Types Of Bipolar Disorders
Bipolar disorder, as discussed in this quiz, is often characterized by extreme moods, they will often come in waves or episodes, the “high” episodes are known as manic episodes, and the “low” episodes are called depressive episodes. Although this quiz is testing for general symptoms of bipolar disorder, there are two types of bipolar disorder, bipolar disorder 1 and bipolar disorder 2.
Bipolar disorder 1 is characterized by at least one manic episode, but no occurrence of a major depressive episode is required for diagnosis with type 1 bipolar disorder. Bipolar disorder 1 is often more extreme in the manic episode that it may require hospitalization for full treatment.
Bipolar disorder 2, on the other hand, is characterized by a major depressive episode that lasts at least two weeks and at least one manic episode. However, manic episodes with bipolar disorder are often not as severe as they are with bipolar 1, they are sometimes referred to as hypomanic episodes, and do not usually result in hospitalization.
Navigating Autism And Bipolar Disorder
If you have autism, its possible you might live with at least one other mental health condition that can impact your emotional well-being. One such condition is bipolar disorder.
Myszak says, For many individuals, it can be like peeling an onion finding appropriate medications to ease attention or mood symptoms could significantly improve these conditions but make other diagnoses more apparent. Taking a stepwise approach could help a person understand how a particular medication or treatment is helping them before moving on to address another condition.
Sonny Jane, educator, consultant, and advocate in Kaurna Land, Australia, shares their experience navigating more than one neurodivergence a term that characterizes when a person learns, behaves, and processes differently than whats considered typical.
Being diagnosed with more than one condition simultaneously can take work to navigate. Being mindful of the needs of both disorders could help.
Signs And Symptoms Of Asd
Not all people with ASD will have all of the signs and symptoms of the disorder, although most will experience several. Signs and symptoms of autism spectrum disorder include:
- Making little or no eye contact
- Not looking at or listening to people
- Failure to respond to someone trying to get their attention
- Having problems having back-and-forth conversations
- Having facial expressions, gestures, and movements that dont match whats being said
- An unusual tone of voice
- Trouble understanding others points of view or predicting others actions
- Unusual behaviors or repeating certain behaviors
- Intense, lasting interest in certain topics
- Overly focused interests
- Inability to cope with changes in routine
- Greater or lesser sensitivity than neurotypical people to sensory input, such as noise or temperature
People with autism also have marked strengths, which may include:
The ability to remember information for a long time
Being a strong visual and auditory learner
Excelling in a particular subject, such as math, art, or music
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Myth: People With Autism Can’t Feel Or Express Emotion Or Understand The Emotions Of Others
Truth: People on the spectrum enjoy a wide range of emotions like neurotypical people, but they often express their emotions in different ways. Although some people with autism may have trouble deciphering unspoken communication or tones of voice, the majority can feel empathy when someone clearly expresses their emotions.
Getting Help With Bipolar Disorder
If you think you may be experiencing some of the symptoms of bipolar disorder, contact your GP. Your GP should be able to refer you to a local mental health team for further help.
To get a better understanding of the symptoms, your GP or the mental health team may ask you some questions.
- How many symptoms do you experience?
- How long do your manic or depressive episodes last?
- How many episodes have you had, and how frequently do they occur?
- What impact do your symptoms have on yourlife?
- What is your family history of mental health conditions?
The mental health team may also ask you to keep a diary of your moods to help them to rule out other possible conditions that could be causing your symptoms.
The full diagnosis process can take a while, as doctors and psychiatrists may want to monitor symptoms over time to avoid misdiagnosis.
Read our Seeking help with mental health information for further details on accessing support.
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Myth: People With Autism Don’t Want Friends
Truth: Surely, there are some people with autism who choose to stay away from other people, but the vast majority enjoy socializing and want to have friends. But some dont know how to interact with others, and they may make social mistakes that leave them feeling anxious about interacting with people in the future.
