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What is Bipolar with Comorbid Conditions?

Bipolar disorder rarely travels by itself. Learn more about other conditions often connected to bipolar disorder and the importance of an accurate diagnosis.

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A doctor looks at thingsWhen a person gets a mental illness diagnosis they likely receive a single label. You have bipolar disorder, you have schizophrenia, and so on. Doctors do their best to take the symptoms the person is suffering and find the best tick-box that describes the condition.

But as we all know, humans are not tick-boxes and people are more complex than singular labels. It is not uncommon, then, for a person to have more than one diagnosis at the same time. These are known as comorbid conditions, or dual diagnoses. The disorder most commonly comorbid with bipolar is addiction, but anxiety and other conditions are common too. Comorbidity in bipolar disorder is the rule, rather than the exception.

Comorbid Addiction and Bipolar Disorder

A lot can be said about addiction in the bipolar disorder population, but in simple terms, persons with bipolar disorder often use recreational drugs and alcohol to control their bipolar symptoms. Often this occurs before the person even gets a diagnosis of bipolar disorder. When people don’t know what’s wrong, they do the best they can to cope, and the best they can may include substance use.

Unfortunately, once substance use turns into abuse and dependence, the problem of handling addiction rears its ugly head. Without dealing with the addiction, the bipolar disorder cannot effectively be treated. And it’s critical to treat the addiction as those with substance use disorders are at greater risk for:

  • violent behavior
  • suicide
  • homicide
  • decreased quality of life

Comorbid substance use disorders were found in 61 percent of people with bipolar I and 48 percent of people with bipolar II disorders—this is the highest comorbidity of any psychiatric disorder.

Comorbid Anxiety and Bipolar Disorder

During a major study more than half of patients with bipolar disorder were found to have had an anxiety disorder at some point and over 30 percent were found to have a current anxiety disorder. People with bipolar disorder are at higher risk for:

  • generalized anxiety disorder
  • simple phobia
  • social phobia
  • obsessive-compulsive disorder
  • posttraumatic  stress disorder
  • panic disorder

Panic disorder may have the highest rate of comorbidity, particularly during mixed moods.

Other Disorders Comorbid with Bipolar

It is also being recognized that attention-deficit/hyperactivity disorder (ADHD) occurs more frequently in children with bipolar disorder and, in some cases, ADHD may be an early indicator of child-onset bipolar disorder. Personality disorders are also often regularly found within the bipolar population.

Medical conditions like migraine headaches, cardiovascular disease, and type 2 diabetes mellitus are also commonly comorbid with bipolar disorder.

Comorbidity Complicates Treatment

Unfortunately, comorbid conditions generally complicate treatment and indicate a less favourable prognosis. However, this is not to suggest that comorbidity necessarily rules out successful treatment and remission. The important point to remember is that recognition of comorbidity allows for treatment and increases the chances of a better outcome.

For references and more information, see the Psychiatric Times article Comorbidity in Bipolar Disorder.

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About the Author

Natasha Tracy is an award-winning writer who specializes in writing about bipolar disorder.

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