Although post-traumatic stress disorder (PTSD) and bipolar disorder are different conditions, it can be difficult to tell them apart because they share many of the same symptoms.
Below, we will explore their similarities and differences and how to tell the conditions apart. Whether you’re experiencing PTSD, bipolar disorder, or both, it’s crucial to seek the proper treatment as soon as possible.
What Is PTSD?
Post-traumatic stress disorder (PTSD) is a mental health condition triggered by witnessing or experiencing a terrifying event, such as a natural disaster, a serious car accident or injury, war or terrorist acts, the loss of a loved one, rape, or being threatened with death. It can also develop from repeated exposure to horrific events, such as what first responders often endure. PTSD causes people to relive their traumatic experiences through flashbacks and nightmares. Something like an unexpected touch or loud noise can trigger an episode.
The severity of the event doesn’t necessarily determine whether you will develop PTSD. For some, what others might consider a “minor” situation can be crippling. On the other hand, others can experience something considered earth-shattering and not develop PTSD.
People who suffer from PTSD may feel sad, fearful, and even angry. They may isolate themselves from loved ones because they feel no one understands what they’re going through.
PTSD is also referred to as combat fatigue or shell shock. These terms came about after World Wars I and II. While a disproportionate amount of combat veterans experience PTSD, it does occur in the general population as well. According to the National Center for PTSD, about six out of every 100 people (or 6% of the population) will experience PTSD at some point in their lives.
What Is Bipolar Disorder?
According to the Mayo Clinic, bipolar disorder, formerly known as manic depression, is a mental health disorder that causes extreme mood swings, including emotional highs (mania or hypomania) and lows (depression).
Mania and Hypomania
Mania and hypomania feature the same symptoms but are different types of episodes.
Mania is considered more severe than hypomania and causes obvious problems functioning at school, work, social settings, and in relationships. It can also trigger a psychotic episode and require hospitalization to be treated.
Both mania and hypomania involve at least three of the following symptoms:
- Impulsivity, such as extravagant shopping sprees, risky sexual behavior, or unwise investments
- Excessive and unusual talkativeness
- Euphoria (an exaggerated sense of self-worth and confidence)
- Feeling wired or abnormally upbeat
- High energy
- Less need for sleep
- Racing thoughts
- Easily distracted
Major Depressive Episode
A major depressive episode also causes difficulty functioning in normal life. An episode includes at least five of the following symptoms:
- Suicidal ideations
- Difficulty concentrating
- Feelings of guilt
- Either slowed behavior or restlessness
- Either sleeping excessively or insomnia
- Extreme weight loss or gain decreased or increased appetite
- Loss of interest in most or all activities
- Depressed mood—feelings of worthlessness, sadness, emptiness, or hopelessness (this can manifest as irritability in teens and children)
The common misconception is that bipolar disorder causes sudden mood swings. While it can cause dramatic mood changes, the episodes typically span a week or more. To be classified as a manic episode, an elevated mood must last for at least a week, while depressive episodes must last for at least two weeks.
Bipolar disorder is a complex condition, but with the right therapy or medication, it can be treated effectively.
How Are PTSD and Bipolar Disorder Related?
PTSD and bipolar disorder are very different mental health disorders. The disorders are in different categories in both the fourth and fifth editions of the DSM. While they are very different disorders, many mental health problems have overlapping symptoms. Plus, they may both increase your risk of mental or behavioral health disorders like addiction or depression.
PTSD and bipolar disorder may have some overlapping symptoms, including the following:
- Low energy levels. Depression can cause fatigue and low energy, but it may also be seen with PTSD. Since PTSD can cause insomnia, it can lead to fatigue during the day.
- Social isolation. This is common for many mental health issues. As symptoms start to get in the way of your life, you may withdraw to avoid shame, embarrassment, or additional stressors.
- Concentration problems. Mental health problems tend to dominate your mind, which can make it difficult to concentrate on anything else. Plus, specific symptoms may impair cognition.
