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PTSD vs Bipolar Disorder: Q+A

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What is PTSD, what Bipolar Disorder, and how are they similar and different?

Post-Traumatic Stress Disorder can occur in people who have experienced or witnessed a traumatic event. (A traumatic event is broadly defined as any situation or circumstance that leads to overwhelming feelings of helplessness, horror, and stress.) PTSD symptoms include negative changes in our thinking, difficulty concentrating, feelings of low-self worth, re-experiencing the event through flashbacks or nightmares, feeling easily startled or on edge, emotional volatility, and difficulty sleeping. The defining characteristic of PTSD is the trauma it succeeds.

Bipolar Disorder is categorized by a Mood Disorder because it involves episodes of depression, coupled with episodes of mania or hypomania. (Hypomania is a less intense experience of mania.) Symptoms of depression can include feeling down or hopeless, suicidal thoughts or urges, difficulty sleeping, changes in appetite, and loss of interest in one’s life activities. Symptoms of mania, by contrast, include an unusually upbeat or euphoric mood, high energy, decreased need for sleep, and an exaggerated sense of well-being that can lend to impulsive or risky behaviors.

Both PTSD and Bipolar Disorder result in profound mood shifts. The origin of Bipolar Disorder is largely in a person’s genes, whereas PTSD results from experiencing a trauma. The mood changes we see in PTSD vary from person to person; mood shifts in Bipolar Disorder, on the other hand, are cyclical.

Can a person be diagnosed with both?

Just as a person can have more than one health condition, a person may also express two different psychiatric disorders. It is certainly possible for an individual to be diagnosed with both PTSD and Bipolar Disorder, as any two mental health disorders can coincide.

Can one precede the other?

PTSD can trigger Bipolar Disorder, particularly for individuals who are genetically predisposed to Mood Disorders. PTSD, however, is more likely to trigger depression, anxiety, and substance use disorders.

Why is PTSD sometimes misdiagnosed as Bipolar Disorder?

PTSD is often misdiagnosed as Bipolar Disorder because PTSD symptoms can mimic those of Bipolar Disorder. Overlapping symptoms can include depression, restlessness, hypervigilance, and paranoia. When an individual presents with activating symptoms of PTSD (i.e., symptoms that reflect increased emotional arousal), a clinician may incorrectly diagnose him, her, or them with Bipolar, mistaking those symptoms for mania.

What are the best treatment options for PTSD or Bipolar Disorder?

Treatment options for PTSD include individual psychotherapy, group psychotherapy, and medication. Individual psychotherapy can include cognitive-behavioral therapy, EMDR, and supportive approaches, while group psychotherapy provides individuals with robust social support. Medication may be used as an adjunctive treatment if the individual presents with debilitating mood or anxiety symptoms that interfere with day-to-day functioning.

Treatment options for Bipolar Disorder almost always include medication, namely mood stabilizers. Mood stabilizers target areas of the brain responsible for mood disruption. Psychotherapy is often an important component of treatment as well, because it can be challenging living with frequent mood disruptions. Psychotherapy can help a person with Bipolar Disorder learn to manage their symptoms, maintain a healthy lifestyle that promotes mood stabilization, and prevent the recurrence of mood episodes.

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