6 Conditions That Can Go Hand-in-Hand With Bipolar Disorder


Co-occurring psychiatric conditions can be common alongside bipolar disorder and need to be diagnosed and managed concurrently. Here are six disorders that can accompany your bipolar diagnosis:

#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 disorder 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.

#2 Attention Deficit Hyperactivity Disorder

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 disorder exhibit alcohol abuse 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 disorder, 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.



  1. I have Bipolar 2 and my anxiety is always through the roof..my Bipolar is stable at the moment but my anxiety is always there..help!

  2. This is a great read and makes me feel like I am not crazy with most of these issues along with Bipolar. Luckily I dont have the issue with my menstrual cycle any more due to having a hysterectomy 8 yrs ago. Just one less issue to deal with. Having bipolar is a daily struggle and do not wish it on anyone even if it controlled. I battle MS and other medical problems aswell. I just hope that one day it is more understood by the general public and not have to be ashamed of it or hear others joke about it in a casual conversation!

    1. Diagnosed with BP @ 16 and now 45

      1. Mine was also linked to my cycle, after menopause I instantly switched to depression instead of mania

  3. Mental health is still such a taboo medical issue that medical professionals as well as health insurance agencies want to turn a blind eye too. Its frustrating to go your doctor and say you have some anxiety but are embarrassed to tell them that you are so depressed and it increases around the time of your period and because you have a feeling of stigma attached that you do not disclose that you have PTSD (because you have to have to have it verified and diagnosed) and that because of the awkwardness of it all you treat it yourself with alcohol. This is where we are failing to help those who need it the most. Sad. Hope the stigma changes soon.

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