Treating Bipolar and Anxiety Simultaneously
When anxiety is a symptom, it could improve with treatment for bipolar disorder. However, if anxiety doesn’t improve, it is possible you have a separate anxiety disorder.
Treating coexisting anxiety and bipolar disorders can be challenging. This is because the most common treatment for anxiety disorders are medications called selective serotonin reuptake inhibitors (SSRIs) and SSRIs are known for triggering manic episodes.
Depending on which research studies you rely on, the risk for a manic episode with an antidepressant is 4 to 44 percent, this according to a report from PsychEducation on various studies about the anxiety-bipolar connection and treatment with antidepressants.
The International Society for Bipolar Disorders does not encourage the use of antidepressants, but because they may benefit some patients, they advise prescribing them with mood stabilizing medications.
Antipsychotics are also common treatments for managing bipolar disorder and lessening anxiety. The research on antipsychotics for treating comorbid anxiety in patients with bipolar disorder is growing, as some antipsychotics have helped patients manage both conditions effectively.
One 2009 study out of the Case Western Reserve University School of Medicine, Cleveland, Ohio, USA, finds newer antipsychotic medications, including olanzapine, risperidone, and quetiapine are well tolerated. While they do cause severe fatigue and drowsiness, the long-term benefits might outweigh risks.
Your primary doctor and mental health provider should work together to find the best treatment plan for you.
Your treatment plan will likely include:
- Medications to treat symptoms of anxiety and bipolar disorder and address sleep issues
- Individual psychotherapy that includes cognitive-behavioral therapy and relaxation therapy
- Family or couples therapy, depending on your circumstance
Your doctor will likely treat your anxiety and bipolar disorders with medication first. Mood stabilizers should be given before antidepressants and antidepressants will be given in low doses.
Make sure you keep your doctor apprised as to any side effects, adverse reactions, and increasing symptoms of anxiety or mania.
Anxiety and bipolar disorders are treatable. Because it can be a challenge to find the right treatment to manage symptoms, it is important to learn to cope with the symptoms of both conditions.
In addition to usual advice about taking care of yourself, eating healthy, and learning to relax and manage stress, you should also strive to improve your sleep and exercise regularly.
Insomnia and other sleep issues increase the chance of having an anxiety attack, manic episode or both. While both conditions can make it hard for you to sleep, establishing good sleeping habits can help you to sleep better.
For example, you could create a bedtime routine to enforce stability and comfort. The routine could involve shutting off all electronic devices an hour before bedtime, taking a relaxing bath before getting into bed, drinking a cup of decaffeinated tea or listening to soothing music.
Exercise works wonders for people with mental health disorders. This is because activity produces extra serotonin, the chemical your body that stabilizes mood and promotes relaxation.
The more serotonin your body gets, the more relaxed your mood will be. And regular exercise will make it easier for you sleep at night.
If you have anxiety symptoms or an anxiety disorder in addition to being bipolar, make sure your doctor and mental health provider know and are on the same page about treating both. The key is to find the right treatments to manage both, without making either condition worse.
Once you begin treatment, keep your doctor updated about how you’re doing and if medications are helping or causing you to feel worse.
Of course, living with both bipolar disorder and anxiety is tough, as both are lifelong conditions. But it is possible to treat both successfully and improve your quality of life so hang in there.