New Study Examines Link Between Biopolar Disorder and Anxiety

A new, national survey found that adults with bipolar disorder are equally likely of developing anxiety and depression after an episode of mania.

A group led by Mark Olfson, MD, MPH, a professor of psychiatry at Columbia University Medical Center, studied 34,000 adults, interviewing participants in an effort to determine the incidence of manic episodes. Olfson and colleagues also conducted second interviews with these patients 3 years later to evaluate the subsequent incidence of depression or anxiety.
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Overall, the investigators found that study participants with mania were at approximately the same risk of developing depression or anxiety, and both conditions were substantially more common among those with mania than those without it. Patients with depression were also at a much greater risk of developing mania or anxiety when compared to those without depression.

In managing adults with bipolar disorder, “it is important to not just track symptoms such as those related to depression and mania, but also to assess patients for common anxiety symptoms, such as feeling restless, nervous, tense, or a sense of panic,” says Olfson, who is also a research scientist at New York State Psychiatric Institute.

Because antidepressants can destabilize patients with a history of mania, “many primary care practitioners are in the habit of asking about a history of mania before prescribing an antidepressant for a new episode of depression,” adds Olfson.

Given that patients with mania also often develop anxiety, “similar questions should be asked before starting a patient who presents with anxiety on an antidepressant,” he says. “Along the same lines, when adults with anxiety do not respond well to antidepressants, it makes sense to ask about a history of manic symptoms.”

—Mark McGraw

Reference

Olfson M, Mojtabai R, et al. Reexamining associations between mania, depression, anxiety and substance use disorders: results from a prospective national cohort. Molecular Psychiatry. 2016.