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Can Bipolar Disorder and Autism Co-Occur?

Is there a connection?

Bipolar disorder (BD) is a common mood disorder. It’s known by its cycles of elevated moods followed by depressed moods. These cycles can happen over days, weeks, or even months.

Autism spectrum disorder (ASD) is a range of symptoms that include difficulties with social skills, speech, behavior, and communication. The term “spectrum” is used because these challenges fall along a wide array. Each person’s signs and symptoms of autism are different.

There’s some overlap between BD and autism. However, the precise number of people with both conditions isn’t known.

According to one study, as many as 27 percent of children with autism show symptoms of bipolar disorder. However, other estimates say the real number may be much lower.

That’s because BD and autism share several common symptoms and behaviors. Some people with ASD may be mistakenly diagnosed as bipolar, when their symptoms are really the result of autistic behaviors.

Keep reading to learn how to recognize legitimate symptoms of BD. This can help you understand if what you or a loved one may be experiencing is BD or not. A diagnosis may not be clear cut, but you and a psychiatrist can work through the symptoms to determine if you have both bipolar disorder and autism.

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Research

What the research says

People who are on the autism spectrum are more likely to show signs and symptoms of bipolar disorder. They’re also more likely to be diagnosed with the psychiatric disorder than the typical population. However, it’s not clear what percentage or why.

Researchers know that bipolar disorder may be linked to your genes. If you have a close family member who has either bipolar disorder or depression, you have a greater chance of developing the condition. The same is true for autism. Specific genes or errors in genes may increase your risk for developing autism.

Researchers have identified some of the genes that may be connected with bipolar disorder, and several of those genes may be linked to autism, too. While this research is preliminary, scientists believe it may help them understand why some people develop both autism and bipolar disorder.

Symptoms

How do the symptoms compare?

Symptoms of bipolar disorder fall into two categories. These categories are determined by the type of mood you’re experiencing.

Symptoms of a manic episode include:

  • acting unusually happy, upbeat, and wired
  • increased energy and agitation
  • exaggerated sense of self and inflated self-esteem
  • sleep disturbances
  • being easily distracted

Symptoms of a depressive episode include:

  • acting or feeling down or depressed, sad, or hopeless
  • loss of interest in normal activities
  • sudden and dramatic changes in appetite
  • unexpected weight loss or weight gain
  • fatigue, loss of energy, and frequent sleeping
  • inability to focus or concentrate

The severity of autism symptoms differs from person to person. Symptoms of autism include:

  • difficulty with social interaction and communication
  • practicing repetitive behaviors that are not easy to disturb
  • displaying very specific preferences or practices that are not easily changed
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Recognizing mania

How to recognize mania in someone who has autism

If you think you or a loved one may have both bipolar disorder and autism, it’s important to understand how the conditions appear together. The symptoms of co-morbid BD and ASD are different than if either condition was by itself.

Depression is often obvious and easy to identify. Mania is less clear. That’s why recognizing mania in someone who has autism can be difficult.

If the behaviors have been a constant since symptoms associated with autism appeared, it’s likely not mania. However, if you noticed a sudden shift or change, these behaviors may be the result of mania.

Once you’ve identified when the symptoms appeared, look for the seven key signs of mania in people with autism.

Key signs of mania

  1. inflated self-esteem or feelings of exaggerated self-value
  2. unusually frequent or incessant talking
  3. focused, sometimes repetitive behavior that is difficult, if not impossible, to redirect
  4. taking part in pleasurable activities that ultimately have negative consequences, such as shopping sprees and foolish financial decisions
  5. being easily distracted by unimportant things
  6. racing thoughts and dramatically increased interest in some task or topic
  7. decreased need for sleep

See a doctor

What to do if you suspect bipolar disorder in someone with autism

If you think your symptoms or those of a loved one are the result of bipolar disorder, see your family doctor. They can determine whether an acute medical issue is responsible for the symptoms observed. If they rule out such a condition, they can refer you to a mental health specialist. While general practitioners are wonderful for many health issues, consulting with a psychiatrist or other mental health expert is best in this situation.

Make an appointment with one of these specialists. Review your concerns. Together, you can work to find a diagnosis or an explanation for the symptoms you’re experiencing, whether that’s bipolar disorder or some other condition.

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Diagnosis

Getting a diagnosis

Getting a diagnosis isn’t always a clear-cut process. In many cases, bipolar disorder in people with autism doesn’t meet the strict medical definition. That means your doctor or therapist may have to use other means and observations to make a diagnosis.

Before a bipolar diagnosis is made, your doctor may want to rule out other conditions. Several conditions often occur with autism, and many of them share symptoms with bipolar disorder.

These conditions include:

If your doctor begins treating you or a loved one for bipolar disorder when it’s not the real cause of symptoms, the side effects of the treatment can be problematic. It’s best to work closely with your doctor to reach a diagnosis and find a treatment option that is safe.

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Outlook

What to expect from treatment

The goal of treatment for bipolar disorder is to stabilize moods and prevent broad mood swings. This can stop problematic manic or depressive episodes. Someone with the disorder may be able to regulate their own behaviors and mood more easily if this happens.

Treatment can help people do this. Typical treatment for bipolar disorder is either psychoactive medications or anti-seizure mood stabilizers.

Lithium (Eskalith) is the most commonly prescribed psychoactive medication. However, it can cause significant side effects, including toxicity. For people with communication difficulties, which is common for people on the autism spectrum, this is a serious concern. If they aren’t able to communicate their symptoms, the toxicity may not be discovered until too late.

Anti-seizure mood stabilizer medicines like valproic acid are used, too.

For children with BD and ASD, a combination of mood-stabilizing medicines and antipsychotic medicines may also be used. These combo medicines include risperidone (Risperdal) and aripiprazole (Abilify). However, there is a significant risk for weight gain and diabetes with some antipsychotic drugs, so children on them must be monitored by their doctor closely.

Some doctors may also prescribe a family treatment intervention, especially with children. This combination treatment of education and therapy may help decrease severe mood swings and improve behavior.

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Support

How to cope

If you are a parent of a child with BD who’s also on the autism spectrum, know that you are not alone. Many parents face the same questions and concerns as you. Finding them and developing a community of support may be helpful for you as you learn to cope with the changes of your child or love one’s disorder.

Ask your doctor or your hospital about local support groups. You can also use web sites like Autism Speaks and Autism Support Network to find people in a situation like yours.

Likewise, if you’re an adolescent or adult dealing with this combination of disorders, finding support can help you learn to cope with the side effects of these conditions. A psychologist or mental health expert is a wonderful resource for one-on-one therapy. You can ask about group therapy options as well.

Asking for help from people who know what it’s like to be in your shoes can go a long way toward helping you feel empowered and capable of handling challenges you face. Because you’ll know you’re not alone, you may feel more enabled and capable.

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