Bipolar Disorder and OCD Symptoms and Treatments
Bipolar disorder is a mood dysregulation condition that results in extreme changes in behavior due to dramatic shifts in moods from feelings of happiness to severe sadness.
Those with OCD or obsessive-compulsive disorder, is a mental health condition characterized by repetitive behaviors and fixated obtrusive thoughts.
Research shows that those people who experience both conditions are about 21% of the population.
Some scientists believe there may be a link between bipolar and OCD.
Bipolar Disorder - What is it?
Bipolar disorder is a mental health condition that involves extreme mood shifts which affect healthy behavior patterns which negatively impacts a persons ability to live a normal life.
Research indicates that about a 1% global and 3% US adult population has this condition. It also suggests that 3-4% of people will experience it at some point in their life. Most with bipolar show signs around 20-25 years old in both men and women.
Bipolar may include episodes of feeling heightened happiness or mania and other periods of extreme sadness and depression. The alternating instability of moods can last for days to months long. While periods of stability between these highs and lows can last longer if the person is on some kind of medications.
Bipolar disorder symptoms in individuals can vary and the exact underlying mechanisms remain unclear. Although, research does suggest a strong hereditary component in 73-93% of the cases.
The cause of bipolar disorder seem to overlap with major depressive disorder when scientists looked at study results in how it affected identical twins.
The genetic indicators suggested that many chromosomal regions are related to bipolar disorder susceptibility and that the risk of developing bipolar rises dramatically when first-degree relatives have the condition.
Depressed state
The depressive episodes of bipolar disorder consist of symptoms like, lethargy, low energy, isolation, lack of interest in normal activities, feelings of dread, reduced motivation, confusion, fear and suicidality. This state of being can last anywhere from days to weeks or months.
Manic state
The manic episode period of bipolar disorder can last as long as the depressive periods. But manic periods of bipolar disorder are characterized by elevated or irritable moods that can range from euphoria to delirium. The main symptoms are increased energy, racing thoughts, decreased need for sleep, being prone to high risk impulsive behaviors that lead to hypersexuality, excessive spending, goal oriented thinking and impaired judgement.
Anatomical Indications
Brain imaging indicates that those with bipolar have certain areas of the brain which are more affected due to its relative increase or reduction of size. These size differences result in the neural pathways ability to create the proper signaling necessary to help maintain and support mood stability.
Meta-analysis of structural MRI studies show abnormalities in the structure and function in brain regions related to cognitive tasks and emotional processing in those with bipolar disorder.
The brain regions most affected in bipolar disorder are the: amygdala, insula, ventral striatum, ventral anterior cingulate cortex and the prefrontal cortex.
OCD - What is it?
Obsessive-compulsive disorder is a mental health condition that has components of anxiety that results in unwanted behaviors involving repeated feelings, thoughts, behaviors or sensations. OCD can result in obsessive thoughts, urges and feelings.
OCD type behaviors take on many forms such as, turning on and off the light switch or opening and closing doors several times in a row. Washing ones hands over and over, excessive cleaning, perfectionism and other ritualistic behaviors which have a detrimental affect on a persons life.
Research shows about 2% of the population has OCD, which typically shows up during childhood years and rarely after the age of 40 years old. OCD affects males and females at the same rate and about 50% of OCD cases notice symptoms before 20 years of age.
The cause for OCD is unknown but risk factors include a history of child abuse, or other stress related events. Some report cases of OCD occurring from streptococcal infections.
Research shows that 10-40% of those with OCD have a lifetime of tic disorder.
Neuro-functional imaging reveal that an OCD brain has differences in the frontal cortex and the subcortical structures. Some people with OCD appear to have lower amounts of the neurotransmitter, serotonin, that some nerve cells utilize to help in the communication process and are involved in an array of functions influencing moods, memory, emotions and sleep.
Other disorders with similar shared symptoms include:
generalized anxiety disorder (GAD)
major depressive disorder
tic disorders
eating disorders
Symptom Similarities and Differences
A bipolar person can demonstrate OCD symptoms (while not being officially diagnosed) depending on which state they are currently in. In other words, a high or low mood state of a bipolar person can bring about similar OCD symptoms.
These may include:
manic episodes
depressive episodes
sleep disturbances
repetitive uncontrollable thoughts
social anxiety
obsessive and compulsive behaviors
several mood changes in a short period of time
It should be noted that although there exists several similar symptoms of bipolar and OCD as listed. The one of mania only exists in a person with bipolar and not in OCD.
The mania episodes are accompanied with high energy, talkative, driven to access, lack of sleep and being easily agitated. Some individuals can be delusional and experience hallucinations.
These type symptoms are not what is seen in one with OCD.
There is evidence to suggest that those with both bipolar and OCD can show fewer compulsions while having more obsessions with sex and religion.
Links with Bipolar and OCD
Experts are unclear if both of these two conditions are separate that can occur at the same time or if OCD is a subtype of bipolar disorder.
A review done in 2016 states that people with bipolar experience OCD symptoms more often when they are in a depressive period or when in the intervals between a depressive and manic phase.
A small amount of research indicates a person with a family history of mood disorders are more likely to show signs of both OCD and bipolar disorder together.
Research shows that OCD symptoms are more prevalent in those with bipolar than in the general population. Also, 21% of individuals with bipolar disorder also experience OCD presentations.
There are indications that people with both OCD and bipolar disorder have a higher risk of suicide than those with either condition alone. So, getting professional help is recommended.
Treatment for OCD and Bipolar Disorder
People with bipolar disorder and OCD can lead very productive and oftentimes symptom-free lives. Those with OCD frequently are prescribed selective serotonin reuptake inhibitors (SSRI’s), which is an anti-depressant that increases the serotonin levels in the brain.
Most doctors are very cautious when they are treating an individual who also has bipolar disorder because of the risk an anti-depressant (SSRI) can have on triggering a manic episode.
Most treatments for OCD include medication along with therapies such as cognitive behavioral therapy (CBT), neurofeedback, and ways to identify triggers, avoidance and preventative strategies.
Treatment for bipolar disorder is directed around a long-term administrative plan of care. This approach includes medication centered around bringing about stabilization to the condition. Medication can include:
anticonvulsants or anti-seizure meds
antidepressants
antipsychotics
lithium
benzodiazepines
Bipolar disorder can be helped with medication and psychotherapies like, CBT, family focused therapy, interpersonal and social rhythm therapy as well as neurofeedback therapy.
Bipolar disorder and OCD share similar symptom profiles that can impact an individuals ability to live a normal life. Both conditions appear to affect certain brain regions and have an underlying genetic component which increase the likelihood of development in family members.
Symptoms of bipolar disorder and OCD can often be reduced when treated early. Higher suicide rates are always a factor in people who experience both conditions. So taking preventative measures starts with early diagnosis and comprehensive care.
-A Balanced Brain is a Better Brain-