Does Anxiety Predict Bipolar Disorder in Children?

Individuals with bipolar disorder struggle with many issues, including poor treatment outcome and overall decreased functioning. Anxiety is common among individuals with bipolar disorder and can exacerbate the negative symptoms, resulting in suicidal ideation, poorer quality of life, more severely impaired functioning, and even nonresponse to medication. But little research has examined how the comorbidity of these two mental health problems affects teens and children. Additionally, there is a narrow body of evidence examining the relationship between the two issues. Understanding the correlates between anxiety and bipolar in young people can significantly benefit their treatment. Children with bipolar who exhibit symptoms of anxiety alone may be prescribed medication that can increase their depressive states, causing their conditions to deteriorate rather than improve.

In an effort to better comprehend how bipolar and anxiety are related in children and to determine if anxiety predicts the onset of bipolar in teens in children, Aswin Ratheesh of the Department of Psychiatry at the National Institute of Mental Health and Neuro Sciences in Bangalore, Karnataka, analyzed the medical records of 46 teens diagnosed with bipolar. Teens with schizophrenia, developmental impairment, and bipolar disorder not otherwise specified were not included in the sampling. Of the 46 teens, nearly half (41%) had received a diagnosis of anxiety at some point in their life, and over one-fourth of the teens were diagnosed with anxiety at the onset of the study. The study revealed that nearly all of the teens (90%) had struggled with anxiety prior to developing bipolar disorder.

Ratheesh also discovered that the teens with anxiety were more likely to have developed bipolar disorder at a younger age than the teens without anxiety. Additionally, they also suffered with longer periods of depression and mania. The teens with anxiety and bipolar displayed a weaker level of functioning and poorer emotional, physical, and social quality of life than those with bipolar alone. Ratheesh realizes that this study does not demonstrate that anxiety causes bipolar but emphasizes the need for clinicians to address anxiety as an isolated issue when treating teens with bipolar. Ratheesh added, “More importantly, treatment studies of bipolar disorder should specifically examine the impact of various comorbid disorders including anxiety disorders on treatment response and outcome.”

Ratheesh, A., Srinath, S., Janardhan R. Y., Girimaji, S., Seshadri, S., Thennarasu, K., Hutin, Y. Are Anxiety Disorders Associated With a More Severe Form of Bipolar Disorder in Adolescents? Indian Journal of Psychiatry 53.4 (2011): 312-18. Print.

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  • Rosemary


    February 2nd, 2012 at 5:27 AM

    Having one of these issues to deal with would be enough by itself, but having to deal with both bipolar and anxiety would be another whole can of worms! How do these patients even manage to get through the day without falling apart?

  • Hewitt


    February 2nd, 2012 at 1:38 PM

    It’s just so important to see if it’s necessary to tweak or even change treatment methods when there are two disorders that coexist.Because when you’re thinking you are curing one of them you could just be making the other worse!!

  • DJ


    February 2nd, 2012 at 5:04 PM

    I am assuming that there are different treatment modes for those suffering from anxiety and bipolar together than there is when one suffers from only one of the disorders.

  • LO


    February 3rd, 2012 at 9:11 AM

    There seems to be an obvious relation between the two,isnt there?rapidly changing moods would leave you depressed.And out of energy.
    just hope the link is better established so as to support better treatment.

  • Daniel


    February 4th, 2012 at 10:39 AM

    This is a really interesting study. In some ways, it isn’t surprising, since so many bipolar patients have anxiety comorbidly anway. However, I was surprised by just how prevalent anxiety diagnoses were, especially among youth.

    It shows that psychiatrists really need to be careful. Many drugs for anxiety are antidepressants, and antidepressants can be very dangerous for people with bipolar disorder, even before their onset (they can even bring on their onset). I hope that pediatric psychiatrists take notice of these findings.

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