Autism and and Co-occurring Conditions: Bipolar Disorder

CC BY-ND by aerie.

Bipolar disorder is a mood disorder characterized by extreme shifts in mood, energy, thinking and behavior. Patients suffering from bipolar disorder alternate between manic highs and devastating lows.

Everyone has their moods, but for the individual with bipolar disorder, they are exaggerated to the extreme. A patient in a manic state may go for days with little or no sleep, and may make impulsive decisions with serious consequences (ex. maxing out their credit cards or engaging in risky sexual behaviors).

Depressive phases tend to be extreme as well, with many patients lacking the energy to get out of bed and function in their daily lives. In extreme cases, some patients may even consider or attempt suicide.

People with autism can also demonstrate extreme moods, though there are differences between the two disorders. Extreme mood shifts or tantrums in patients with autism are often caused by the individual’s frustration at being unable to communicate or connect with others. This difficulty, which is a core symptom of autism, can also lead to anxiety and depression.

It is possible for both disorders to occur together, though diagnosis can be challenging. Individuals with autism may be unable to communicate their feelings, which can make it difficult for medical professionals to figure out why they are engaging in certain behaviors.

Some studies have shown that as much as 27% of individuals with autism also suffer from symptoms of bipolar disorder, though this may be exaggerated, due to overlapping symptoms between the two disorders. A 2010 study published in the Journal of Developmental and Physical

Disabilities found that many children with autism demonstrate symptoms that can also be indicators of bipolar disorder, including elevated moods, irritability, excessive talking, distractibility, and sleep disturbances.

Other studies have shown a genetic link between autism and bipolar disorder, along with other disorders such as ADHD and schizophrenia. A 2012 study from the University of North Carolina School of Medicine found that individuals with autism were more likely to have parents or siblings who had been diagnosed with bipolar disorder of schizophrenia.

One key factor in differentiating autism from bipolar disorder is to look carefully at when the symptoms appear and how long they last. An individual with autism who is high-energy, talks incessantly, and paces would not be considered bipolar, unless the symptoms appeared suddenly, along with other indicators such as lack of sleep and an increase in tantrums.

Even in a case like this, the patient should also be tested for other possible causes, including seizure disorders or exposure to food or environmental allergens. If these manic phases come and go, and if no other physical cause can be determined, then the patient may be suffering from bipolar disorder.

Bipolar disorder is often treated with a combination of psychoactive medications such a lithium and psychotherapy. Lithium can have serious side effects, and studies have shown that many individuals with autism respond well to valporic acid along with a low dose of an antipsychotic medication.

To read other articles in this series on autism and co-morbidity click here