Bipolar Disorder: 4 Related Mental Health Conditions
Mental Health ConditionsBipolar Disorder

Bipolar Disorder Raises Your Risk for These 4 Mental Health Conditions, Too

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Updated on December 15, 2025
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Bipolar Disorder Raises Your Risk for These 4 Mental Health Conditions

Bipolar disorder is characterized by manic and depressive episodes. Being diagnosed could mean you are at risk for these related mental health conditions.
Bipolar Disorder Raises Your Risk for These 4 Mental Health Conditions

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If you’re being treated for bipolar disorder but still have persistent, unexplained mental health symptoms, you’re certainly not alone. It’s not uncommon for persistent symptoms to signal one or more additional undiagnosed mental health conditions. Research indicates that about 65 percent of people with bipolar disorder have at least one other psychiatric condition.

While experts aren’t entirely sure why bipolar disorder occurs alongside other mental health conditions, research indicates that genetics and childhood trauma likely play a role.

 Unfortunately, being told you have multiple mental health conditions — called comorbid or co-occurring conditions — can also result from misdiagnosis, since other conditions often share symptoms with bipolar disorder, such as changes in mood, energy, and activity levels.

Nonetheless, if you have bipolar disorder, learning about related conditions may be helpful for improving your overall well-being. That’s because having an untreated co-occurring psychological condition can worsen your bipolar symptoms, making it harder to function day-to-day, says Howard Weeks, MD, a psychiatrist at University of Utah Health in Salt Lake City.

Here are four mental health conditions that research says frequently co-occur with bipolar disorder.

1. Anxiety Disorders

Anxiety disorders are a group of mental health conditions characterized by disproportionate fear or worry that affects your ability to function normally. They’re the most common mental health condition, affecting 30 percent of adults at some point in their lives. Anxiety disorders include generalized anxiety disorder, social anxiety disorder, and panic disorder, among others.

Symptoms include the following:

  • Continual, often intense feelings of worry that interfere with day-to-day activities
  • Difficulty concentrating
  • Increased heart rate or palpitations
  • Nausea
  • Shaking or trembling
  • Upset stomach
It’s very common for people with bipolar disorder to have an anxiety disorder, too. One research review found that about 40 percent of people with bipolar disorder will also have an anxiety disorder at some point during their lives.

Anxiety disorders that occur alongside bipolar disorder can complicate the course and treatment of both conditions, according to research.

 For instance, when someone with bipolar disorder has a manic or depressive episode, it could worsen their anxiety, Dr. Weeks says.

 And the reverse is true: Some symptoms of anxiety, such as difficulty sleeping, could trigger or deepen bipolar manic and depressive symptoms.

brain in four puzzle pieces

It's not uncommon for people with bipolar disorder to have other mental health conditions, too, such as anxiety disorders.

Andrii Tokarchuk/iStock; Canva

2. Substance Use Disorders

A substance use disorder (SUD) is a complex condition that is defined by the unrestrained use of drugs or alcohol in spite of adverse consequences.

The symptoms of SUDs include the following:

  • Cravings or a strong desire to use drugs or alcohol
  • A wish to cut down or quit use of drugs or alcohol, or past failed efforts to do so
  • Unmet responsibilities at school, work, or home due to substance use
  • Less time spent doing things you normally do for work, at home, for leisure, or for socializing
  • Consumption of substances in unsafe circumstances or places
  • Persistent use despite adverse effects
  • An increased tolerance to the substances you use, requiring larger amounts
  • Withdrawal symptoms after use
It’s estimated that at least 40 percent of people with bipolar disorder will develop an SUD at some point in their lifetime, according to research.

There are several reasons that the co-occurrence of these disorders is so common. In some cases, people turn to substances to self-medicate their bipolar symptoms and then, over time, their substance use evolves into a disorder, says Weeks.

According to research, using substances is one way some people cope with mood-episode-related symptoms — using alcohol or substances to ease depression or enhance the high of mania, for example. Unfortunately, using substances can trigger or worsen mood episodes, and it may increase the risk of developing an SUD.

“Another possibility is that when patients are depressed or manic, they may begin using substances when they normally would not,” says Weeks. “Again, over time this can trigger a substance use disorder.”

Genetics may also play a role. One large study suggested that alcohol use disorder, excessive alcohol consumption, bipolar disorder, and schizophrenia may all be genetically linked.

3. Borderline Personality Disorder

Borderline personality disorder (BPD) is a mental health condition marked by difficulty regulating emotions, impulsive behaviors, and dysfunction in relationships.

 BPD is often confused with bipolar disorder by medical professionals, largely because their symptoms often overlap, says Weeks.

