What Is Bipolar Anxiety? Understanding Symptoms And Treatments

Updated March 12, 2023by BetterHelp Editorial Team

Bipolar disorder and anxiety disorders are challenging enough to manage independently, but the effects can be exacerbated and cause additional problems when combined. Read on to learn about how to recognize bipolar anxiety and how treatments can be affected by comorbid mental health conditions. 

Are Bipolar Symptoms Affecting Your Anxiety?

What Is Bipolar Disorder?

According to the Mayo Clinic, bipolar disorder (formerly manic depression) is a mental health condition that causes significant functional impairment and is characterized by alternating cycles of mania or hypomania (intense symptoms and lack of emotional/behavioral control) and more extended periods of depression (persistent feelings of sadness and hopelessness). This condition involves severe mood swings. Depression can cause anhedonia, which makes it challenging to take pleasure from or interest in the things you once enjoyed. As you cycle into mania (or less extreme hypomania), common symptoms include feeling euphoric, energized, or irritable. Bipolar mood swings can impact your judgment, sleep patterns, energy levels, and capacity to think clearly and focus. 

Can You Have Anxiety And Bipolar Disorder?

According to a 2015 study, anxiety disorder and bipolar disorder have a high comorbidity rate, with panic disorder as the most common anxiety problem among bipolar patients. The presence of both conditions can cause adverse effects and influence treatments. 

“A comorbid anxiety disorder in bipolar patients greatly complicates the presentation, the interpretation of symptoms, and the treatment of bipolar disorder, and it negatively alters the prognosis.” — The Anxious Bipolar Patient

A recent study shows that over 50% of people living with bipolar disorder are likely to also develop an anxiety disorder at some point. The comorbidity of the two conditions can lead to complications, such as increased severity of both disorders, delayed diagnoses, and an increased risk of suicidal thoughts, ideation, or behaviors. 

If you or a loved one are experiencing suicidal thoughts, seek help immediately. The National Suicide Prevention Lifeline can be reached at 988 and is available 24/7.

The anxiety disorders most commonly seen in people with bipolar disorder are:

According to an article published in the Psychiatric Times medical journal, the comorbidity of anxiety and bipolar disorders is associated with substantial increases in the burden symptoms place on the affected person, including a higher risk for psychosis, earlier onset of psychiatric symptoms, decreased response to treatment, impaired quality of life, and increased risk for substance or alcohol use or suicidal thoughts and behaviors. 

Bipolar Disorder Symptoms And Treatments

Mental health experts at the National Alliance on Mental Illness report that approximately 2.3 million adults in the US are diagnosed with bipolar disorder, though they say the number of people affected by the condition may be substantially higher. 


Bipolar mania (hypomania is a less severe form) can significantly interfere with your functional ability in multiple areas of your daily life by causing more pronounced symptoms and decreasing your control over emotions and behaviors. The criteria for both manic and hypomanic episodes require at least three of the following symptoms. 

  • You may be jumpy or wired with an abnormally upbeat or energized mood. 

  • You may have excess energy or be easily agitated during a period of increased activity.

  • An exaggerated sense of self-confidence and well-being makes you feel invincible and euphoric. 

  • You may have a decreased need for sleep or have trouble falling or staying asleep. 

  • You may be uncharacteristically talkative or unable to stop the flow of thoughts to speech without a filter. 

  • Racing thoughts and trouble focusing make it challenging to function. 

  • You may notice that you’re easily distracted or frequently jump from one thing to another with no transition or warning. 

  • You show poor judgment with your decisions, such as going on spending sprees, indulging in risky sexual behavior, or making hasty, unwise investments. 


Bipolar disorder often involves extended periods of major depression with symptoms that cause a noticeable impact on your day-to-day life. Depressive episodes typically last longer than manic episodes. Five or more of the following symptoms are required for a bipolar depression diagnosis. 

  • Your mood is depressed, and you frequently feel sad, empty, hopeless, or irritable.

  • Anhedonia, or a noticeable loss of interest in or pleasure from nearly all activities

  • Substantial weight gain or loss due to changes in eating habits and appetite. 

  • Isolating yourself from social contact or feeling lonely.

  • You may have trouble falling or staying asleep or sleeping too much. 

