Mood disorders have long affected the United States, but diagnoses appear to have ramped up in recent memory. According to the World Health Organization (WHO), the prevalence of mood disorders like anxiety and depression increased significantly by 25 percent globally, highlighting the stress caused by the pandemic. Unfortunately, stressful circumstances often trigger the symptoms of bipolar disorder and worsen post-traumatic stress disorder (PTSD). Social isolation has led to the unprecedented stress many have experienced, which has been a major trigger for suicidal thinking.
PTSD is a more common condition than many of us would like to believe. According to the most recent statistics from the National Center for PTSD, an estimated 60 percent of men and 50 percent of women will endure at least one trauma in their lives. PTSD can occur any time after you experience trauma, which is a shocking and dangerous event that might happen to you and can lead to a host of mental health issues. Unfortunately, women are more prone to developing PTSD due to sexual assault and sexual abuse. In contrast, men are more likely to develop the disorder as a result of physical assault, accidents, combat, disorders, or witnessing severe injuries or death. The condition can happen to anyone.
While bipolar disorder is also more common than most would think, it’s not something anyone can endure as a result of an event. Although stressful situations can activate the condition, those who are genetically predisposed are more likely to develop the disorder. Millions of Americans struggle with mental illness each year – an estimated one in five – and 2.8 percent, or 7 million people, are living with bipolar disorder. Bipolar disorder, sometimes referred to as manic-depressive disorder, affects a person’s energy, mood, and activity levels. There is more than one type, and it can severely impact lives.
Mental illness impacts your body more than you might think – those suffering from depression have a 40 percent higher risk of developing cardiovascular disease than the general population. If you’re diagnosed with severe mental illness like bipolar disorder, you’re twice as likely to develop this issue. Another overlooked problem is the prevalence of substance use disorders (SUDs), which affect 32.1 percent of those with severe mental illness.
These are only a few of the impacts of mental illness, so learning more about PTSD, bipolar disorder, and the similarities and differences can save lives. The right treatment to manage symptoms can mitigate some of these risks. Let’s learn more about it below.
PTSD: What Is It?
Post-traumatic stress disorder (PTSD) is a sometimes severe or debilitating psychiatric disorder that occurs in those who experienced or witnessed trauma, including a terrorist attack, severe accident, combat, rape, or those threatened with death, sexual violence, or major injury. PTSD was once referred to as “shell shock” during World War I and “combat fatigue” after World War II. However, the more we’ve learned about the condition, it doesn’t happen to only combat veterans. The condition can occur to people of all nationalities, ethnicities, or cultures at any age. An estimated 3.5 percent of U.S. adults are impacted in a given year, and an estimated one in 11 will be diagnosed in their lives.
Like other mood disorders, the severity of the condition will vary from one person to the next. Those with severe PTSD will experience intense, disturbing thoughts or feelings long after the trauma has concluded. The individual will relive the event through nightmares or flashbacks, causing them to feel fear, anger, or sadness. Feelings of detachment from others are also common. A PTSD diagnosis can mean the person avoids people or situations that remind them of the event and will have adverse reactions to loud noises or accidentally being touched.
Symptoms fall into four categories.
Someone with intrusive thoughts, including distressing dreams, repeated and involuntary memories, or flashbacks, often note they’re so vivid that it’s like they’re right back in the traumatic experience. It’s extremely distressing.
Avoidance refers to avoiding reminders of the traumatic event. The individual will avoid friends, family, places, or situations that trigger stressful memories. They’ll do their best to avoid even thinking about the traumatic event as it can bring them right back to it. However, that may not be enough.
Altered Cognition and Mood
This refers to the inability to remember crucial aspects of the traumatic event or have negative thoughts or feelings that lead to distorted beliefs about oneself or others. Such thoughts include that no one can be trusted or that they’re a bad person. These distorted thoughts of the event can lead to blaming yourself or others – even when that’s the right thing to do. Ongoing fear, anger, horror, guilt, or shame can also follow. The individual will feel detached from others or be unable to experience positive emotions.
Alterations in Arousal
This set of symptoms refers to becoming irritable or having angry outbursts or behaving recklessly. The individual is easily startled, has problems concentrating or sleeping, and will become self-destructive.
Unfortunately, PTSD can be severe and lead to severe depression or suicide. PTSD is known to co-occur with mood disorders, such as bipolar disorder. Those with bipolar disorder are more likely to be diagnosed with PTSD than the general population.
Bipolar Disorder: What Is It?
The term manic depression was once used as a term for bipolar disorder. Bipolar disorder is a mental health condition that leads to extreme mood swings, including emotional highs called mania or hypomania and lows called depression. The condition is wrongfully portrayed in television and film, and it’s not uncommon to hear someone say, “stop acting so bipolar,” when referring to mood swings. While that’s a part of the condition, it doesn’t tell the whole story – it’s far more severe.
