Even though post-traumatic stress disorder (PTSD) and bipolar disorder are two separate disorders, it is possible to have some trouble telling them apart because of the symptoms they share.
Below, we will cover some of the ways they are alike and different and how you can tell them apart. In either case, no matter which one is present, a person with mental illness should seek out help for their condition as soon as possible.
What Are Bipolar Disorder and PTSD?
Bipolar disorder is a mental health disorder that, per the National Institute of Mental Health (NIMH), is marked by dramatic shifts in mood, energy, and activity levels that make it challenging for a person to live normally and carry out their daily tasks. The disorder affects the brain and is also known as manic-depressive disorder or manic-depressive illness. According to NIMH, an estimated 2.8% of U.S. adults had bipolar disorder in the past year.
There are different kinds of bipolar disorder. NIMH lists three types of bipolar: bipolar I, bipolar II, and cyclothymic disorder (cyclothymia).
Bipolar I: Someone with bipolar I will have manic episodes that can last as long as seven days. They are marked with disruptive periods of unusually high energy and high mood. These manic symptoms can be so severe that they require hospital treatment. It is possible for psychosis to set in, meaning a person with bipolar I can lose touch with the outside world.
Bipolar II: While many people think of bipolar I upon hearing about the condition, the more common form of the illness is bipolar II, which involves cycles of high and low moods. People with this form of bipolar do not have full-blown manic episodes. They have a milder form of mania (hypomania) and experience at least one depressive episode.
Cyclothymic disorder (cyclothymia): This form of bipolar disorder is milder and involves a person having hypomanic symptoms and depressive symptoms, although neither will meet the diagnostic requirements for a hypomanic episode and a depressive episode, NIMH says. The symptoms must occur for at least two years in adults and at least a year in children and adolescents for it to be diagnosed as cyclothymic disorder.
What Is Post-Traumatic Stress Disorder?
Post-traumatic stress disorder (PTSD) is a mental health disorder that develops after a disturbing event occurs. This event can range from war combat to a vehicle accident, natural disaster, or violence, among others. It can also happen after a non-extreme life event, such as a divorce, job loss, a loved one’s death, or a medical emergency. PTSD makes it near impossible to move on from the distressing situation, no matter how much one tries to. According to the National Center for PTSD, about 6% of the U.S. population will have PTSD at some point in their lives.
It’s important to note that PTSD doesn’t always happen immediately after trauma occurs. It can present in a person years after the event. Women are more likely to experience PTSD than men, data shows.
A person with PTSD can experience any of the following:
- Flashbacks
- Nightmares
- Disturbing thoughts that won’t go away
- Insomnia or other sleep disturbances
- Anger or angry outbursts
- Avoiding reminders of the event, such as a place that triggers a memory
- Avoiding uncomfortable feelings after an event
- Feeling constantly uneasy
- An inability to remember important details about what happened
- Experiencing negative feelings about oneself
- Feeling guilt, blame, or shame (survivor’s guilt)
- Not being able to trust people
- Not being able to enjoy one’s life or pursuits
NIMH advises that a person diagnosed with PTSD must have any of these symptoms for one month:
- At least one re-experiencing symptom (such as a recurring flashback or a bad dream)
- At least one symptom of avoidance
- At least two arousal and reactivity symptoms
- At least two cognition and mood symptoms
Diagnosis of any mental illness should come from a licensed mental health professional who is qualified to make a determination. They should also consult the Diagnostic Statistical Manual of Mental Health Disorders (DSM-5) or the most recent edition available.
Similarities Between Bipolar Disorder and PTSD
Although bipolar disorder and PTSD are different illnesses, there is some overlap between them. Both disorders can cause people to experience depression, which has distinct characteristics. A person with either disorder may:
- Have low energy or feel tired
- Socially withdraw from others, including family members
- Have a hard time concentrating on what they’re doing
- Find it difficult to fall asleep or stay asleep
- Have trouble remembering things or experience mind fog
- Oversleep or sleep for long periods
- Show no interest in activities they once enjoyed
- Have suicidal thoughts or other self-harm
People with bipolar and PTSD can also experience other paranoia, restlessness, and detachment. They also can feel hyper-aware or that they must always be on guard, which overtaxes the body and brain. To self-medicate against these symptoms, they could turn to addictive drugs and alcohol to find relief. While this may provide temporary comfort, it is not safe or effective, and it can lead to the development of substance dependence or addiction.