Autism And Bipolar Disorder Prevalence
In a on Aspergers syndrome, a condition now included under the scope of autism spectrum disorders , researchers found as many as 27% of autistic children showed symptoms of bipolar disorder.
A small-scale study from 2019 suggested autistic people were 9.34 times more likely than neurotypical people to receive a clinical diagnosis of bipolar disorder.
More recent studies continue to support this correlation but indicate the actual number of dual diagnoses may be either higher or lower.
In 2013, a large, family-based study found as many as 30% of people living with bipolar disorder also met the criteria for an ASD diagnosis. The average onset of bipolar disorder was also noted as significantly earlier when co-occurring with ASD.
A 2016 study, however, found the co-occurrence rate was closer to 8%, also noting the onset of bipolar disorder was earlier among autistic people.
That same study found co-occurring ASD and bipolar disorder more frequently included symptoms of:
- racing thoughts
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The Connection Between Bipolar Disorder And Autism
Bipolar disorder and autism are distinct diagnoses. There are, however, some ways in which the two disorders can look similar, and it is perfectly possible to be diagnosed with both autism and bipolar disorder.
According to one study, about 7% of people with autism are also bipolar this is nearly three times the percentage of people in the general population.
Another study found about 30% of youth diagnosed with bipolar I disorder are also diagnosable with autism spectrum disorder.
Recently, studies have found genetic connections between autism and several mental illnesses, including schizophrenia and bipolar disorder this probably explains some of the symptom crossovers.
In addition to the reality that there are real crossover symptoms, there are many symptoms of bipolar that appear in people with more severe autism but for entirely different causes. Some of these include hyperactivity, disturbed sleep, impulsivity, agitation, and irritability.
While it’s reasonable to ascribe some of those symptoms to bipolar disorder, it can be very difficult to sort out bipolar from autistic symptoms.
Myth: People With Autism Are Intellectually Challenged
Truth: Autism spectrum disorder is a developmental, not an intellectual, disorder. This means that people who have autism generally have a normal IQ and can excel in many pursuits. In fact, 44 percent of children identified with autism spectrum disorder have average or above-average intellectual ability.
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You Don’t Seem To Understand Feelings
A person on the autism spectrum can understand what emotions are in theory but have a hard time putting that knowledge to work in real time. This can lead to awkward or upsetting interactions.
Dr. Marsh says, “You have successfully learned to imitate and engage in ‘small talk’ through observation, but you find yourself unable to converse about anything personal, emotional, or in-depth.”
How Are Bipolar Disorder And Autism Similar
Jessica Myszak, PhD, psychologist, and founder of the Help and Healing Center in Glenview, Illinois, says, Autism and bipolar disorder could both sometimes have sleep difficulties and behaviors that others dont understand such as behavioral rigidity, impulsivity, becoming overwhelmed, and differences in speech.
Some additional overlapping symptoms of autism and bipolar disorder could include:
- talking excessively or rapidly
According to Myszak, one of the major differences between bipolar disorder and autism is that autism is a neurodevelopmental disorder that is present from childhood, while bipolar disorder is usually diagnosed sometime between late adolescence and early adulthood.
Bipolar disorder is episodic and consists of periods of mania or hypomania and depression, she adds.
Bipolar disorder is considered a mood disorder. You can have extreme highs or extreme lows that can last weeks or even longer. Many people experience both highs and lows.
Autism, on the other hand, is considered a neurodevelopmental condition that affects the way a person communicates, behaves, and interacts with others. If you have autism, youll likely show certain patterns of behavior and communication.
Myszak says bipolar disorder can often be managed with medication. As for autism, medications might be prescribed to help manage certain conditions that commonly coexist with autism, such as depression, anxiety, and hyperactivity.
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You Have A Tendency To Monologue
People with autism have a tough time interacting with others. It goes to follow that having a conversation is difficult for them at times, usually because they don’t know when to speak, when to ask questions, and do other things that people often take for granted.
“You can lecture at length on topics of interest to you, but you freeze up when confronted with making ‘small talk’ or responding to another persons questions,” says Dr. Marsh.
