Table of ContentsView AllTable of ContentsWhat Is Obsessive-Compulsive Disorder?What Is Bipolar Disorder?Link Between OCD and BDDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
What Is Obsessive-Compulsive Disorder?
What Is Bipolar Disorder?
Link Between OCD and BD
Diagnosis
Treatment
Obsessive compulsive disorder (OCD) andbipolar disorderare two medical conditions that can occur together in the same person at the same time.Studies vary, but a large meta-analysis from 2021 estimated that about 69% of people living with OCD have a second psychiatric diagnosis at some point in their lifetime.It’s bipolar disorder in about one in four of those cases.
This is called acomorbidity.Some symptoms of the two diagnoses overlap, but the comorbidity of OCD with bipolar disorder can be different enough from either to be considered a separate type of diagnosis.This also means that treatment can be different.
This article explains what it means to be diagnosed with both OCD and bipolar disorder. It explains the symptoms and diagnosis of each, as well as how they’re treated both separately and together.
Obsessive-compulsive disorderis a mental health condition in which a person experiences intrusive thoughts over and over that prompt them to perform an action to try and neutralize the thoughts.In this case, the recurrent intrusive thoughts are the obsessions, and the rituals of various subtypes are used to try to counterbalance the thoughts and compulsions.
It is common for the obsessions to be related to maintaining cleanliness or avoiding germs and illness, or doubts about having completed a task such as turning off a stove.These thoughts and actions are excessive and interfere with daily life.
OCD SymptomsCommon symptoms of OCD include:Perfectionism, or the need for things to be in perfect orderUnwanted thoughts of aggression, sex, religion, or harmExcessive fear of germsExcessively checking to see if something has been doneExcessive cleaning or hand washingRituals of counting things, or placing them in precise symmetry
OCD Symptoms
Common symptoms of OCD include:Perfectionism, or the need for things to be in perfect orderUnwanted thoughts of aggression, sex, religion, or harmExcessive fear of germsExcessively checking to see if something has been doneExcessive cleaning or hand washingRituals of counting things, or placing them in precise symmetry
Common symptoms of OCD include:
Bipolar disorder is a mental health condition that involves a person experiencing fluctuations betweenmaniaor hypomania often alternating with major depressive episodes.
There may be phases between bipolar episodes ofdepressionandmaniain which the person is not experiencing symptoms, or their symptoms are not severe enough to be considered a bipolar episode.
Even though these phases between episodes can last years, bipolar disorder is a lifelong condition.
Bipolar SymptomsCommonsymptoms of bipolar disorderinclude:In a manic phase, the person may talk excessively, have racing thoughts, feel extreme happiness, be jumpy or on edge, sleep less, and experience delusions,In a depressive phase, the person may feel extreme sadness, have deep fatigue, talk little, have very low feelings of self worth, and feel restless or empty.
Bipolar Symptoms
Commonsymptoms of bipolar disorderinclude:In a manic phase, the person may talk excessively, have racing thoughts, feel extreme happiness, be jumpy or on edge, sleep less, and experience delusions,In a depressive phase, the person may feel extreme sadness, have deep fatigue, talk little, have very low feelings of self worth, and feel restless or empty.
Commonsymptoms of bipolar disorderinclude:
What Are the Differences Between Bipolar 1 and 2?
What’s the Link Between OCD and Bipolar?
The link between OCD and bipolar disorder is not entirely clear, and there is some debate among healthcare professionals about how they are connected. The symptoms are commonly seen together. Researchers have identified similar brain changes, and they’re shared with other conditions includingdepressionandsocial anxiety disorder.
It is generally thought that OCD and bipolar disorder are two separate conditions, although in some cases there may be an interconnected genetic relationship that studies continue to explore.
The OCD diagnosis may be more likely in type II bipolar disorder, and both OCD and bipolar disorder can be more severe in those diagnosed with both. For example, people with both conditions may be more at risk of suicide.The timing of OCD symptoms also can be cyclical, as is bipolar disorder.
In addition to OCD, some examples of comorbidities that are associated with bipolar disorder are anxiety disorder, attention deficit hyperactivity disorder (ADHD), drug or alcohol use disorders, andeating disorders.
