Anxiety, depression, and bipolar disorder have a lot of similarities. Yet, medical treatment works best when each condition is treated separately. Therefore, it may be confusing if you have a bipolar disorder diagnosis, but want treatment for symptoms of depression. Or anxiety. Or vice versa.

Throughout this article, we’ll take a deeper look at the symptoms of each condition. From there, we’ll determine whether or not anxiety and depression are linked with bipolar disorder.

Differences Between Anxiety/Depression and Bipolar

Mental health conditions are a natural response of our brains. For example, in life-threatening situations, everyone experiences anxiety. Or, it’s common to feel moments of depression when faced with difficult times.

These natural responses become psychiatric disorders when they start to inhibit our daily lives. ¹ In terms of bipolar disorder, it can cause unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks. ²

There are three different types of bipolar disorder, each of which is characterized by manic and depressive episodes.

• Bipolar I Disorder – Manic episodes that last seven days or are so severe that you need medical attention. These periods will be followed by a depressive episode that lasts up to two weeks.

• Bipolar II Disorder – A similar pattern of episodes as Bipolar I. However, instead of full-blown manic episodes, people with Bipolar II will experience hypomanic episodes.

• Cyclothymic Disorder (Cyclothymia) – Like Bipolar II, this type will bring on hypomanic and depressive symptoms. However, these symptoms are usually much more severe, with depressive symptoms lasting up to 2 years (1 year in children and adolescents).

These types lay out the key differences when comparing bipolar to anxiety or depression. Bipolar disorder is characterized by shifts in mood (from up to down). Depression and anxiety usually have one stable mood.

However, this still begs the question, “Can people with bipolar disorder experience anxiety and/or depression?”

What Are the Symptoms?

The symptoms are the best way to identify which disorder you struggle with. As mentioned, the symptoms of these conditions are often identical. As such, there may be some confusion and you’ll need a medical professional’s guidance to come to a clear diagnosis.

Bipolar Disorder Symptoms

Symptoms of bipolar disorder are separated into two categories; mania (or hypomania) and depressive episodes. To receive a bipolar disorder diagnosis, you must show signs of symptoms from both episodes.

Mania (Hypomania) Symptoms

• Abnormal talkativeness
• Distractibility
• Euphoria (exaggerated sense of self-confidence and well-being)
• Inability to sleep (may appear as insomnia)
• Increased energy, activity, and/or agitation
• Poor decision-making (i.e. taking sexual or financial risks)
• Racing thoughts
• Unusually upbeat

Depressive Symptoms

• Emotions of sadness, emptiness, and hopelessness
• Feelings of worthlessness and/or guilt
• Inability to concentrate or make decisions
• Loss of interest in activities you once enjoyed
• Restlessness or slowed behavior
• Sleeping too much or too little
• Suicidal ideation
• Weight changes (can appear as weight loss or weight gain)

Anxiety Symptoms

Common symptoms of anxiety include: ³

• Avoiding situations and things that cause anxiety
• Breathing rapidly (hyperventilation)
• Difficulty concentrating
• Experiencing gastrointestinal (GI) problems
• Fatigue
• Feeling a sense of impending danger (panic attacks)
• Getting nervous, restless, and/or tense
• Increased heart rate
• Sleep problems
• Sweating
• Trembling
• Trouble controlling worry

Depression Symptoms

Common symptoms of depression include: ⁴

• Aches or pains, headaches, cramps, or digestive problems (without physical cause)
• Appetite changes
• Difficulty concentrating, making decisions
• Difficulty with memory
• Fatigue
• Emotions of worthlessness or guilt
• Feelings of sadness, hopelessness, and emptiness
• Irritability
• Loss of interest in activities you once enjoyed
• Moving or talking slowly
• Restlessness
• Sleeping too much or too little
• Suicidal ideation
• Weight changes (can appear as weight loss or weight gain)

Bipolar’s Connection to Anxiety and Depression

With that list, you can see why you may confuse bipolar disorder with another mental health condition, especially depression. Still, the question remains, “Can people with bipolar disorder experience anxiety and/or depression?” To answer this, we need to look at anxiety and depression separately.

Bipolar Disorder and Anxiety

There are five major types of anxiety disorders, including: ⁵

• Generalized Anxiety Disorder (GAD) – Marked by excessive anxiety for no logical reason.

• Obsessive-Compulsive Disorder (OCD) – When you have disorderly, continuous thoughts (obsessions) and behaviors (compulsions).

• Panic Disorder – When you experience sudden terror when there is no real danger. These are better known as panic attacks. ⁶
  
• Post-Traumatic Stress Disorder (PTSD) – When you go through mental or emotional stress due to severe psychological shock.

• Social Anxiety Disorder (SAD) – Fear of social situations involving large crowds or social interactions with other people. ⁷

The majority of people with bipolar disorder will experience one anxiety disorder at some point in their life. ⁸ While both disorders are lifelong conditions, they’re also treatable. Just keep in mind that these conditions are best treated separately.

Bipolar Disorder and Depression

Since bipolar disorder causes depressive episodes, you may assume you can be diagnosed with depression too. However, you’ll rarely encounter this dual diagnosis.

When it comes to bipolar disorder, you only experience episodes of depression. To be diagnosed with depression, you must experience its symptoms for long periods, without counteracting manic episodes.

Still, with a bipolar diagnosis, you may undergo similar treatments as those with depression.

Final Word

While it’s possible to be diagnosed with bipolar disorder and anxiety, you’ll rarely see a bipolar and depression diagnosis.

If you struggle with more than one anxiety symptom, we suggest consulting a mental health professional. They will put you on track to treating both disorders simultaneously.

If you struggle with depressive symptoms, you may be going through a depressive episode. Again, it’s important to talk to a mental health professional.

References

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² Jain A, Mitra P. Bipolar Disorder. 2023 Feb 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644424.

³ Penninx BW, Pine DS, Holmes EA, Reif A. Anxiety disorders. Lancet. 2021 Mar 6;397(10277):914-927. doi: 10.1016/S0140-6736(21)00359-7. Epub 2021 Feb 11. Erratum in: Lancet. 2021 Mar 6;397(10277):880. PMID: 33581801; PMCID: PMC9248771.

⁴ Chand SP, Arif H. Depression. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 28613597.

⁵ Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci. 2015 Sep;17(3):327-35. doi: 10.31887/DCNS.2015.17.3/bbandelow. PMID: 26487813; PMCID: PMC4610617.

⁶ Cackovic C, Nazir S, Marwaha R. Panic Disorder. 2023 Aug 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 28613692.

⁷ Alomari NA, Bedaiwi SK, Ghasib AM, Kabbarah AJ, Alnefaie SA, Hariri N, Altammar MA, Fadhel AM, Altowairqi FM. Social Anxiety Disorder: Associated Conditions and Therapeutic Approaches. Cureus. 2022 Dec 19;14(12):e32687. doi: 10.7759/cureus.32687. PMID: 36660516; PMCID: PMC9847330.

⁸ Vázquez GH, Baldessarini RJ, Tondo L. Co-occurrence of anxiety and bipolar disorders: clinical and therapeutic overview. Depress Anxiety. 2014 Mar;31(3):196-206. doi: 10.1002/da.22248. PMID: 24610817.