When you feel depressed, it can result in sadness, hopelessness, or a loss of interest in activities that once brought you pleasure or joy. When your mood becomes manic or hypomanic, you’ll become energetic and feel euphoric. These mood swings interrupt sleep, activity, energy, judgment, and other behaviors that enable you to think clearly. These mood swings can happen on some occasions or multiple times a year. Most people experience a few symptoms between episodes, while others experience none. Bipolar disorder is most commonly diagnosed in your teenage years or early 20s.
Bipolar disorder is a lifelong condition that requires treatment. However, symptoms can be managed by following a treatment plan set forth by a psychiatric doctor. You must determine the type of bipolar disorder before a treatment plan.
Bipolar I Disorder
Bipolar I disorder is characterized by having someone who has one manic episode that’s preceded or followed by hypomania or other major depressive episodes. On some occasions, the mania can trigger a break from reality, known as psychosis.
Bipolar II Disorder
Bipolar II disorder is characterized having one major depressive episode at one hypomanic episode. However, the individual has never had a manic episode. Contrary to popular belief, bipolar II disorder is not a milder version of bipolar I disorder – it requires a separate diagnosis. Those with this condition are depressed for months at a time, which can lead to significant impairment or suicidal thinking.
An individual with cyclothymic disorder has had at least two years, or one year for children and teenagers, of multiple periods of hypomanic symptoms and periods of depressive symptoms. However, these are often less severe than major depression.
Other Bipolar Disorder Types
This refers to bipolar and related disorders induced by drug or alcohol abuse or due to a medical condition, such as stroke, multiple sclerosis, or Cushing’s disease.
How Do PTSD and Bipolar Disorder Differ?
While PTSD and bipolar disorder represent two seemingly different mental health diagnoses, they share enough symptoms that often overlap and resemble one another, giving even the most experienced healthcare providers unique challenges. Diagnosis and treatment are often complicated. Knowing the key similarities and differences between PTSD and bipolar disorder are important. Below, we’ll examine some of the most pressing questions to help you understand what you’re dealing with and how to manage it.
PTSD and Bipolar Disorder: Similarities and Differences
Many symptoms of PTSD and bipolar disorder can appear similar on the surface. However, the two have many differences, including in the symptoms and the patterns they follow. For starters, bipolar disorder belongs to a category known as mood disorders. This means the symptoms are primarily related to your emotions and mood. These can also pop up in distinct episodes marked by dramatic changes in energy and mood.
The episodes referenced above are a mix of mania, depression, hypomania, or a combination of them known as a mixed episode. These can last for several days or weeks. However, depression can persist for several months. As mentioned earlier, it’s possible to experience no symptoms at all between episodes.
With PTSD, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies the condition as a “trauma-and-stressor-related disorder.” This means you will not develop PTSD unless you experience trauma, which is the complete opposite of bipolar disorder. PTSD also doesn’t involve symptoms of manic, including:
- Increased self-esteem, grandiosity, or self-absorption
- Feeling fine after little to no sleep
- Confusing speech
- A high characterized by euphoria and unusual energy levels
PTSD does involve irritability, as well as the tendency to take risks and be impulsive, which is often out of character for the person. These symptoms often occur with mania. PTSD also includes other trauma-specific symptoms, such as:
- Intrusive thoughts, memories, nightmares, or flashbacks
- Detaching or disconnecting from friends, family, or situations
- Trouble remembering the event
- Avoiding anything that reminds the person of the trauma
- Negative and pessimistic thoughts about yourself, others, and the world
- Physical response when remembering the trauma
PTSD and Bipolar Symptoms That Overlap
Unfortunately, PTSD and bipolar symptoms often overlap, providing even the most experienced with challenges when making a diagnosis. These include the following:
- Trouble sleeping – the rise of insomnia symptoms
- An inability to concentrate or focus
- Persistent low or negative mood, including worthlessness, fear, guilt, or anger
- Inability to experience positive emotions, such as love, affection, joy, or optimism
- Losing interest in daily activities
- Losing interest in hobbies
- Withdrawing from friends, family, and other obligations
- Suicidal thoughts
In PTSD, symptoms typically don’t begin immediately after you endure trauma. They often reappear when something triggers a memory of the event. However, once they do appear, they will not go away until you seek help. While they can briefly improve before turning, they can share characteristics of bipolar mood episodes.
PTSD and Bipolar Disorder: Can One Cause the Other?
There is no clear evidence that indicates PTSD causes bipolar disorder. However, there are links between the two. Despite extensive research, experts are unsure of what causes bipolar disorder but have found links between genetics, brain chemistry, and other environmental factors.
Some examples of environmental triggers include the following:
- Going through a breakup or divorce
- Dealing with extreme challenges at work
- Moving far away from home
Traumatic events can also create stress, both in the moment and later on, as you try to recover from the experience. Not everyone who encounters trauma will develop PTSD, bipolar disorder, or any mood disorders, but the lingering stress of trauma can lead to depression or anxiety. Childhood trauma can also lead to the development of complex PTSD (C-PTSD).
Research conducted in multiple studies found a link between childhood trauma and bipolar disorder. The research concluded that trauma didn’t only increase the risk of bipolar disorder; it led to more severe symptoms, including suicidal thoughts or attempts. Those diagnosed with traumatic stress also had a higher risk of developing bipolar disorder.
One interesting point brought up in the studies said that someone with bipolar disorder is more impulsive during a manic episode. These impulses can lead the individual to take risks that endanger their lives or cause traumatic events. These include:
- Driving too fast, which can cause a severe accident
- Fighting with your boss, which can result in termination
- Trying extreme sports with little regard for safety
These experiences can result in lasting trauma, which can put you under enough stress that leads to bipolar disorder symptoms or PTSD.
How Is PTSD Misdiagnosed and Bipolar Disorder?
Even experts make mistakes. Sometimes, mental health conditions are misdiagnosed, mostly because key symptoms overlap. Even more, the same symptoms could affect everyone differently. For example, many people feel they can get a lot done during a manic episode. It includes the following scenarios:
- You feel inspired to rush to the store, purchase all the necessary pieces to build a model car, then spend the entire night building the car and marveling at your work.
- Another person might start many projects all at once but leave them all unfinished.
Symptoms also fluctuate with time, so the picture the healthcare professional has at first is an inaccurate representation of how you are regularly. With PTSD and bipolar disorder, misdiagnosis happens. Even though they’re different, there are similar symptoms. For that reason, healthcare professionals will diagnose one as the other.
Another explanation is that PTSD doesn’t show up for several months after the event. When you begin experiencing emotional distress and changes in your emotions, you won’t associate them with the traumatic event because you’re so far removed from it. If you start therapy but don’t mention the trauma, the psychiatrist can’t connect the two. Abrupt mood changes and emotions trigger them to believe you’re having a manic episode, which is related to bipolar disorder. However, the reality of the matter is that it stems from your trauma that you’re not consciously aware of at that moment.
It’s not always easy to describe your symptoms. The stress you experience as a result of the traumatic event can remain vivid in your mind, but specific details might evade your memory. You might have difficulty recalling when these symptoms began and how long they persisted, proving to be extremely challenging.
Is It Possible to Have PTSD and Bipolar Disorder?
Unfortunately, it’s certainly possible to have both conditions – many people are struggling to contain both. There is evidence we mentioned earlier that PTSD increases the chances of developing bipolar disorder, while bipolar disorder can also increase your chances of facing a traumatic experience due to lowered inhibitions and increased impulses. A more recent study also supports the notion that each condition contributes to the other.
In the study, there were 212 participants diagnosed with bipolar disorder that received inpatient care. Of them, 72 percent had encountered some form of trauma in their lives prior to their diagnosis, while 35 percent of them had a PTSD diagnosis. PTSD occurs in around 16 percent of people with bipolar disorder, compared to about eight percent of the general population.
If you have both conditions, you must seek treatment to ease your symptoms. Some treatments can worsen symptoms. Professional help is the best option to manage how you feel.
Treating PTSD and Bipolar Disorder
Taking some medications to treat PTSD might trigger mania in someone with bipolar disorder. For that reason, precautions must be taken – you must speak to a medical professional before taking medication or self-medicating with drugs or alcohol. Below are the most common options for treating PTSD and bipolar disorder.
- Individual Psychotherapy: Individual psychotherapy consists of one-on-one meetings with a psychiatrist a few times a week. Speaking to someone can help immensely with what you’re going through. Most people won’t understand, but a psychiatrist can help you walk through your problems and find solutions. It’ll change your outlook and how you move forward. One such method to combat negative thoughts is cognitive behavioral therapy, which is an effective means of improving function and quality of life. CBT focuses on problems that produce unhelpful thinking, learned patterns of unhelpful behavior, and better ways of coping with your symptoms.
- Group Psychotherapy: Group therapy is an excellent means of treating PTSD and bipolar disorder. Being part of a group can be as helpful as individual therapy. It provides you with validation, how to learn from others, and social support. Some may not be receptive to the idea, but surrounding yourself with peers dealing with similar problems can remind you that you’re not alone and can overcome this.
- Medication: As mentioned above, the use of medications must be closely monitored. Antidepressants can cause manic symptoms, so they must be used in conjunction with other medicines. If you’re battling a chemical imbalance, the use of medication is vital in treating both conditions. Mood stabilizers target areas of the brain where the mood is disrupted, helping people find stability in their lives.