Bipolar and PTSD: What is the Connection?

As mental health conditions go, bipolar and PTSD are some of the worst commonly occurring ones. And it’s fair to say that they have a lot in common — maybe even enough to be connected.

Both bipolar disorder and PTSD can make normal social, professional and mental function difficult to achieve or sustain, and both can cause problems with relationships and other quality-of-life priorities. 

PTSD and bipolar disorder both have a variety of potential causes and risk factors that might cause them to occur in one person, while not occurring in another. And these conditions share enough similar symptoms that it can be hard to distinguish them without proper, professional analysis. 

Whether you’ve been diagnosed with bipolar disorder, post-traumatic stress disorder, both or neither yet, sorting out the differences and commonalities of these conditions can be difficult.

We’re here to help you navigate these questions the best that we can, but before we get into the gray areas, it’s important to understand both conditions in black-and-white terms.

The easiest way to understand the differences between PTSD and bipolar is to look at how they’re defined. So, let’s look at the definitions of these two mental health conditions side by side, and explore the ways they manifest in symptoms.

Bipolar Disorder

Bipolar disorder is a mood disorder, like depression. In fact, half of the symptoms of bipolar disorder are shared symptoms with depression. 

The easiest way to understand bipolar disorder is as a constant back and forth between mood extremes. A person with bipolar disorder has two distinct moods that characterize their disorder: manic (elated, energized, enthusiastic) and depressed (low, down, hopeless). 

Both can be problematic, especially when the episodes become extreme.

Manic episodes can include behaviors like:

• Agitation

• Boundary violations

• Intense euphoria

• Erratic or unpredictable behavior

Depressed episodes, meanwhile, often appear as:

• Emptiness

• Hopelessness

• Self-isolation

• Guilt

Depending on the type of bipolar disorder a person has, extreme mood swings between one and the other can happen suddenly or periodically. Four or more episodes over the course of a year is typically the minimum for a diagnosis of bipolar II. Psychotic features — paranoia, phobias and delusions — characterize the more extreme version of bipolar, known as bipolar I.

Post-Traumatic Stress Disorder

PTSD, meanwhile, is a psychiatric disorder similar to anxiety and panic disorders. While panic and anxiety are characterized by an overwhelming fear of potential threats and dangers in the future, PTSD sufferers are actually reliving past traumas whenever they have an episode.

Common symptoms of PTSD include:

• Nightmares

• Flashbacks

• Dissociation

• Sadness

• Guilt

• Irritability

• Increased startle responses and anxiety

• Avoidance

• Social impairment

PTSD is often caused by a traumatic event, which can mean anything from surviving an assault to experiencing a natural disaster and pretty much any “traumatic” event that can occur in between. 

There’s a lot of overlap in the symptoms of these two conditions. But apples and oranges are both sweet, tree-growing fruits, and the average person would readily point out that they are different in significant ways. 

So, can the seed of an apple grow an orange tree? Can PTSD cause bipolar, or vice versa?

Bipolar disorder and PTSD are most definitely connected. The question of “how?”, however, is very much unclear. 

For starters, science hasn’t fully explained how either of these conditions are caused. While we know certain risk factors increase your chances of developing one or both of these disorders, the data is far from clear on the details of how it happens. 

One 2017 study explored whether traumatic stress disorders can increase the risk of bipolar disorder in a nationwide population. It found that there was an association between the diagnosis of traumatic stress and subsequent bipolar diagnosis, suggesting that there may be a cause-and-effect relationship. 

It could be inferred from this that (as other research has shown) trauma can increase a person’s risk of developing a mood disorder like bipolar disorder. 

But that study stopped short of naming one such relationship, and further went on to explain that the relationship between PTSD and bipolar did not appear to be genetic.

We didn’t find any such research to suggest it can occur the other way around. Though PTSD and mood disorders often co-occur, it doesn’t appear to be the case that bipolar can cause or increase your risk of PTSD.

When you have both PTSD and bipolar disorder, your treatment plan can become quickly complicated. 

Each of these conditions has specific recommended treatments, but it’s also important to make sure that one doesn’t step on the toes of the other. 

For instance, your therapy for bipolar disorder shouldn’t unintentionally cause you to relive your traumatic event without proper support or experience with exposure therapy. 

Likewise, medications that are otherwise considered effective for PTSD treatment like antidepressants aren’t considered effective for bipolar disorder, and the National Library of Medicine explains that they should never be used by themselves in the treatment of bipolar disorder.

Here’s a closer look at recommended approaches to treating these two conditions.

PTSD Treatment Options

Treating PTSD is best accomplished by a combination of therapy and medication. Experts recommend trauma-focused therapy, which may include forms of therapy like cognitive behavioral therapy or desensitization. 

In both cases, the ultimate goal of therapy is to reduce the instances of reliving your trauma every time you think about it through repeated exposure to those feelings and sensations. 

Medication can help with the emotional element of this. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are both considered effective, though certain tranquilizers like trazodone can be used to treat PTSD’s notorious insomnia problems.

Bipolar Disorder Treatment Options

With bipolar disorder, a variety of medications are effective for treatment, but none of them are antidepressants. 

Depending on your needs, lithium and other mood stabilizers or antipsychotics might be exactly what you need to feel some relief and reestablished control over your life. 

Therapy, meanwhile, might take the form of anything from electroconvulsive therapy to cognitive behavioral therapy.

Psychoeducation has a generally beneficial effect on mental health in people with bipolar disorder along with pharmacotherapy, though long-term treatment can still be a challenge that might require more tailored options.

Bipolar disorder, PTSD, anxiety, depression — mental illness affects millions of adults around the world in a variety of forms. If you have one or the other, your treatment plan is going to be complicated and, frankly, it may take time to identify the appropriate approach. 

Treatment isn’t always a one-and-done process when it comes to mental health, and so you and your mental healthcare provider may need to experiment with a variety of medication combinations and therapy before you find what you need. 

All of this is why engaging a healthcare professional or mental health professional in your treatment plan is so important and essential. 

A professional will be able to assess your responses to different types of treatment and help you tailor an effective approach to your conditions. They’ll also help you make the tough choices based on your needs, like which condition to address first. 

Feeling overwhelmed? Not sure where to start? Take a look at our mental health resources and consider our online therapy platform for your needs.

Above all, take your mental health seriously, make it a priority, and get help for whatever disorder(s) you have today.