Thinking about writing about anxiety and bipolar disorder made me feel overwhelmed. I felt like I would have to spend months compiling my experiences and knowledge and consult with several professionals to do the topic justice. Rather than attempting to do this I have chosen to focus on my own experience for this blog.

In my case, it has been a challenge to figure out the difference between the anxiety I have because of bipolar disorder and my anxiety that was borne from life experiences.

In 2010, I had a manic episode that was followed by a severe depressive episode. I felt lifeless. I did not have the energy to shower, get out of bed and I had to force myself to eat. My anxiety was so high that the thought of opening the door to leave my home made my heart race, my throat tighten, and my muscles would ache with dread like they were trying to prevent me from leaving. Once the episode subsided, my anxiety level dropped substantially and leaving my home was not an issue.

When I am not having a depressive episode, I also experience anxiety but the source of it seems to be my life experiences. I know this because I have had psychotherapy to address the issues from my past and my level of anxiety has dropped tremendously.

 A couple of years ago, I started experiencing a difficult side effect from an antipsychotic I was taking to help manage my bipolar disorder. My psychiatrist’s assessment of my bipolar disorder at the time was that we could try going off the medication. After being off the medication for about a week, I went to a grocery store and my heart began to race, the muscles in my throat tightened and I felt like I was going to throw up.  My anxiety had returned. After describing this experience to my psychiatrist, she put me on a different antipsychotic and my anxiety went back to a manageable level.

These experiences tell me that my anxiety has a bipolar disorder source and a life experiences source. I am not sure where the boundary is between the two or if they are interconnect. I believe that there is a difference because I know psychotherapy alone would not have helped me recover from the anxiety I experienced during my last severe depressive episode or when I was taken off my antipsychotic. I do not believe that medication could have helped the anxiety I suffer from because of some of the experiences I have had in my life.

There are a wide range of approaches available to deal with issues with anxiety. These include mindfulness, a life practice that grounds you in the present moment and includes meditation, Cognitive Behavioral Therapy, a form of therapy that helps you address negative thought patterns, and there are different types of therapy to address issues from the past. In terms of medication, there is a range of approaches psychiatrists can take based on their assessment of their patients’ needs.

Addressing anxiety issues for people who have bipolar disorder is complex and it takes the expertise of a psychiatrist to be able to tease out the source of the problem and the most effective way to treat it. It is one of the most debilitating aspects of having bipolar disorder for many of us but there is a range of strategies, therapies, and medications available that can facilitate a better life for people who struggle with it.