Diagnosis and Prevalence of OCD and Bipolar Disorder
About 2.3 million people in the United States have bipolar disorder.About 2.2 million adults in the United States have obsessive-compulsive disorder.Studies have shown that people with bipolar disorder have higher risks of certain mental health conditions, with about 11% also having OCD.
How Bipolar Disorder Is Diagnosed
How Obsessive-Compulsive Disorder (OCD) Is Diagnosed
Treating Comorbid OCD and Bipolar Disorder
Treating comorbid mental disorders presents a challenge beyond treating one alone. This is because some treatments for one condition may make another worse, or because the treatments for one could interfere with the other. For example, selective serotonin reuptake inhibitors, orSSRIs, are often used to treat OCD, but they increase the risk of bipolar manic episodes and symptoms.
Treating OCD
Obsessive-compulsive disorder is treated with prescription medications, psychotherapy ortalk therapy, or both together. For prescription medications, selective serotonin reuptake inhibitors are generally used as a first option.Cognitive behavioral therapy, orCBT, is often used, particularly as a type of behavioral therapy known as exposure and response prevention (ERP).
Transcranial magnetic stimulation, or TMS, is a newer treatment for OCD that is being studied along with the other treatment options.
How Is OCD Treated?
Treating Bipolar Disorder
Like OCD, bipolar disorder can be treated with prescription medications, psychotherapy or talk therapy, or a combination of the two. For prescription medications, mood stabilizers and second-generation antipsychotics are generally used, along with possible additional medications to treat specific bipolar symptoms.
Cognitive-behavioral therapy and psychoeducation may be used as talk therapy methods.
Additionally, there are newer therapies calledinterpersonaland social rhythm therapy, or IPSRT, andfamily-focused therapythat are tailored to bipolar disorder.Deep brain stimulation, including electroconvulsive therapy (ECT) and transcranial magnetic stimulation may also be used.
Beyond medications and psychotherapy, coping methods such as exercise and supplements can help.
Management of Bipolar Disorder
Treating Both Conditions Together
When treating comorbid bipolar disorder and OCD, the mood needs to be stabilized with mood stabilizer medications before treating the OCD. The combination of mood stabilizers and antidepressants, including SSRIs, can be used to treat comorbid bipolar disorder type II and OCD.
However, SSRIs can potentially increase manic episodes or mood cycling in bipolar illness.Research continues into the use of antipsychotic drugs (typically at lower doses than when used with other conditions) and other treatments that show promise.
Talk therapy is recommended alongside medications, and other coping methods can be helpful, too.
Mental Health HelplineIf you or a loved one are struggling with bipolar disorder and/or OCD, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
Mental Health Helpline
If you or a loved one are struggling with bipolar disorder and/or OCD, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
Summary
Bipolar disorder and obsessive-compulsive disorder, or OCD, can be comorbid, meaning they occur together. Bipolar disorder involves fluctuations between depressive episodes and manic episodes, while OCD involves excessive intrusive thoughts and behavioral responses to those thoughts.
The treatment of co-occurring bipolar illness and OCD can present some challenges. However, successful treatment is possible, and people with symptoms of both have treatment options that include medications, specific forms of psychotherapy, coping methods, or a combination of these options.
