Bipolar disorder (clinical bipolar depression) is characterized by episodes of alternating depressed and manic moods. Comorbidity means that there are two distinct syndromes in the same person. Other psychiatric conditions are common among individuals with bipolar disorder. In a study by McElroy published in the March 2001 issue of the "American Journal of Psychiatry", about 65 percent of patients with bipolar disorder met criteria for at least one other psychiatric disorder.
Substance Use
Abusing alcohol or drugs is common among individuals with bipolar disorder and occurs at a higher rate than for other psychiatric conditions. The "Journal of the American Medical Association" reported that about 61 percent of patients with bipolar disorder abused substances. Alcohol abuse is more common than drug abuse, and the alcohol abuse rate is higher for men (49 percent) than women (29 percent) with bipolar disorder, as found by Frye in the May 2003 issue of the "American Journal of Psychiatry." Individuals abusing alcohol or drugs are at risk for not following bipolar treatment, which often leads to impaired functioning.
Anxiety
Anxiety disorders are also common among those with bipolar disorder. About 51 percent of individuals with bipolar disorder had an anxiety disorder at some point in their lifetime, according to the "American Journal of Psychiatry." These anxiety disorders include panic disorder (anxiety attacks), phobias, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and generalized anxiety disorder (excessive worry about many things). Anxiety can make bipolar disorder more severe and complicated to treat.
Personality Disorders
A personality disorder is a long-standing pattern of thinking, relating to others, and perceiving situations that cause much distress or impair work or social functioning. Garno reported in the March 2003 issue of the "Journal of Clinical Psychiatry" that about one-third of individuals with bipolar disorder were found to have at least one of the following personality disorders: borderline personality disorder, narcissism, antisocial behavior and histrionic personality disorder. Characteristics of borderline personality disorder include having unstable relationships with others, being impulsive and engaging in suicidal or self-injuring behavior (cutting or burning themselves). Individuals with narcissistic personality disorder have a grandiose sense of self-importance, are preoccupied with themselves and lack compassion for others. Those with antisocial personality disorder tend to be aggressive and manipulative and feel no remorse after violating the rights of others. People with histrionic personality disorder tend to be seductive, vain and showy.
References
- "American Journal of Psychiatry"; Anxiety Disorder Comorbidity in Bipolar Disorder Patients: Data from the First 500 Participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD); Naomi Simon, Michael Otto, Stephen Wisniewski, Stephen, Mark Fossey, Kernal Sagduyu, Ellen Frank, Gary Sachs, Andrew Nierenberg, Michael Thase, and Mark Pollack; December 2004.
- "American Journal of Psychiatry"; Axis I Psychiatric Comorbidity and Its Relationship to Historical Illness Variables in 299 Patients with Bipolar Disorder; Susan McElroy, Lori Altshuler, Trisha Suppes. Paul Keck, Mark Frye, Kirk Denicoff, Willem Nolen, Ralph Kupka, Gabriele Leverich, Jennifer Rochussen, John Rush, and Robert Post; March 2001.
- "American Journal of Psychiatry"; Gender Differences in Prevalence, Risk, and Clinical Correlates of Alcoholism CoMorbidity in Bipolar Disorder; Mark Frye, Lori Altshuler, Susan McElroy, Trisha Suppes, paul Keck, Kirk Denicoff, Willem Nolen, Ralph Kupka, Gabriele Leverich, Chad Pollio, Heinz Grunze, Jorge Walden and Robert Post; May 2003.
- "Journal of the American Medical Association"; Comorbidity of Mental Disorders With Alcohol and Other Drug Abuse: Results from the Epidemiologic Catchment Area (ECA) Study; Darrel Regier, Mary Farmer, Donald Rae, Ben Locke, Samuel Keith, Lewis Judd, and Frederick Goodwin; November 21, 1990.
- "Journal of Clinical Psychiatry"; Bipolar Disorder with Comorbid Cluster B Personality Disorder Features: Impact on Suicidality; Jessica Garno, Joseph Goldberg, Paul Ramirez, Barry Ritzler; March 2005.