- Insomnia. Sleeplessness or trouble falling asleep is common in both PTSD and bipolar disorder. Manic phases of bipolar disorder can limit your need for sleep, but it’s usually followed by a crash when the mania is over.
- Hypersomnia. Hypersomnia is sleeping for long hours or more than normal. It’s a common symptom of depression, which can accompany PTSD and bipolar disorder.
- Brain fog. Brain fog is a general term for lack of mental sharpness. It may also cause memory issues.
- Loss of interest. Loss of interest in most activities is a hallmark symptom of depression and depressive episodes of bipolar disorder. But a loss of interest can also occur with PTSD as it starts to weigh on your life.
- Suicidal thoughts. Suicidal thoughts are severe symptoms of many, many health issues. If you experience these thoughts, it’s important to seek help as soon as possible.
Other possible overlapping symptoms can include paranoia, restlessness, anxiety, hyper-vigilance, and restless thoughts. Both disorders may also lead to self-medication with drugs or alcohol, which increases your risk of a substance use disorder. While self-medication can offer temporary relief from symptoms in some cases, addiction and chemical dependency will more likely make your situation worse.
Substance use disorder, alongside mental health issues, can be complex. The two disorders can feed off of one another, and they will need to be treated at the same time. Treating one disorder while ignoring another can lead to limited treatment outcomes.
How Are They Different?
Bipolar disorder and post-traumatic stress disorder are both similar because they can cause some overlapping symptoms that are common among many mental health disorders. However, when you look closely, these disorders are very different. Bipolar disorder is sometimes called a mood disorder because it deals with a fluctuation of moods. In the DSM-5, it’s put in the unique category of “bipolar and related disorders.” Post-traumatic stress disorder is often grouped with anxiety disorders, but it too got its own category in the DSM-5 called trauma and stressor-related disorders.
Mental health disorders can have a complex set of factors as root causes. Bipolar disorder and PTSD may have some similar causes, but not always. PTSD always has a traumatic event at its root. Most symptoms will have something to do with that trauma, like nightmares or intrusive thoughts about the event. Someone with bipolar disorder may have experienced trauma in the past, but bipolar disorder can occur with no history of trauma.
Research is still being done to find out what causes bipolar disorder and why some people experience PTSD and other people who have gone through trauma don’t. Bipolar disorder may be caused by a mix of factors, including:
- Genetics. Genes passed down from your parents or grandparents may play a role in your risk for mental health disorders like bipolar disorder. Researchers haven’t pinpointed one gene that causes this disorder, but they have found that there is likely a genetic component to a person’s risk factors.
- Biology. There may be biological differences in the brains and bodies of people that have bipolar disorder. For instance, anomalies in brain structure may be a risk factor for certain mental health issues.
- Environment. Environmental factors can include your school, work, and home surroundings. This includes stress and trauma you may experience. It can also include exposure to drugs and alcohol, culture, and other factors.
PTSD and bipolar disorder may also have very different symptom profiles. For instance, mania is a unique effect of bipolar disorder that involves a week or more of a very high mood, high energy, sleeplessness, elation, and anxiety. PTSD can also cause its own unique symptoms like dissociative flashbacks that feel like you are re-experiencing a traumatic event.
Finally, the treatment options for these two disorders may be very different. Bipolar disorder is often treated with lithium, which isn’t used for PTSD. PTSD may require trauma-focused therapies that may not be necessary for bipolar disorder.
Getting Help for Bipolar Disorder and PTSD
PTSD and bipolar can become worse if left untreated. If you or someone you know has either disorder, consider getting professional help.
Once you’ve received an official diagnosis, a mental health professional can create a treatment plan that meets your unique needs. Your plan may include therapy, medication, or a combination of the two. Depending on the severity of your condition, you may need to receive treatment in an inpatient facility, which will provide the time and support needed to address your condition.