List of Psychological Disorders
18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Peng D, Jiang K.Comorbid bipolar disorder and obsessive-compulsive disorder.Shanghai Arch Psychiatry. 2015;27(4):246-248. doi:10.11919/j.issn.1002-0829.215009Sharma E, Sharma LP, Balachander S, et al.Comorbidities in obsessive-compulsive disorder across the lifespan: a systematic review and meta-analysis.Front Psychiatry. 2021;12:703701. doi:10.3389%2Ffpsyt.2021.703701Gaetano R, de Filippis R, Segura-Garcia C, De Fazio P.Impact of bipolar disorder and obsessive-compulsive disorder comorbidity on neurocognitive profile: a mini-review.Psychiatr Danub. 2020;32(3-4):346-350. doi:10.24869/psyd.2020.346.American Psychological Association.Comorbidity.Singh A, Anjankar VP, Sapkale B.Obsessive-Compulsive Disorder (OCD): A Comprehensive Review of Diagnosis, Comorbidities, and Treatment Approaches.Cureus. 2023 Nov 17;15(11):e48960. doi:10.7759/cureus.48960.American Psychological Association.Obsessive-compulsive disorder.International OCD Foundation.What Is OCD?National Institute of Mental Health.Obsessive-compulsive disorder.American Psychological Association.Bipolar disorder.National Institute of Mental Health.Bipolar disorder.Stein DJ, Costa DLC, Lochner C, Miguel EC, Reddy YCJ, Shavitt RG,et al.Obsessive-compulsive disorder.Nat Rev Dis Primers. 2019 Aug 1;5(1):52. doi:10.1038/s41572-019-0102-3.Akbari M, Eghtedarian R, Hussen BM, Eslami S, Taheri M, Ghafouri-Fard S.Angiotensin I converting enzyme gene polymorphisms and risk of psychiatric disorders.BMC Psychiatry. 2022 May 23;22(1):351. doi:10.1186/s12888-022-04007-w.Mental Illness Policy Org.Bipolar disorder (manic-depressive illness).Anxiety and Depression Association of America.Facts and statistics.Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018 Apr 26;8(9):251-269. doi: 10.1177/2045125318769235.Mutz J.Brain stimulation treatment for bipolar disorder.Bipolar Disord.2023 Feb;25(1):9-24. doi: 10.1111/bdi.13283.Kazhungil F, Mohandas E.Management of obsessive-compulsive disorder comorbid with bipolar disorder.Indian J Psychiatry. 2016 Jul-Sep;58(3):259-269. doi: 10.4103/0019-5545.192001.Paxos C.Moving beyond first-line treatment options for OCD.Ment Health Clin. 2022 Nov 3;12(5):300-308. doi: 10.9740/mhc.2022.10.300.
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Peng D, Jiang K.Comorbid bipolar disorder and obsessive-compulsive disorder.Shanghai Arch Psychiatry. 2015;27(4):246-248. doi:10.11919/j.issn.1002-0829.215009Sharma E, Sharma LP, Balachander S, et al.Comorbidities in obsessive-compulsive disorder across the lifespan: a systematic review and meta-analysis.Front Psychiatry. 2021;12:703701. doi:10.3389%2Ffpsyt.2021.703701Gaetano R, de Filippis R, Segura-Garcia C, De Fazio P.Impact of bipolar disorder and obsessive-compulsive disorder comorbidity on neurocognitive profile: a mini-review.Psychiatr Danub. 2020;32(3-4):346-350. doi:10.24869/psyd.2020.346.American Psychological Association.Comorbidity.Singh A, Anjankar VP, Sapkale B.Obsessive-Compulsive Disorder (OCD): A Comprehensive Review of Diagnosis, Comorbidities, and Treatment Approaches.Cureus. 2023 Nov 17;15(11):e48960. doi:10.7759/cureus.48960.American Psychological Association.Obsessive-compulsive disorder.International OCD Foundation.What Is OCD?National Institute of Mental Health.Obsessive-compulsive disorder.American Psychological Association.Bipolar disorder.National Institute of Mental Health.Bipolar disorder.Stein DJ, Costa DLC, Lochner C, Miguel EC, Reddy YCJ, Shavitt RG,et al.Obsessive-compulsive disorder.Nat Rev Dis Primers. 2019 Aug 1;5(1):52. doi:10.1038/s41572-019-0102-3.Akbari M, Eghtedarian R, Hussen BM, Eslami S, Taheri M, Ghafouri-Fard S.Angiotensin I converting enzyme gene polymorphisms and risk of psychiatric disorders.BMC Psychiatry. 