Those symptoms include the following:

  • Difficulty regulating emotions
  • Fear of abandonment
  • Inability to maintain stable relationships
  • A distorted sense of self-identity, which is usually overly negative
  • Drastic mood changes that can last a few hours or days
  • Impulsive or risky behaviors, including excessive spending or substance use
  • Feeling worthless
  • Intense anger
While it’s possible for someone to have both bipolar disorder and BPD — sometimes referred to as “borderpolar” — misdiagnosis can happen. One research review found that as many as 40 percent of people who have BPD were initially misdiagnosed with bipolar disorder.

Approximately 10 percent of people with bipolar 1 and 20 percent of people with bipolar 2 also have BPD, according to research.

4. ADHD

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by difficulty focusing, hyperactivity, or impulsive behavior.

Common symptoms include the following:

  • Difficulty focusing, staying organized, and completing tasks
  • Making seemingly careless mistakes
  • Forgetfulness
  • Easily distracted
  • Inability to finish tasks
  • Seeming distracted or in a daydream when engaged in conversation
  • Constant movement or significant feelings of restlessness
  • Excessive talking or interrupting others
  • Fidgeting or feeling unable to sit still
  • Impatience
  • Making impulsive decisions without considering the consequences first
As many as 17 percent of adults with bipolar disorder will also be diagnosed with ADHD during their lifetime, according to research. Having ADHD along with bipolar disorder is connected to lower levels of functioning and worse bipolar illness, specifically to a higher number of rapid cycling episodes.

Although bipolar disorder primarily affects mood and ADHD primarily affects attention and behavior, the conditions share some symptoms, such as irritability and impulsivity, making differentiating between the two challenging.

 The high energy levels, disorganized thought process, and lack of planning skills in some people with untreated ADHD can look a lot like mania, for example.

With ADHD, depression is also common — studies have estimated that anywhere from 18.6 to 53.3 percent of people with the condition will experience it, which can complicate diagnosis.

Having both bipolar disorder and ADHD can worsen aspects of each condition, according to research, which is why it’s critical for people with these two conditions to be properly treated for both.

If you have symptoms that aren’t explained by your bipolar disorder diagnosis, talk to your psychiatrist about other potential causes. Accurate diagnosis and treatment of co-occurring conditions is crucial; treating them appropriately can improve your quality of life.

The Takeaway

  • A majority of people with bipolar disorder live with other mental health conditions, too.
  • Many conditions can occur alongside bipolar disorder, including anxiety disorders, substance use disorders, borderline personality disorder, and attention deficit hyperactivity disorder.
  • It’s important to investigate any mental health symptoms not explained by your bipolar disorder diagnosis; treating co-occurring conditions adequately can improve your quality of life.

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Lee S. Cohen, MD

Medical Reviewer
Castle Connolly Top Doctor, From NewYork-Presbyterian

Lee S. Cohen, MD, is an associate professor of clinical psychiatry at Columbia University Irving Medical Center, maintains a clinical practice focused on expert and complex diagnostics, and is considered an international expert in clinical psychopharmacology. He is also the director of the Clinical Neuroscience Center, involved in innovative development and discovery of new compounds for neuropsychiatric conditions and directly consults with multiple pharmaceutical companies worldwide.

Dr. Cohen graduated from the Sophie Davis Biomedical Education Program at the CUNY School of Medicine at The City College of New York, an accelerated six-year BS/MD program. He then completed his MD at SUNY Stony Brook School of Medicine.

He trained in pediatrics and adult psychiatry at Mount Sinai Hospital in New York City, followed by a fellowship in child and adolescent psychiatry at New York Presbyterian Columbia University Irving Medical Center. He served for 20 years as the director of psychiatry at the Clinical Neuroscience Center at Mount Sinai West Hospital.

He is a senior reviewer for multiple journals, including the Journal of Child and Adolescent Psychopharmacology, the Journal of Developmental and Physical Disabilities, and the International Journal of Autism and Related Disabilities.

Cohen teaches and presents research domestically and internationally at meetings such as those of the American Psychiatric Association and at major universities around the country.

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Michelle Pugle

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Michelle Pugle is a Canadian freelance health writer who is certified in mental health first aid, with training in suicide prevention and several counseling methodologies. Her work highlights the latest knowledge from peer-reviewed research, subject matter experts, and lived experiences to create credible, accessible, and inclusive content that has a meaningful impact on readers. Pugle writes comprehensive yet concise articles for award-winning websites, such as Healthline, Verywell, Psych Central, and Health.com.

Her health recovery narratives can be found at the National Eating Disorder Information Centre, The Mighty, and in Ana, Mia & Me: An Eating Disorder Recovery Memoir. She writes about mood disorders, eating disorders, addictions and recovery, and nutrition news and trends. Pugle's educational background is interdisciplinary with a strong focus on research methodologies, social determinants of health, and mental health. She is also trained in Holistic Herbal Therapy, Reiki training, and safeTALK suicide prevention.

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