When To Contact A Doctor
Parents or caregivers who notice a child may be developing slower, or differently, than expected should talk with a doctor.
If children have trouble adjusting to, or engaging with, daily activities or demonstrate other symptoms or differences in behavior that impact behavior or communication, it is advisable to contact a doctor.
People who think they may be experiencing symptoms of mania or depression should also talk with a doctor as soon as possible.
Getting early, proper treatment typically reduces the risk of negative complications and increases the chance someone can live a normal life.
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Autism And Psychosis Can Co
The previous post claimed that the diametric model of mental illness fits the finding that people who suffer from both bipolar disorder and autism show relatively better overall functioning.
But what I did notand at the time could notexplain was exactly how or why. After all, according to the model, psychotic and autistic disorders are opposites, and so should never be found as pathologies in the same person!
As Abu-Akel and colleagues point out in the report on which my previous post was based, even though schizophrenia spectrum disorders and autism spectrum disorders are considered distinct conditions, there is evidence for an overlap between ASD and BD:
To date, the majority of reports of ASD-BD comorbidity are in ASD samples, with prevalences ranging from 6% to 21.4% . Only two studies have assessed ASD in BD samples: in youths , 30% met diagnostic criteria for ASD and in a small sample of adults , 50% had high levels of autistic traits as measured with the Social Responsiveness Scale .
Indeed, a self-report which illustrates the indisputable co-occurrence of ASD and BD was included in my book, The Imprinted Brain:
You Want More Friends But Don’t Know How
There’s a common misconception that people with autism don’t like people, but that’s just not the case. People with autism really want to have close friends, they just don’t know how.
Dr. Marsh says that, “If you marveled at how other kids could make friends so easily, but you didnt know how,” this could be a sign of autism.
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Mental Illness Vs Developmental Disorder
Mental illnesses are health conditions that involve changes in mood, emotion, thinking, and behaving. They are associated with mental distress and problems with social functioning. Around one in five adults in the United States has some form of mental illness at any given time, according to the American Psychiatric Association.1 The most common mental illnesses are anxiety and depression. Mental illness can occur at any age and is treatable with medication, therapy, or a combination of medication and therapy.
One in Five Adults Have a Form of Mental Disorder
Developmental disorders like autism differ from mental illness in several important ways. Developmental disorders generally appear at birth or during childhood and are diagnosed by the age of 18. While mental illness doesnt typically interfere with cognitive abilities, a developmental disorder may impact a persons ability to learn or to understand certain thoughts. Unlike mental illness, which can be successfully treated, developmental disorders are lifelong disabilities.
Autism is 4 Times More Common in Boys Than Girls
Autism And Bipolar Disorder
May 22, 2014
This weeks Got Questions? answer comes from psychiatrist Jessica Hellings, MD, and psychologist Andrea Witwer, PhD, program directors at Ohio State Universitys Nisonger Center, which is part of Autism Speaks Autism Treatment Network.
For those of you not familiar with bipolar disorder, its a mood disorder once known as manic depression. Persons with bipolar disorder alternate between a frenzied state known as mania and episodes of depression. While some individuals experience only the manic episodes, many affected individuals rapidly alternate between these two states and experience great irritability.
As with other psychiatric disorders, studies suggest that bipolar disorder may be relatively common among children and adults with autism. Some studies have found that as many as 27 percent of those with autism also have symptoms of bipolar disorder. By contrast, its prevalence in the general population is around 4 percent.
However, we believe that bipolar disorder is mistakenly over-diagnosed in those with autism. In part this is because some of their symptoms can overlap.
For these reasons, traditional methods of assessing psychiatric disorders can be inappropriate for many of those with autism. Its particularly important for the doctor to get to know the individual and his or her family and environment before attempting such a diagnosis.
The point is that all these behaviors could be considered symptoms of bipolar disorder!
