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Bipolar disorder complications

Substance use disorders are one of the most common complications of bipolar disorder. A 2019 study involving more than 316,000 people with bipolar disorder found that more than half had a substance use disorder.

Alcohol use disorder is the type of substance use disorder that most commonly affects people with bipolar disorder. However, the use of cannabis or other recreational drugs is not uncommon.

People with bipolar disorder may use these substances in an attempt to relieve manic and depressive symptoms. However, these individuals may have an increased risk of addiction. Researchers propose that this is due to bipolar disorder and substance use disorders sharing genetic factors and both affecting the parts of the brain related to impulsivity and reward.

Although substance use may seem to provide temporary relief from bipolar disorder symptoms, it does not treat the underlying cause of the disease. In fact, it often makes bipolar disorder symptoms worse.

Following a treatment plan for bipolar disorder may help prevent substance use disorders from developing or improve a person’s outcome. A psychiatrist can help adjust a person’s treatment plan if their current regimen is not controlling their bipolar disorder symptoms sufficiently.

They might also suggest using medication or cognitive behavioral therapy to help manage the symptoms of addiction.

About 4 in 10 people with bipolar disorder will also receive an anxiety disorder diagnosis at some point in their life.

It can sometimes be challenging to distinguish the symptoms of an anxiety disorder from those of bipolar disorder. A person with bipolar disorder may also have anxiety if they experience:

  • panic attacks, anxiety, or nervousness between episodes of depression and mania
  • significant sleep problems and anxiety when not in a manic state
  • difficulty adjusting to medication side effects and finding the right dosage of medications

Anxiety symptoms do not respond to bipolar disorder treatment. Untreated anxiety may also increase the likelihood of developing a substance use disorder.

People who experience anxiety symptoms outside of manic and depressive episodes should talk with a psychiatrist. Although it can be difficult to prevent anxiety from occurring, medication or cognitive behavioral therapy can often treat the symptoms effectively.

Migraine is a common complication of bipolar disorder, with close to one-third of people with bipolar disorder experiencing migraine headaches. Experts believe that inflammation plays a role in both conditions.

People with bipolar disorder and migraine tend to have more frequent and more severe depressive episodes than people without migraine, having a more significant effect on overall mental health.

A primary care provider or neurologist can help determine whether medication is necessary to manage migraine symptoms. Using a headache journal to track migraine episodes may also help identify potential migraine triggers that people can then avoid to prevent attacks from occurring.

People with bipolar disorder are about twice as likely as the general population to have metabolic syndrome. Obesity and metabolic syndrome affect roughly one-third to one-half of people with bipolar disorder.

Bipolar disorder significantly affects a person’s mood and can reduce their energy levels. Studies suggest that people with bipolar disorder have higher levels of sedentary behaviors than people without bipolar disorder. This makes it less likely that they will reach the recommended levels of physical activity.

Certain types of medications, including some antipsychotics, also increase the likelihood of weight gain.

Behavioral and lifestyle changes, including getting regular exercise and following a well-balanced diet, may help prevent weight gain in people with bipolar disorder. If weight gain resulting from a bipolar disorder medication is problematic for a person’s health, their doctor may prescribe a different treatment.

Heart disease and diabetes

People with bipolar disorder have a higher risk of both metabolic syndrome and diabetes, which may increase the risk of heart disease. People with metabolic syndrome, diabetes, or both should undergo regular monitoring for changes in their lipid and blood glucose levels.

Heart disease is a leading cause of death among people with severe mental health disorders, including bipolar disorder. According to an analysis of 12 different studies involving nearly 67,000 people, people with bipolar disorder are especially at risk of developing congestive heart failure.

Increasing physical activity and eating a heart-healthy diet can help with weight maintenance and the prevention of serious complications from obesity and metabolic syndrome.

People with bipolar disorder are more likely also to have a variety of psychiatric and neurodevelopmental disorders than people without bipolar disorder.

It may be that emotional dysregulation in bipolar disorder increases the likelihood of developing other mental health conditions. Or it may be that these conditions have similar underlying causes. Both of these factors likely play a role.

Research suggests that the following conditions are more prevalent among people with bipolar disorder:

  • Eating disorders: Some studies estimate that up to one-third of people with bipolar disorder will experience an eating disorder in their lifetime. Bulimia nervosa and binge eating disorder are especially common.
  • Obsessive-compulsive disorder (OCD): Studies estimate that 11–21% of people with bipolar disorder also experience OCD.
  • Attention deficit hyperactivity disorder (ADHD): An analysis of 71 studies involving more than 646,000 people from 18 countries found that nearly 1 in 6 adults with bipolar disorder also has ADHD.
  • Autism spectrum disorder (ASD): Research suggests that ASD often occurs alongside bipolar disorder. As ASD affects emotional regulation, it may be challenging to diagnose bipolar disorder in these individuals.

It is important for mental health professionals to monitor people with bipolar disorder so that they can diagnose and treat any other mental health conditions.

People with bipolar disorder may experience a variety of psychiatric, physical, and mental health conditions that can complicate managing their health. In many cases, effectively treating bipolar disorder can help reduce a person’s likelihood of developing complications from other health conditions.

A person’s psychiatric and primary care teams will work together to optimize their health and well-being. If a person’s treatment plan is proving ineffective, their psychiatrist can help find the right combination of medication and psychotherapy to reduce the symptoms. A primary care provider can help care for some complications linked to bipolar disorder and provide referrals to specialists if necessary.

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