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Panic Disorder and Bipolar Disorder

Possible Co-Occurring Conditions


Updated October 09, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

It is not uncommon for a person with an anxiety disorder to also be diagnosed with a co-occurring mood disorder. Research has suggested that panic disorder has a particularly high co-occurrence with bipolar disorder. Formally known as manic depression, bipolar disorder is a condition that involves fluctuations in mood, depression, and mania.

What is Bipolar Disorder?

The Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) is the handbook that professionals who treat panic disorder and other mental health conditions use to make diagnoses. According to information in the DSM-IV-TR, bipolar disorder is a diagnosable condition that is characterized by episodes of both depression and mania. The following lists some of the common symptoms of mania and depression:

Common Symptoms of Depression:

  • Depressed mood most of the time
  • Loss of interest and satisfaction in activities previously enjoyed
  • Changes in appetite, often noticed by weight gain or loss
  • Sleep disturbances, including insomnia and sleeping too much
  • Psychomotor changes, such as being noticeably restless or slowed down
  • Frequent fatigue and loss of energy
  • Feelings of worthlessness, helplessness, hopelessness and excessive guilt
  • Lack of concentration, trouble thinking, and difficulty making decisions
  • Repeated thoughts of death or suicide

Common Symptoms of Mania:

  • Increased energy and restlessness
  • Little to no need to sleep
  • Racing thoughts
  • Increased impulsivity
  • Impaired judgment
  • Risky behaviors that may involve:
    • Financial risks, such as excessive spending or gambling
    • Sexual risks, such as promiscuity or unprotected sex
    • Substance abuse
    • Other reckless behaviors that present safety concerns

Types of Bipolar Disorder

The separate types of bipolar disorder are distinguished by the intensity of symptoms. Bipolar disorder is classified differently depending on changes in moods known as episodes. As outlined in the DSM-IV-TR, there are three main types of bipolar disorder:

Bipolar Disorder Type I: This type of bipolar disorder is characterized by at least one episode of mania, and usually involves episodes of depression.

Bipolar Disorder Type II: Episodes of depression and hypomania are experienced with this type of bipolar disorder. States of hypomania are milder than full-blown manic episodes and are marked by an elevated or irritable mood.

Cyclothymia: This condition involves episodes of hypomania and depressive symptoms that don't meet full criteria for major depression.

Panic Disorder and Bipolar Disorder

Similar to the symptoms of bipolar disorder, panic disorder can have cognitive, emotional, and physical indicators. The main feature of panic disorder is the experience of panic attacks. These attacks consist of a variety of symptoms that can affect one’s thought processes, and they're often felt through varying physical sensations, such as shortness of breath, shaking, trembling, and chest pain. Despite the difference between these two conditions, both are treatable and have comparable treatment options that may include a combination of medication, psychotherapy, and self-help strategies.

Treatment Options

Bipolar disorder is a complicated condition that can only be diagnosed by a qualified professional. Consult your doctor if you suspect that you may be experiencing symptoms of depression or bipolar disorder. If left untreated, bipolar disorder can lead to impairments in one’s relationships, career, and quality of life. Additionally, people with bipolar disorder are at risk for experiencing suicidal thoughts and behaviors.

Fortunately, there are coping techniques and treatment options available that can help in managing the symptoms of bipolar disorder. Additional information can be found at the About.com’s site for bipolar disorder, where you can find information on medications and other treatment options for bipolar disorder. More facts can also be found that address the symptoms, diagnosis, and support for bipolar disorder.

If you are having thoughts of suicide, seek help immediately by calling 911 or a suicide prevention hotline. These hotlines are toll-free and can provide you with 24-hour assistance. If you are in the United States, you can call the National Suicide Prevention Hotline at (800) SUICIDE (1-800-784-2433), or the National Suicide Prevention Lifeline, (800) 273-TALK (1-800-273-8255).


American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision. Washington, DC: Author.

Chen, Y. & Dilsaver, S. C. (1995). Comorbidity of Panic Disorder in Bipolar Illness: Evidence from the Epidemiologic Catchment Area Survey, AM J Psychiatry, 152, 280-282.

MacKinnon, D. F., & Zamoiski, R. (2006). Panic Comorbidity with Bipolar Disorder: What is the Manic–Panic Connection?. Bipolar Disorders, 8(6), 648-664.

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