Co-occurring Conditions – Link between Autism and Bipolar Disorder

Bipolar disorder is a brain disorder that causes periods of mood swings, depressions, an unusual shift in energy and activity levels. The constant changing mood swings or elevated mood swings are known as Mania or hypomania. During mania, usually, people feel abnormally high in energy, irritated or very happy. Therefore, bipolar disorder(BD) is also known as manic depression. People sometimes spend days or more than weeks between a frenzied state and manic depressions.

Autism spectrum disorder (ASD) is a developmental and neurological disorder which starts early in a person’s childhood and continues throughout his life. It is a “spectrum condition” which affects every person differently and to varying degrees.  Most of the behaviors linked to autism are difficulty making eye contact, speech or language delay, making effective conversation. Some of the symptoms also include a problem with executive functioning in relation to planning and reasoning and poor motor skills.

How autism and Bipolar syndrome are connected?

According to an article on NCBI, autism continues through the life but its phenotype expression shows constant variation with age. According to the survey, among all the autistic people, 16 percent show mania and 26 percent show bipolar disorder(BD).

There is an etiological link between Autism and Bipolar disorder. In most of the cases, professionals believe that bipolar disorder is accidentally over-diagnosed in those with autism. This happens as a few of both of the symptoms can overlap. However, autism and BD share several common behaviors and symptoms.

It is very important to recognize the symptoms of BD correctly so that a person or a psychiatrist starts working on the symptoms as soon as possible. However, Autistic people are not able to communicate freely, which cause a huge problem for the psychiatrist to determine particular behavior in those patients. To determine if a person has autism and bipolar both or not? a lot of research is done.

Research on Autism and Bipolar disorder

According to some research, there is a genetic link between autism and bipolar disorder,  with other types of disorders including schizophrenia and ADHD. Also, according to another study, in University of North Carolina School of Medicine found that autistic people have a higher possibility of having sibling or parents who already had diagnosed with the bipolar disorder of schizophrenia. Some specific kind of genes can something increase the possibility of having autism.

A new study shows that there may be an overlap between bipolar disorder (BD) linked to rare genetic variations. It also says that bipolar disorder is extremely heritable and genes are regarded as the potentially responsible in case of bipolar disorder. Several of those genes are involved in autism.

People with autism are linked with higher sensitivity in relation to sight and hearing. Both people with autism and Bipolar disorder experience some kind of hallucinations. An individual with bipolar disorder sometimes also experience some kind of psychotic symptoms, including hallucinations or delusions. Some of the hallucination associated with autism and Bipolar Disorder are –

  • Higher sensitivity to sight or imagining things like shapes, object or light which are not present at that time.
  • Hearing voices or sounds which no one else can hear.

How to compare symptoms of Autism and bipolar disorder?

An individual with bipolar disorder often experiences intense emotions, unusual behavior, and sleep deprivation. Each person experiences different mood swings. Therefore, there are two categories according to the symptoms, one is the manic episode and other is depressive episode depending on the mood and behavior of the person.

Symptoms of people with the manic episode –

  • Feeling irritable, agitated or “touchy”,
  • Sleep deprivation,
  • A sudden change in thoughts,
  • Most of the time feel “wired” or “jumpy”,
  • High in energy,
  • Become impulsive suddenly like spending a lot of money,
  • Suddenly elated self-esteem.

Symptoms of people with the depressive episode –

  • Sudden decreased activity level,
  • Increase or decrease in appetite suddenly,
  • Unexpected weight gain or weight loss,
  •  Difficulty in focusing,
  • Most of the time have felt tired or “slowed down”,
  • Feeling suicidal,
  • Constant worrying about something or the other,
  • Loss of interest in daily activities.

Every autistic person is different from the other. Therefore, the symptoms of autism vary from one person to another.

Some of the autism symptoms are –

  • Impairment in social interaction
  • Face communication challenges,
  • Show very limited practices or preferences which are very difficult to change.
  • Experience repetitive behaviors,

Recognising Mania in a person with Autism

In autism, it is very easy to recognize autism but it becomes very difficult to recognize mania in any person whether the person is your relative or any friend.

If the behavior of the person remains same but some of the autistic symptoms appeared, this is not the case of mania. But if some shift or change appears in the behavior of the person, it can be because of mania. In case you noticed the change in symptoms then from the following mania symptoms try to identify mania.

Some of the symptoms of Mania are –

  • Sleep deprivation,
  • Get distracted very easily,
  • Experience repetitive behaviors or more talkative than usual,
  • Inflated Self-esteem,
  • Psychomotor agitation or Increase in goal-directed activity,
  • Sudden racing of thoughts,
  • Increase involvement in pleasurable activities that involve high energy.

In most of the cases, the bipolar disorder symptoms in people with autism can sometimes appear different than they would in other people. Some of the symptoms are “pressured speech” ( loud, rapid and virtually nonstop talking), an abrupt decrease in sleep, constant pacing, and increased impulsivity which often results in aggression.

In case you think both the symptoms of autism and bipolar are similar. Then, consult a doctor. A mental health specialist will examine the autistic patient medically. Try to review all your concerns and later on the basis of the diagnosis, the doctor will decide whether its bipolar disorder or not?

Diagnosis of Autism and bipolar disorder

The process of diagnosis is not an easy task. In some of the cases, health professionals have to adopt different methods for getting a diagnosis. Before making any kind of diagnosis, the doctor will eliminate some of the autism conditions. There are many autism conditions which occur with bipolar disorder such as –

  • Oppositional defiant disorder
  • The attention deficit hyperactivity disorder
  • Schizophrenia
  • Depression

The expectation from the treatment plan

A Healthcare professional or psychiatrists usually suggest psychoactive medications for bipolar disorder treatment.  One of the most common treatments for bipolar disorder is Lithium. However, Lithium(Eskalith) has some side effects such as excessive drinking, thirst, life-threatening toxicity, bed wetting and shaky hands. These side effects became a major concern for those autistic people who face communication difficulties. They will not able to even communicate their problem to others in case of life-threatening situations.

There are some other medications such as anti-seizure and mood-stabilizing medications like Valproic acid. It is a much safer option for the treatment of autistic people with bipolar disorder.

Doctors also prescribe a combination of a low dose of an antipsychotic medication and mood-stabilizing medicine. Some of the medications combinations are aripiprazole (Abilify) and risperidone (Risperdal). But there is some risk in consuming these medicines such as diabetes and weight gain with some of the antipsychotic drugs. Therefore, caretakers or doctors carefully monitor children.

Especially for children, some of the doctors use a combination of therapy and education. This combination not only controls excessive mood swings but also improve their behavior and reduces the stress level.

The goal of Long-term treatment

In case you have an autistic family member who has bipolar disorder, don’t lose hope. Try to find or develop a community of support that can be helpful to you or similar people like you. Consult the doctor and ask him about the support groups.

You can also opt for one-on-one therapy from a certified health specialist. One can also ask for group therapy sessions depending on the availability of time and resources.

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Co-occurring Conditions – Link between Autism and Bipolar Disorder
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