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Antipsychotic Or Mood Stabilizing Medication To Treat Bipolar Disorder
Since significant amelioration of symptoms occurred in the study referred to above the authors conclusion, relating to treatment of mood disorder in ASD improving clinical outcomes, makes sense. Unfortunately this may be a complicated feat as mood disorders are difficult to diagnose in a pediatric population with communication deficits and symptoms masking and overlapping with those of other mental disorders. Even when a child is accurately diagnosed with ASD and comorbid bipolar disorder, the medication described for mood disorders has many side effects that may be especially severe in children.
With doctors increasingly recommending multiple medications to effectively treat autism and comorbid bipolar disorder, safety concerns are amplified. Considerations focused on safety are crucial, and should encourage further studies to establish outcomes of long-term use of antipsychotics and mood stabilizers in children, especially when such medication is combined with other medicine prescribed for ASD symptoms.
Research suggests youth with comorbid ASD and bipolar disorder may experience more severe symptoms, and pharmacological intervention may improve quality of life. The safety concerns of prescribing multiple mood altering medication for young children means parents should seek diagnosis and intervention from medical experts with extensive experience in the complicated manifestation of comorbid psychiatric conditions.
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How To Recognize Mania In An Autistic Person
If you think you or a loved one may have both bipolar disorder and autism, its important to understand how the conditions appear together. The symptoms of comorbid bipolar disorder and autism are different than if either condition appeared by itself.
If the behaviors have been a constant since symptoms associated with autism appeared, theyre unlikely to be the result of mania. However, if you noticed a sudden shift or change, these behaviors may be the result of mania.
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How Autism Spectrum Disorder Is Diagnosed And Treated
Autism spectrum disorder is diagnosed based on a childs development and behavior, according to the National Institute of Mental Health.3 It can be detected as early as 18 months, although most children arent diagnosed until after the age of four. The sooner its diagnosed, the better the developmental outcomes.
While theres no cure for ASD, early intervention services available under the Individuals with Disabilities Education Act can dramatically improve a childs development, including walking, talking, and interacting socially.
Treatment for autism spectrum disorder is highly individualized and involves a combination of therapies, services, and support. Although there are no medications that can treat the core symptoms of autism, medication may be used to improve functioning by helping individuals manage issues like seizures, depression, high energy levels, or difficulty focusing.
For the most part, treating ASD involves non-pharmaceutical interventions, such as:
Offers emotional support and resources to people with autism and their families
Other interventions may include intensive parent training programs, social skills groups, and play-based skills groups.
Symptoms Or Differences In Autistic People
Experts consider autism to be a spectrum disorder because there is such a large variation in the differences people experience and their severity. The American Psychiatric Association diagnose ASD by looking at these potential differences:
- repetitive behaviors
- restricted interests in the external environment
- trouble interacting and communicating with others
- symptoms that impact someones ability to function normally
- trouble making or maintaining eye contact
- long lasting, intense interest in special topics
- reacting negatively to changes in routine
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Treatment Of Bipolar Disorder
Currently, bipolar disorder cannot be cured, though psychiatrists and psychologists believe that it can be managed. The emphasis of treatment is on effective management of the long-term course of the illness, which usually involves treatment of emergent symptoms. Treatment methods include pharmacological and psychotherapeutic techniques such as Cognitive Behavioral Therapy. Ultimately ones prognosis depends on many factors, which are, in fact, under the individuals control: the right medicines the right dose of each a very informed patient a good working relationship with a competent medical doctor a competent, supportive, and warm therapist a supportive family or significant other and a balanced lifestyle including a regulated stress level, regular exercise and regular sleep and wake times.
There are obviously other factors that lead to a good prognosis, as well, such as being very aware of small changes in ones energy, mood, sleep and eating behaviors, as well as having a plan in conjunction with ones doctor for how to manage subtle changes that might indicate the beginning of a mood swing. Some people find that keeping a log of their moods can assist them in predicting changes.
The goals of long-term optimal treatment are to help the individual achieve the highest level of functioning while avoiding relapse.
Click here for the full range of Asperger’s and autism fact sheets at www.autism-help.org