2022 May 23;22(1):351. doi:10.1186/s12888-022-04007-w.Mental Illness Policy Org.Bipolar disorder (manic-depressive illness).Anxiety and Depression Association of America.Facts and statistics.Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018 Apr 26;8(9):251-269. doi: 10.1177/2045125318769235.Mutz J.Brain stimulation treatment for bipolar disorder.Bipolar Disord.2023 Feb;25(1):9-24. doi: 10.1111/bdi.13283.Kazhungil F, Mohandas E.Management of obsessive-compulsive disorder comorbid with bipolar disorder.Indian J Psychiatry. 2016 Jul-Sep;58(3):259-269. doi: 10.4103/0019-5545.192001.Paxos C.Moving beyond first-line treatment options for OCD.Ment Health Clin. 2022 Nov 3;12(5):300-308. doi: 10.9740/mhc.2022.10.300.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Peng D, Jiang K.Comorbid bipolar disorder and obsessive-compulsive disorder.Shanghai Arch Psychiatry. 2015;27(4):246-248. doi:10.11919/j.issn.1002-0829.215009Sharma E, Sharma LP, Balachander S, et al.Comorbidities in obsessive-compulsive disorder across the lifespan: a systematic review and meta-analysis.Front Psychiatry. 2021;12:703701. doi:10.3389%2Ffpsyt.2021.703701Gaetano R, de Filippis R, Segura-Garcia C, De Fazio P.Impact of bipolar disorder and obsessive-compulsive disorder comorbidity on neurocognitive profile: a mini-review.Psychiatr Danub. 2020;32(3-4):346-350. doi:10.24869/psyd.2020.346.American Psychological Association.Comorbidity.Singh A, Anjankar VP, Sapkale B.Obsessive-Compulsive Disorder (OCD): A Comprehensive Review of Diagnosis, Comorbidities, and Treatment Approaches.Cureus. 2023 Nov 17;15(11):e48960. doi:10.7759/cureus.48960.American Psychological Association.Obsessive-compulsive disorder.International OCD Foundation.What Is OCD?National Institute of Mental Health.Obsessive-compulsive disorder.American Psychological Association.Bipolar disorder.National Institute of Mental Health.Bipolar disorder.Stein DJ, Costa DLC, Lochner C, Miguel EC, Reddy YCJ, Shavitt RG,et al.Obsessive-compulsive disorder.Nat Rev Dis Primers. 2019 Aug 1;5(1):52. doi:10.1038/s41572-019-0102-3.Akbari M, Eghtedarian R, Hussen BM, Eslami S, Taheri M, Ghafouri-Fard S.Angiotensin I converting enzyme gene polymorphisms and risk of psychiatric disorders.BMC Psychiatry. 2022 May 23;22(1):351. doi:10.1186/s12888-022-04007-w.Mental Illness Policy Org.Bipolar disorder (manic-depressive illness).Anxiety and Depression Association of America.Facts and statistics.Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018 Apr 26;8(9):251-269. doi: 10.1177/2045125318769235.Mutz J.Brain stimulation treatment for bipolar disorder.Bipolar Disord.2023 Feb;25(1):9-24. doi: 10.1111/bdi.13283.Kazhungil F, Mohandas E.Management of obsessive-compulsive disorder comorbid with bipolar disorder.Indian J Psychiatry. 2016 Jul-Sep;58(3):259-269. doi: 10.4103/0019-5545.192001.Paxos C.Moving beyond first-line treatment options for OCD.Ment Health Clin. 2022 Nov 3;12(5):300-308. doi: 10.9740/mhc.2022.10.300.
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Akbari M, Eghtedarian R, Hussen BM, Eslami S, Taheri M, Ghafouri-Fard S.Angiotensin I converting enzyme gene polymorphisms and risk of psychiatric disorders.BMC Psychiatry. 2022 May 23;22(1):351. doi:10.1186/s12888-022-04007-w.
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Anxiety and Depression Association of America.Facts and statistics.
Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018 Apr 26;8(9):251-269. doi: 10.1177/2045125318769235.
Mutz J.Brain stimulation treatment for bipolar disorder.Bipolar Disord.2023 Feb;25(1):9-24. doi: 10.1111/bdi.13283.
Kazhungil F, Mohandas E.Management of obsessive-compulsive disorder comorbid with bipolar disorder.Indian J Psychiatry. 2016 Jul-Sep;58(3):259-269. doi: 10.4103/0019-5545.192001.
Paxos C.Moving beyond first-line treatment options for OCD.Ment Health Clin. 2022 Nov 3;12(5):300-308. doi: 10.9740/mhc.2022.10.300.
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