The Effect of Complex PTSD Among People with Bipolar Disorder


You probably know that mood disorders such as major depression, bipolar disorder, and seasonal affective disorder (also called SAD) are generally very common. But it may surprise you to learn that they’re much more common in certain groups of people–including those with posttraumatic stress disorder (PTSD) and Complex PTSD. This is called comorbidity. When two disorders or illnesses occur in the same person, simultaneously or sequentially, they are described as comorbid. Comorbidity also implies interactions between the illnesses that affect the course and prognosis of both.

In fact, Complex PTSD and mood disorders often occur together. When this happens, the mood disorder may be more severe in the person with PTSD and lead to unhealthy behaviours such as substance abuse.

It’s important for to understand 1) the connection between PTSD and mood disorders and 2) the relationship between PTSD and the problems that mood disorders can cause, such as sleep disturbances, suicidal thoughts, and self-harm.

Within the general population, approximately 4% of the population will have a diagnosis of bipolar disorder at some point in their lives. What is bipolar disorder? Bipolar disorder is considered a mood disorder. There are two types of bipolar disorders, described as bipolar I and bipolar II. However, the DSM (the Diagnostic Manual for Psychiatrists is looking at extrapolating to further expand bipolar diagnosis’s as more is understood about the complexity of the condition.

In bipolar I disorder, a person has experienced one or more manic episodes. Someone with bipolar disorder will experience mood changes between manic and depressed episodes.

When experiencing a manic episode, it’s common to feel or experience:

  • Feeling Really happy
  • Being Energetic
  • Having Racing thoughts
  • Irritability
  • A reduced need to sleep
  • More sexual than usual

When experiencing a depressed episode, it’s common to feel or experience:

  • Uninterested in all activities
  • Changes in appetite
  • Weight loss or gain
  • Changes in sleeping patterns
  • A loss of energy
  • Unable to concentrate

In bipolar II disorder, hypomanic episodes have been experienced but not manic episodes. In addition, to be diagnosed with bipolar II disorder, a person needs to have also experienced a major depressive episode.

Bipolar disorder can have a major impact on your life, and it can also increase the risk that you develop other disorders. In fact, people with bipolar disorder have been found to be at high risk for developing a number of other mental health disorders. One such disorder that co-occurs with bipolar disorder at high rates is post-traumatic stress disorder (PTSD).

The Relationship between Bipolar Disorder and PTSD

Studies have found that anywhere between 11% to 39% of bipolar patients also meet criteria for PTSD or Complex PTSD. It is not entirely surprising that high rates of PTSD are found among people with bipolar disorder, as many people with bipolar also have a history of traumatic exposure. Traumatic exposure may be more likely to occur during a manic episode when a person with bipolar disorder is more likely to make risky or impulsive decisions.

In addition to being a risk factor for the development of PTSD, traumatic exposure during childhood, such as childhood physical or sexual abuse, may also be risk factors for the development of bipolar disorder.

The Effect of Complex PTSD Among People with Bipolar Disorder

Having PTSD along with bipolar disorder can have a major negative impact on your life.

People with PTSD and bipolar disorder appear to have more problems across a number of different areas in their lives. For example, PTSD has been found to reduce the quality of life for people with bipolar disorder. It has also been found to make the bipolar disorder worsen, resulting in more rapid cycling and increased risk for suicide attempts. Finally, PTSD has also been found to be associated with greater levels of depression among people with bipolar disorder.

Finding the Help You Need

If you have PTSD and bipolar disorder, it is very important to take steps to manage both conditions. There are a number of healthy coping strategies for managing your symptoms of bipolar disorder and PTSD. There are also a number of effective treatments for bipolar disorder and PTSD. You need to seek professional help for treatment of bipolar disorder or PTSD or Complex PTSD. See Minefield on Choosing a Therapist for more information. There are many terrific online Support Groups on Facebook too if you just want people going through the same experiences and treatments to talk to in confidence. These are closed groups. Community Health can suggest Support Groups also.

I suffer from Complex PTSD and Bipolar II. They are co-morbid and each are difficult to treat and make medication prescription a nightmare to prescribe for due to adverse reactions and side effects which can benefit one condition but worsen another. At the moment I appear to be on a regime that is working well and my mood is steady although flashbacks are pretty out of control. There is no known drug with efficacy at this stage for that. Clonadine works well for the nightmares so at least I get relief from those and my sleep is under control. Medication is basically trial and error and you have to be patient with your Psychiatrist because it is not an exact science. What works for one person can be a disaster for someone else even though they have the same diagnosis.

Medication alone cannot be the only approach. Psychotherapy or some similar approach is also required to keep life running smoothly. I attend Psychotherapy and use EMDR (Eye Movement Desensitisation Movement) which I find very effective as it reprocesses traumatic material.  I also have Dissociative Identity Disorder (DID) so for my family that can at times be very traumatic as my alters appear.  My life is a team approach between my caregivers, medical team, therapists, family and myself and hopefully, yours is too. Without such a cohesive attitude it will remain an uphill struggle. Also, encourage your family to get support too. Living with someone with such conditions is very taxing and stressful and they need help too. They need to know they are not on their own. Self-harm, suicidality, manic episodes, depressive lows, dissociative episodes are a trial and they are not professionally trained to deal with them so encourage them to seek outside help for their sake as well as yours.


I would love to hear from you so please leave a comment. All feedback is much appreciated. Thank you. Erin

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