Co-occurring psychiatric conditions––like anxiety and addiction––often go hand-in-hand with bipolar disorder. What we need to remember is that these conditions require separate diagnoses and each have different treatment plans that manage symptoms and improve your quality of life. Here are six disorders that commonly accompany bipolar diagnoses:
#1 Anxiety Disorders
Anxiety as a symptom occurs during the course of illness for most people living with bipolar disorder and can resolve as part of the standard treatment. However, studies report that anxiety disorders are three to four times more common in bipolar with obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and panic disorder most consistent. Since anxiety disorders can worsen the course of bipolar, they generally require additional treatment.
About one-third of adults with bipolar disorder have co-occurring ADHD, as do up to 80 percent of children and adolescents, notes Stephen M. Strakowski MD, Chair of Psychiatry at Dell Medical School in Texas. “The decrease with aging in rates of co-occurring ADHD may be due to ADHD symptoms resolving over time. Alternatively, this decline in rates with age may represent a complex interplay between cognitive and brain development…”
#3 Personality Disorders
Studies have reported high rates of co-occurring personality disorder with bipolar. “Elevated rates of borderline, narcissistic, histrionic, obsessive-compulsive, and avoidant personality disorders are particularly common and occur in up to half of bipolar individuals,” Strakowski points out in his book Bipolar Disorder (Oxford University Press 2014). Personality disorders, he explains, generally require long-term and focused psychotherapies to gain improvement, in addition to treating the primary bipolar disorder.
#4 Alcohol Use Disorders
Studies show that up to half of people with bipolar consume alcohol excessively at some point in their life. “Alcohol abuse is associated with impaired treatment response, increased time in depression, increased risk of suicide, and worse functional outcome,” explains Strakowski. Therefore, health professionals would be wise to watch for evidence of alcohol abuse in their patients with bipolar disorder.
#5 Nicotine Use Disorders
Smoking seems to share common ground with bipolar, affecting up to 80 percent of individuals. This is concerning since cigarette use is associated with increased anxiety, as well as heart disease, stroke and cancer. Studies also show that people living with bipolar who smoke are less successful at quitting. Consequently, it’s extremely important for doctors to address nicotine use in the management of bipolar disorder.
#6 Other drug use disorders
In addition to the excess use of nicotine and alcohol, there is also an elevated abuse of illicit and prescription drug use associated with bipolar disorder. As Strakowski notes, the lifetime predominance of drug abuse in bipolar is three to six times greater than in people without bipolar disorder. Drug abuse significantly worsens the course of the disorder, adding to increased affective episodes and poor psychosocial recovery.
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