Bipolar disorder

Bipolar disorder

What is bipolar disorder in PTSD?

Bipolar disorders are a group of disorders characterised by episodes of mania or hypomania and depression. In between episodes, mild symptoms of mania and/or depression may, or may not, be present. The bipolar disorders include bipolar I, bipolar II, and cyclothymic disorder. Bipolar I disorder is characterised by mania, while bipolar II disorder is characterised by less severe hypomania. Cyclothymic disorder is the mildest of the bipolar disorders.

A major depressive episode is at least two weeks of at least five of the following symptoms. Intense sadness or despair; feelings of helplessness, hopelessness or worthlessness; loss of interest in activities once enjoyed; feelings of guilt, restlessness or agitation; sleeping too little or too much; slowed speech or movements; changes in appetite; loss of energy; difficulty concentrating, remembering or making decisions; and/or thoughts of death or suicide.

A manic episode is at least one week of extremely high spirits or irritableness most of the time. A manic episode involves changes in normal behaviour. These include exaggerated self-esteem, less sleep, talking a lot and loudly, being easily distracted, doing many activities at once, risky behaviour, uncontrollable racing thoughts, and quickly changing ideas or topics. These changes in behaviour are significant and clear to friends and family and are severe enough to cause major dysfunction. A hypomanic episode is similar to a manic episode but less severe and need only last four days. Hypomanic symptoms do not lead to major dysfunction that mania often causes.

What is the evidence for rates of bipolar disorders in people with PTSD?

Moderate quality evidence finds current bipolar disorder in people with PTSD ranges between 4% for bipolar II disorder and 19% for bipolar I disorder. For any lifetime diagnosis, the rate ranges between 20% for bipolar II disorder and 35% for bipolar I disorder.

August 2021

Image: ©Christos Georghiou –

Last updated at: 4:11 am, 20th October 2021
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