the Confusion: Anxiety vs. Bipolar Disorder Symptoms

Anxiety disorder and bipolar disorder?

About a year ago, I sought medical attention and was diagnosed with bipolar disorder.
Recently, I have been experiencing mood swings and decided to visit a new clinic, where I was informed that my condition is completely different and is actually anxiety disorder.
However, I do not feel that I exhibit symptoms of anxiety.
I tend to be easily irritable, suddenly angry, and restless, but these feelings pass quickly.
I have also been experiencing difficulty sleeping and waking up early, along with trouble falling asleep.
Others have noted that I generally lack energy, but one day I felt particularly excited.
Recently, I have been binge eating and constantly eating, which may be related to anxiety.
At work, I have unconsciously pressed down on a pen, which I mentioned to the doctor.
I also explained my previous diagnosis of bipolar disorder and mentioned self-harming behaviors, but these were limited to times of extreme emotional instability.
I later forgot to ask the doctor what the symptoms of anxiety disorder were, and upon inquiring, I learned that it is simply anxiety and insomnia.
After taking medication, I felt the need to return for a follow-up, but I am now considering seeing a doctor again due to my emotional instability and loss of interest in everything.
I am unsure how my symptoms compare to those described online for anxiety disorder, and I am confused about which doctor's judgment to trust.
I am not clear whether I have bipolar disorder, depression, or anxiety.
During times of emotional instability, I can become irritable and experience particularly pessimistic thoughts, and I have even contemplated suicide, though I lack the courage to act on it.
I was quite surprised to learn that I have anxiety disorder because I do not understand how it relates to my experiences, and the doctor did not provide a detailed explanation.

Wu, 20~29 year old female. Ask Date: 2023/04/14

Dr. Qiu Junda reply Psychiatry

Hello.
Please do not become overly attached to the diagnostic labels, as this may add to your mental and emotional distress.
It is advisable to consider both physicians' diagnoses with the understanding that they are symptoms.
Initially, it seems that you may be experiencing issues related to emotional instability, leaning towards symptoms of bipolar disorder.
However, it appears that negative emotions (depression) are more prevalent.
In this context, symptoms of anxiety may also occasionally arise.
Medically, the treatments for these symptoms often overlap.
I recommend seeking treatment for these symptoms of bipolar disorder and anxiety to facilitate improvement (there is no need to definitively establish a diagnosis; for example, having depressive feelings does not necessarily mean one has major depressive disorder).

Reply Date: 2023/04/14

More Info

Understanding the distinction between anxiety disorders and bipolar disorder can be quite challenging, especially when symptoms overlap. Your experience of fluctuating moods, irritability, and sudden emotional changes can indeed be indicative of both conditions, but they manifest in different ways and have distinct underlying mechanisms.

Bipolar disorder, also known as manic-depressive illness, is characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). During manic phases, individuals may feel euphoric, full of energy, or unusually irritable. They may engage in risky behaviors, experience racing thoughts, and have decreased need for sleep. Conversely, during depressive episodes, they may feel sad, hopeless, and lose interest in activities they once enjoyed, often accompanied by feelings of worthlessness or thoughts of self-harm.

On the other hand, anxiety disorders, including generalized anxiety disorder (GAD) and panic disorder, are characterized by excessive worry, fear, and apprehension. Symptoms can include restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances. While individuals with anxiety may experience sudden panic attacks that can mimic the intense feelings of a manic episode, the underlying cause is different. Anxiety is often rooted in chronic stress and worry about future events, while bipolar disorder involves distinct mood episodes that can last for days, weeks, or even longer.

Your description of feeling irritable and experiencing sudden anger, followed by periods of calm, could suggest a mood instability that is often seen in bipolar disorder. However, if these mood changes are more reactive to stressors and do not fit the classic patterns of mania or depression, it may lean more towards an anxiety disorder. The fact that you mentioned feeling a lack of energy and interest in activities, along with sleep disturbances, could indicate a depressive component that is often present in both anxiety and mood disorders.

It's essential to consider that mental health diagnoses can be complex and multifaceted. Many individuals experience symptoms that do not fit neatly into one category, leading to confusion and misdiagnosis. The overlap of symptoms can make it difficult for both patients and healthcare providers to arrive at a clear diagnosis.
In your case, it would be beneficial to seek a comprehensive evaluation from a mental health professional who can take a detailed history of your symptoms, their duration, and their impact on your daily life. This evaluation may include standardized assessments and questionnaires that can help clarify your diagnosis. It’s also important to communicate openly with your healthcare provider about your concerns and experiences, including any self-harming behaviors or thoughts of suicide. These are serious issues that require immediate attention and intervention.

If you feel that your current treatment plan is not addressing your symptoms effectively, it may be worth discussing this with your doctor. Sometimes, a second opinion can provide new insights or alternative treatment options. Treatment for anxiety disorders often includes psychotherapy, such as cognitive-behavioral therapy (CBT), which can help you develop coping strategies and address negative thought patterns. Medications, such as selective serotonin reuptake inhibitors (SSRIs), may also be prescribed to help manage anxiety symptoms.

In conclusion, while it can be confusing to navigate the distinctions between anxiety disorders and bipolar disorder, understanding your symptoms and seeking appropriate help is crucial. Mental health is a complex field, and it’s important to find a provider who can work with you to develop a tailored treatment plan that addresses your unique needs. Remember, you are not alone in this journey, and there are effective treatments available to help you regain control over your mental health.

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