Anxiety and Bipolar Disorder

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Anxiety attacks are fairly common in people who have bipolar disorder. In fact, researchers have found that more than half of those with bipolar disorder also had a comorbid anxiety disorder.

Anxiety Attacks

There is no formal psychiatric definition of "anxiety attacks." When the term is used, people are most often referring to a panic attack, which does have a definition. In a panic attack, a person feels sudden and intense fear, even to the point of terror, without the presence of actual danger.

Some symptoms are pounding heart, chest pain, sweating, light-headedness, nausea, shortness of breath or choking sensations, trembling, and feeling detached from reality. Many people who first experience such an anxiety attack think they are having a heart attack.

Some studies suggest that panic attacks in patients with bipolar disorder are quite common.

Here is an overview of anxiety disorders that may co-occur with bipolar disorder. As such, they could cause those with BP to suffer from a variety of anxiety symptoms including panic attacks.

Panic Disorder

In panic disorder, a person suffers from sudden and frequent panic attacks. Researchers have found that around 16% of people with bipolar disorder also have panic disorder.

If you are experiencing what you call anxiety attacks, take them seriously and talk to your mental health provider.

Agoraphobia is a type of intense fear that can develop in people who have panic disorder. It can also occur without accompanying panic symptoms. People with agoraphobia are afraid to be in any place that might cause or be hard to escape anxiety attacks. Agoraphobia can be so severe that the sufferer refuses to leave his or her home.

Generalized Anxiety Disorder (GAD)

GAD is a condition characterized by excessive worry and physical symptoms of anxiety that have been present for at least six months. The excessive worry is generally related to everyday situations.

The person has significant difficulty controlling anxiety, and it causes substantial distress or problems in everyday life. For GAD to be diagnosed, at least three of these additional symptoms of anxiety must be present as well: restlessness, muscle tension, fatigue, sleep disturbances, concentration problems, and irritability.

Persons who have GAD may also experience anxiety attacks. GAD has been widely reported to accompany bipolar disorder. However, additional research is needed in this area.

Post-Traumatic Stress Disorder (PTSD)

PTSD is a disorder that develops after a traumatizing event such as rape, assault, disasters (natural or otherwise), accidents or military combat. There are many symptoms of PTSD.

Some of the most common are flashbacks to the event, recurring nightmares, having difficulty remembering all or part of the event, sleep disturbances, outbursts of anger, and having strong negative reactions to reminders of the event. Symptoms must be present for more than a month for PTSD to be diagnosed.

More than one study has found that people with bipolar disorder often report having suffered childhood abuse (physical and/or sexual).

In one such study of 330 veterans with bipolar disorder, most of them men, almost half the men had undergone some kind of abuse as children. Thus, it is not surprising that PTSD and bipolar disorder are often diagnosed together.

Anxiety Attacks From Medications

Some psychiatric medications can cause anxiety symptoms as a side effect. Whenever you start a new medication, check the literature that accompanies it so you will recognize a side effect if it occurs. If you do experience anxiety symptoms after starting a new treatment, contact your doctor as soon as possible.

6 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Cackovic C, Nazir S, Marwaha R. Panic Disorder (Attack). National Center for Biotechnology Information.

  3. Preti A, Vrublevska J, Veroniki AA, Huedo-medina TB, Kyriazis O, Fountoulakis KN. Prevalence and treatment of panic disorder in bipolar disorder: systematic review and meta-analysis. Evid Based Ment Health. 2018;21(2):53-60. doi:10.1136/eb-2017-102858

  4. Locke A, Kirst N, Shultz CG. Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults. American Family Physician.

  5. Daruy-filho L, Brietzke E, Lafer B, Grassi-oliveira R. Childhood maltreatment and clinical outcomes of bipolar disorder. Acta Psychiatr Scand. 2011;124(6):427-34.doi:10.1111/j.1600-0447.2011.01756.x

  6. The National Institute of Mental Health. Mental Health Medications.

Additional Reading

By Marcia Purse
Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing.