negative thoughts about themselves or the world around them, or have trouble remembering key aspects of their traumatic experience.
Symptoms of Bipolar Disorder
Bipolar disorder involves shifting between episodes of hypomania, mania, and depression, with each phase lasting for several days or weeks. The symptoms are different for each of the three phases of bipolar disorder.
During a hypomanic phase, an individual may experience periods of over-activeness and increased excitability. This phase is typically mild and lasts a few days, though it can cause the individual to feel disconnected from the world.
After a hypomanic phase, individuals go through a period of depression. During this time, an individual can experience detachment from their loved ones. They may also feel an overwhelming sadness, face difficulties sleeping or concentrating, experience a lack of interest in enjoyable activities, and feel like they are experiencing life in slow motion.
A manic phase is more severe than hypomania and may last a few weeks. Mania can severely impact daily activities, though individuals often feel more productive during this phase. Symptoms of mania include intense feelings of joy or irritability, racing thoughts, talking fast, feeling unusually active, and having a reduced need for sleep.
During a manic episode, individuals may develop an inflated self-esteem, creating an exaggerated level of self-importance or an unrealistic sense of superiority. This can cause them to believe they can have supernatural abilities or achieve impossible things.
In addition, mania may lead an individual to behave impulsively and take part in unsafe activities, such as excessive spending, reckless driving, risky sexual encounters, or drug use. Severe cases of mania may require hospitalization, as individuals can experience hallucinations, delusions, and even seizures.
Misdiagnosing PTSD as Bipolar Disorder
Misdiagnosing Post-Traumatic Stress Disorder (PTSD) as Bipolar Disorder is a significant concern in the field of mental health due to the overlap in symptoms between the two conditions, such as mood swings, irritability, and difficulty with sleep. PTSD is a mental health condition triggered by experiencing or witnessing a terrifying event, while Bipolar Disorder is characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).
The misdiagnosis can occur because both disorders can present with symptoms of impulsivity, agitation, and mood dysregulation. However, the treatment and management strategies for PTSD and Bipolar Disorder differ markedly. For instance, while mood stabilizers and antipsychotics are often prescribed for Bipolar Disorder, PTSD is primarily treated with psychotherapy, such as Cognitive Behavioral Therapy (CBT), and may also include selective serotonin reuptake inhibitors (SSRIs).
Misdiagnosis can lead to inappropriate treatment, which not only fails to address the root cause of the patient’s distress but may also exacerbate their symptoms. Therefore, accurate diagnosis is critical to ensure that individuals receive the most effective treatment and support for their condition.
Treatment Options for Comorbid PTSD and Bipolar Disorder
Treating comorbid Post-Traumatic Stress Disorder (PTSD) and Bipolar Disorder presents a complex challenge, requiring a nuanced, integrated approach to address both conditions simultaneously. Given the distinct and overlapping symptoms of PTSD and Bipolar Disorder, treatment plans must be carefully tailored to manage the mood swings characteristic of Bipolar Disorder while also addressing the trauma-related symptoms of PTSD.
Pharmacotherapy often includes the use of mood stabilizers and atypical antipsychotics to manage bipolar symptoms alongside selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) that can be effective for PTSD symptoms.
Psychotherapy plays a crucial role, with evidence-based therapies such as Cognitive Behavioral Therapy (CBT) adaptable to treat both conditions. Trauma-focused therapies, like Prolonged Exposure (PE) or Eye Movement Desensitization and Reprocessing (EMDR), are also integral for addressing traumatic memories and reducing PTSD symptoms.
Additionally, lifestyle modifications, support groups, and psychoeducation are necessary adjunctive treatments, helping patients develop coping strategies and a supportive community. The complexity of treating comorbid PTSD and Bipolar Disorder underscores the importance of a personalized, multidisciplinary approach involving psychiatrists, psychologists, and other mental health professionals to optimize outcomes for affected individuals.
Start Bipolar Disorder or PTSD Treatment
At The Summit Wellness Group, we’re here to help patients overcome mental illness and substance abuse. If you’re struggling with comorbid PTSD and bipolar disorder or other issues, you don’t have to go through it alone.
Fight back with innovative treatment options that prioritize your well-being. To get started on your recovery, call our 24/7 helpline at 770-637-0579 or fill out our contact form.