  • Slowed or restless behavior

  • Persistent fatigue or low energy

  • Feelings of worthlessness or excessive and misplaced guilt

  • Trouble making decisions, or difficulty focusing and concentrating

  • Thoughts, plans, threats, or suicidal behaviors—this requires immediate treatment. 


As with most mental health conditions, the treatments for bipolar disorder involve a combination of medication and psychotherapy, also called talk therapy. Speak to your physician or mental healthcare provider about assessment for bipolar disorder if you are experiencing mania and depression symptoms. 

Anxiety Disorder Symptoms And Treatments

While everyone feels worried or afraid occasionally, anxiety disorders occur when those feelings don’t fade away after the danger passes, leaving you stuck in fight or flight mode with your brain and body convinced you face imminent danger. When anxiety symptoms linger and worsen over time, causing interference with your ability to function in multiple areas of your life, you may have an anxiety disorder. 


  • Physical—Sweating, trembling, headache, stomachache, racing pulse, hyperventilation or other breathing problems, muscle tension, neck pain or other unidentified pain without apparent cause, and fatigue 

  • Behavioral—You may actively avoid visiting people or going to places that may cause anxiety. You may also notice drastic changes to your eating and sleeping habits. 

  • Psychological—Mood swings, “brain fog” or your mind going blank, trouble concentrating, disorientation, irritability, a persistent and overwhelming sense of impending doom or constant danger, extreme nervousness that doesn’t go away, and difficulty controlling your worry 


Like bipolar disorder, the most common and effective treatments for anxiety disorders include a combination of psychotherapy and medication. Cognitive behavioral therapy (CBT) is a frequent talk therapy approach, as it helps you shift negative thought patterns and behaviors to healthier habits. Speak to your doctor or therapist if you’re experiencing symptoms of an anxiety disorder. 

Differences Between Bipolar Mania And Anxiety

  • Sleep—People with bipolar mania feel a decreased need for sleep, while those with anxiety are distressed by the lack of sleep.  

  • Energy—Bipolar mania often comes with excess energy, but those with anxiety can feel drained and fatigued.  

  • Thought Patterns—People experiencing bipolar mania may have an influx of creative and goal-oriented thoughts, while anxiety can make it hard to concentrate with the constant worry. 

  • Emotional Balance—Bipolar mania often causes high self-esteem and impulsivity, while anxiety can lead to low self-esteem and irrational fears. 

  • Social—People with bipolar mania are often talkative and outgoing, while anxiety typically leads them to avoid social contact. 

  • Risk Assessment—Bipolar mania can interfere with your ability to determine how risky situations would be, though people with anxiety disorders may be overly aware of potential dangers.  

  • Episode Duration—Symptoms of bipolar mania typically last between two and four months, with longer periods for depression cycles. Anxiety is often a chronic condition persisting for years.  

  • Common symptoms between bipolar mania and anxiety disorders may include difficulty sleeping, restlessness, agitation, racing thoughts, and trouble concentrating. 

Are Bipolar Symptoms Affecting Your Anxiety?

How Therapy Can Help

If you or someone you love is experiencing the symptoms of bipolar anxiety, consider working with a licensed therapist online through a virtual therapy platform like BetterHelp. For parents seeking therapy for a child, TeenCounseling serves children from ages 12 to 19. Cognitive behavioral therapy is one of the most common treatments for bipolar anxiety because it focuses on teaching you to recognize unhealthy behaviors and thought patterns, shifting them toward healthier, more productive habits with the support and guidance of a qualified mental health professional. Therapy can also help you develop communication and coping skills to take charge of your mental health and effectively express your feelings to others. 

According to a 2019 study, online psychotherapy is a viable and effective treatment method for various mental health conditions, such as bipolar and anxiety disorders. According to the research, patients with no therapy experience often showed increased results over those receiving in-person treatment. Many patients said the increased physical distance of teletherapy made it easier to divulge personal details with a therapist, and the convenience of attending from home made it possible to participate in more sessions. Medical professionals agree that the duration and effectiveness of therapeutic outcomes increase with the number of sessions completed. 


Approximately half of the people living with bipolar disorder also experience anxiety disorders, which can increase the severity of both conditions. The information provided in this article may offer some insight into bipolar anxiety and how therapy can help you manage the effects of your symptoms so you can live a productive life. 

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