Bipolar disorder - a guide for autistic adults
Bipolar disorder (BD) is a mental health condition that affects how you feel. Sometimes you can feel low in mood or depressed but this can swing to feeling excitable and high in energy.
There is no research into how many autistic people have bipolar disorder.
Bipolar disorder can have a significant impact on a person’s life, but with treatment, it can be managed. This guide explores how BD might affect you, and the treatment and support options.
What is bipolar disorder?
“Bipolar disorder is a mental health condition that affects your moods, which can swing from one extreme to another. It used to be known as manic depression. Bipolar usually means a person experiences episodes of mania (high energy, excitable) and depression (low energy and mood).” NHS (2019)
Symptoms of bipolar disorder can include:
- manic episodes
- hypomanic episodes (similar to mania but generally shorter episodes and can feel more manageable)
- depressive episodes
- mixed episodes of mania and depression
- psychotic symptoms (not everyone experiences these).
Mind has further information on these symptoms.
Anyone can be diagnosed with bipolar disorder. It usually develops in the late teens (15-19 years old) - it’s rare for it to develop after the age of 40. The exact cause of bipolar is unknown but some potential triggers include:
- extreme stress
- overwhelming problems (eg financial)
- life-changing events such as relationship breakdowns or the death of loved ones
- genetic factors
- drug use.
Bipolar disorder can affect your life in various ways, including:
- mood swings that are severe enough to affect everyday life
- driving (anyone diagnosed with BD must notify DVLA)
- suicidal thoughts and self-harm
- difficulty with sleeping
- difficulty with eating
- strained relationships
- changing personality – making a usually calm person more agitated or aggressive.
Due to a lack of research, we don’t know if there are specific triggers for bipolar disorder in autistic people, or how many autistic people may have the condition. Some research suggests there are similarities between symptoms of bipolar disorder and autistic traits, making a diagnosis of both difficult. This is echoed in the personal accounts of autistic people and parents of autistic children.
Bipolar disorder can be upsetting and distressing for the person experiencing it and can result in significant changes in behaviour and mood. Bipolar disorder can have a substantial/serious impact on your relationships with friends, family and partners. Treatment and support is essential to help manage BD.
Getting help with bipolar disorder
If you think you may be experiencing some of the symptoms of bipolar disorder, contact your GP. Your GP should be able to refer you to a local mental health team for further help.
To get a better understanding of the symptoms, your GP or the mental health team may ask you some questions.
- How many symptoms do you experience?
- How long do your manic or depressive episodes last?
- How many episodes have you had, and how frequently do they occur?
- What impact do your symptoms have on your life?
- What is your family history of mental health conditions?
The mental health team may also ask you to keep a diary of your moods to help them to rule out other possible conditions that could be causing your symptoms.
The full diagnosis process can take a while, as doctors and psychiatrists may want to monitor symptoms over time to avoid misdiagnosis.
Read our Seeking help with mental health information for further details on accessing support.
Treatment for bipolar disorder
There are no guidelines for the treatment and support for autistic people with a diagnosis of bipolar disorder. The National Institute for Health and Care Excellence NICE (2014) has general guidelines for the assessment and treatment of BD and recommends both medication and psychological treatments such as cognitive behavioural therapy (CBT) and individual therapy. Therapy should be adapted for autistic patients.
NICE recommends certain types of medications, specifically antipsychotic or mood stabilisers, which can be prescribed to manage BD. These include:
The NICE guidance also states that if antipsychotic medication is not sufficient, Lithium or Valproate may be used (excluding women who may become pregnant), but it should not be the first course of treatment.
Organisations offering advice
There is no specific advice for autistic people with BD, but there are several charities and organisations that offer general help and information on BD, such as Mind and the NHS.
Useful links
Personal accounts
Some of the following accounts share information and experiences that you may find distressing.