Bipolar and Autism Spectrum Disorder
People with autism spectrum disorder (ASD) have a higher risk of developing bipolar disorder. But researchers have not found a direct link that 1 causes the other.1
The signs of bipolar disorder can look similar to ASD. This makes it difficult to know if you have 1 or both and the best treatment.1
The conditions share genetic patterns. This may explain the overlap of symptoms. Bipolar symptoms also show up earlier in people with ASD.1
What is bipolar disorder?
Bipolar is a mental illness usually diagnosed in a person's teens or twenties.2
People with bipolar disorder exhibit extreme mood shifts. You can feel happy and have high energy, known as mania. Other times, you may have bouts of depression.2
Researchers continue to explore what causes bipolar disorder. Risk factors include:2
- Family history
- Early trauma or abuse
- Changes in the brain
- Drug or alcohol abuse
Bipolar also disrupts a person's:2
- Thinking
- Energy
- Sleep patterns
It may interfere with their ability to:2
- Go to work
- Go to school
- Form relationships
What is autism?
ASD develops at a much younger age. Symptoms begin from infancy to 3 years old.3
Scientists classify ASD as a developmental disorder. They believe something is different in the brains of people with ASD.3
Things that may increase the risk a child will have ASD include:3
- Genetic conditions
- Siblings with ASD
- Older parents
- Birth complications
People with ASD display a range (spectrum) of symptoms and levels of ability. Some are slow to talk and walk. Others talk very fast and struggle with social skills.3,4
Are autism and bipolar disorder related?
Bipolar and other mood disorders occur at higher rates in people with ASD. They can occur together or at different times across a person's life.1-5
- Bipolar affects the brain and causes major swings in mood and behavior.
- Research suggests they share genetic expression patterns.
- Behaviors common with ASD can look similar to bipolar mood swings.
- ASD includes several ongoing (chronic) disorders of the nervous system and development.
- People with ASD have a higher risk of developing a mental health condition.
How do the conditions overlap?
Genetics seem to be 1 important factor that connects ASD and bipolar disorder. Studies have found common genes for:5
- ASD
- Schizophrenia
- Bipolar disorder
Bipolar and ASD have similar mood-related symptoms:4,5
- Rapid speech
- Pacing
- Irritability
- Trouble concentrating
- Agitation or aggression
Many people with both conditions have trouble with:4
- Sleep
- Social skills
- Relationships
- Controlling impulses
- Aggression
Similarly, having both conditions together increases risk of:5
- Morbidity
- Suicide
- Psychosis
- Disability
How do the conditions differ?
Besides the age of onset, bipolar disorder and ASD have important differences.2-4
Bipolar:2
- Chronic mental health condition with cycling mood episodes
- Usually diagnosed in early adulthood based on symptoms and frequency
- Not linked to early problems with development or learning
- Treated with drugs that stabilize mood, depression, or psychosis
- Regular sleep, talk therapy, and journaling can help manage it
ASD:3,4
- Affects how the nervous system processes information
- Relates to delays in growth, learning, and brain development
- Common signs include delays with walking, talking, and eye contact
- Some mood traits, but they are related to behavior and learning
- Treatment is more about managing symptoms: it focuses on life skills, behavioral therapy, and managing emotions
Other factors to consider
It can be hard to diagnose psychiatric disorders in children. Trouble with speech and intellectual disabilities can occur for a variety of reasons. And the range of function that people with ASD have complicates the process of diagnosing other conditions.3-5
Often, people have dual diagnoses or complex behaviors that are difficult to single out.4,5
For example, other conditions that co-occur with ASD include:1,5
- Anxiety
- Depression
- Attention deficit hyperactivity disorder (ADHD)
- Psychosis
Bipolar disorder and ASD share similar symptoms and behaviors. Some people believe bipolar disorder is overdiagnosed in those with ASD because of this overlap.4
ADHD is even more common in people with ASD than bipolar disorder. And some symptoms of ASD, bipolar disorder, and ADHD also overlap. ADHD symptoms include:4
- Emotional outbursts
- Frustration
- Distractibility
- Impulsivity
In 1 study, autistic children showed symptoms that mimic bipolar. It is important to track:4
- When symptoms appear
- How long symptoms last
- Signs of mania