Having an additional illness only complicates the existing mental illness. A person who develops a substance use disorder in addition to a mental illness must receive professional treatment for each illness at the same time to improve their overall health.
Differences Between Bipolar Disorder and PTSD
Bipolar disorder and post-traumatic stress disorder don’t necessarily have the same root causes, which makes them different. Research continues to find out what exactly causes bipolar disorder. According to Mayo Clinic, it is thought that several factors can cause one to develop it, including:
Genetics: A first-degree relative can have the disorder, such as a parent or sibling
Biological differences: A person with bipolar disorder may have physical differences in their brain structure.
Environment: A person’s surroundings can also have a role in the development of bipolar disorder. Mayo Clinic also says that stressful periods or a traumatic event can cause bipolar disorder to develop in some people. Some of those traumatic events also cause PTSD to develop in a person. Drug and alcohol abuse is also a risk factor for a bipolar episode, it says.
Extreme Emotional Responses Not Common in PTSD
When it comes to PTSD, anyone can develop it after experiencing a traumatic event, whether directly or by witnessing someone else experience it. It doesn’t have to be genetic or biological in nature. However, even if a person has a strong reaction to a trigger that makes them relive a traumatic event, their response will likely not mirror an extreme emotional mood shift as it does with a person who has bipolar disorder. 
In other words, in many cases, a person with PTSD will show emotional and mental breakdown due to dealing with the aftermath of trauma they experienced. In contrast, a person with bipolar may be dealing with their own thoughts that aren’t necessarily tied to any particular event or trauma.
That said, people with bipolar disorder can experience PTSD and can be at higher risk of developing it, which is why it is possible to misdiagnose PTSD as bipolar disorder. In one study published in Bipolar Disorders, researchers observed 1,214 patients with bipolar and noted that they had higher rates of post-traumatic stress disorder.
According to their findings, “the mean prevalence of PTSD in bipolar patients is 16.0%,” which they said is a rate that was about double the lifetime prevalence for PTSD in the general population.
Interestingly, the study also concluded that risk factors for bipolar disorder and PTSD both include greater exposure to trauma, elevated neuroticism, and lower social support and socioeconomic status. This may offer insight into how trauma exposure can affect how one develops either of these disorders.
Misdiagnosing CPTSD as Bipolar Disorder
Complex post-traumatic stress disorder (CPTSD) develops when a person experiences trauma repeatedly over an extended time, such as months or years. These situations can include domestic abuse, child abuse, sexual abuse, human trafficking, and other disturbing events.
Usually, CPTSD starts during childhood, which means experiencing extreme trauma at an early age disrupts normal brain development and rewires the way a person experiences the world and themselves. Many of the symptoms of PTSD are common in CPTSD. Some that may not occur with PTSD include, according to CPTSD Foundation, are:
- Seeking or becoming a rescuer
- Depending on religion to boost one’s self-worth
- Becoming preoccupied with seeking revenge
According to the CPTSD Foundation, CPTSD is misdiagnosed as bipolar disorder because it is not listed in the DSM-5. Without it being listed there, the foundation says mental health professionals have no choice but list it as a condition that is in the DSM.
While this may be subject to debate, the foundation encourages patients to get a second opinion about a diagnosis.
Getting Help for Bipolar Disorder and PTSD
Whether a person has bipolar disorder or PTSD, both mental illnesses can worsen if left untreated. If you or someone you know has either disorder, consider getting professional help as soon as possible. Vista Pines Health in Pembroke Pines, Florida, is among the many facilities in South Florida and the United States that help people find relief and recovery from mental disorders the right way.
People who try to move forward without properly addressing their bipolar or PTSD symptoms will struggle in many areas of their lives, including at work, school, and in their personal and professional relationships.
Once you are diagnosed, a mental health professional can figure out the best treatment plan for you. This plan can include medication, therapies, and both. You may be required to complete treatment in an inpatient/residential facility, which will allow you the time and space to address your illness.
At Vista Pines, we develop customized treatment plans to suit your needs and do everything possible to ensure that you receive the right diagnosis and the right care for your needs. We regularly evaluate our patients and adjust their treatment plans as needed.
Give us a call today to discuss your recovery plan. If you also have substance use disorder, we partner with our sister facility, Arete Recovery, to ensure you can receive treatment help for substance dependence, too.
