Can Bipolar Disorder and Autism Co-Occur?
Bipolar disorder is a mental illness characterized by episodes of mania (high energy) or depression (low energy). About one percent of the population suffers from bipolar disorder. A person with bipolar disorder may experience manic episodes lasting days to weeks, while depressive episodes last hours to days. Bipolar disorder can occur at any age but it most commonly occurs during adolescence and young adulthood. There are two types of bipolar disorder: mania and depression.
The first episode of bipolar disorder usually begins in early adulthood. The second episode typically follows a period of high school graduation, marriage, or other major life change.
People with bipolar disorder have a higher risk for suicide than the general population. However, they do not commit homicide or attempt suicide at similar rates compared to the rest of society.
Autism Spectrum Disorders (ASD) are a group of developmental disorders affecting communication, social interaction, and behavior. These disorders include pervasive developmental disorder–not otherwise specified (PDD-NOS), autistic disorder, Asperger syndrome, Rett’s disorder, childhood disintegrative disorder and childhood disintegrative autism.
The prevalence rate for ASD ranges from 1% to 3%. Individuals with ASD often have difficulty communicating their needs to others. They may also find it difficult to make friends, and lack understanding of social norms. There is no single treatment for ASD; however, there are various types of therapy and medication.
Autism vs. Bipolar Disorder
In the past, people with bipolar disorder were thought to be on the autism spectrum. Today, experts know that is not necessarily true.
Most people with ASD do not have bipolar disorder and most people with bipolar disorder do not have ASD.
Bipolar I disorder involves episodes of mania and depression. A manic episode is a distinct period of hyperactivity, euphoria, and unstoppable energy.
If left untreated, it can last days or even months. A manic episode is also called bipolar type I. A depressive episode involves unusually low energy and sadness lasting at least two weeks.
People with severe cases of bipolar I have psychotic episodes as well. A psychotic episode involves a loss of contact with reality.
During a psychotic episode, a person loses the ability to know what is real and what is not. If left untreated, a psychotic episode can last days or weeks.
People with bipolar II disorder experience hypomanic episodes instead of manic ones. A hypomanic episode is similar to mania but not as severe.
It involves an unusual amount of energy and activity levels but not to the point where it is disruptive to a person’s life.
Asperger’s vs. Bipolar Disorder
Asperger’s syndrome (AS) is a mild form of autism. People with Asperger’s have normal to high intelligence, but they still experience difficulty in social situations.
They may have trouble holding a conversation or empathy. The signs of Asperger’s vary in degree from person to person.
People with Asperger’s may also experience depression or bipolar disorder. The combination of depression and Asperger’s can lead to a lower quality of life.
Younger children may display obvious symptoms, such as hand flapping or pacing. Older children and adults may have more difficulty expressing their needs.
They may be socially isolated or have uncontrollable mood swings.
Asperger’s syndrome vs. Bipolar Disorder: Overlap
People with Asperger’s are often hypersensitive to sensory input. They may be overwhelmed by the feeling of clothing touching their skin or loud noises.
This can cause people with Asperger’s to lash out or retreat from certain situations.
Finding a therapist that is knowledgeable in both AS and bipolar disorder is essential for getting a proper diagnosis. Without the correct treatment plan, a person with AS and bipolar disorder may become increasingly moody or withdrawn.
Treatments for Asperger’s and Bipolar Disorder
There is no cure for Asperger’s or bipolar disorder. Instead, patients have to manage the symptoms throughout their life.
Due to the nature of both conditions, patients may have a hard time finding the right treatment plan.
On one end of the spectrum, patients with severe mood swings may be misdiagnosed with bipolar disorder when they actually have undiagnosed Asperger’s. On the other end, people with Asperger’s may be misdiagnosed with anxiety or depression.
Both conditions can be treated with a combination of medication and therapy. For patients with bipolar disorder, a healthcare provider may prescribe mood stabilizers.
Antidepressants and anti-anxiety medications can help patients with Asperger’s.
The most important part of treatment is therapy. Cognitive-behavioral therapy (CBT) is the most commonly used therapy for mood disorders.
Sources & references used in this article:
Case study: comorbidity among Tourette’s syndrome, autistic disorder, and bipolar disorder by J Kerbeshian, L Burd – Journal of the American Academy of Child & …, 1996 – Elsevier
Comorbidity and autism: Trends, topics and future directions by JL Matson, RL Goldin – Research in Autism Spectrum Disorders, 2013 – Elsevier
Comorbidity of Asperger’s syndrome and bipolar disorder by M Raja, A Azzoni – Clinical Practice and Epidemiology in Mental Health, 2008 – Springer
Bipolar Disorder and Psychosis in Autism by M Ghaziuddin, N Ghaziuddin – Child and Adolescent …, 2020 – childpsych.theclinics.com
Comorbid psychopathology with autism spectrum disorder in children: An overview by JL Matson, MS Nebel-Schwalm – Research in developmental disabilities, 2007 – Elsevier
The association between autism and schizophrenia spectrum disorders: A review of eight alternate models of co-occurrence by K Chisholm, A Lin, A Abu-Akel, SJ Wood – Neuroscience & Biobehavioral …, 2015 – Elsevier