What is bipolar disorder?
Bipolar is a category of mental health conditions that center around extreme mood swings. Usually, someone experiencing a bipolar disorder will have periods of mania, which involve upbeat and high-energy moods and feelings, or hypomania, a less intense form of mania. They will also experience periods of depression, which is marked by low energy and feelings of sadness or hopelessness.
There are several types of bipolar disorder diagnoses, including:
1
- Bipolar I: Manic episodes last at least 7 days and are on the more extreme end, with potential mania-induced psychosis. Depressive episodes may occur as well, but may also be "mixed," with elements of both depression and mania.
- Bipolar II: More defined by the length and severity of depressive episodes. Manic episodes are more likely to be hypomanic, or less severe.
- Cyclothymic disorder (cyclothymia): Involves depressive and hypomanic episodes, but not as extreme or as long as bipolar I or II.
In any case, these symptoms are highly disruptive, impacting mood and energy and activity levels, and some symptoms are potentially dangerous. Bipolar I especially carries the chance of psychosis, which is a break from reality, and behavior in any of these diagnoses is often unpredictable.
Bipolar is a lifelong condition, but with the right care, treatment, and medication, these issues can be managed and their negative impacts can be reduced.
Connection between bipolar disorder and eating disorders
As bipolar disorders impact mood and energy, so too can they influence eating behavior, which is one reason why bipolar and eating disorders can easily become connected.
One study on patients with bipolar disorder found:2
In patients with eating disorders, the study found the prevalence of bipolar disorder was also high, ranging anywhere from 11.5% to 68.1%.2
There are many potential reasons for this high overlap, though more scientific studies on the connection are needed.
Mood and eating patterns
Mood and appetite are powerfully connected, as mood can have both a psychological and biological influence on appetite, and vice versa.
6 As such, eating disorders of all types have long been linked to mood disorders, with numerous
anxiety and depression disorders understood to be common comorbid conditions.
Mood dysregulation, or trouble with regulating moods, seems to be a particularly important aspect in developing and maintaining binge eating disorder.
4 This may be one reason why binge eating disorder and bipolar frequently co-occur. It's possible that someone with bipolar disorder who binge eats will also turn to "compensatory" behaviors, such as self-induced vomiting, excessive exercise, or
laxative misuse, to "make up" for that behavior, which can lead to the development of bulimia nervosa.
Energy levels and appetite
Another powerful influence on appetite is energy levels. In particular, someone's circadian rhythm—or
sleep and waking cycle—has been found to work in concert with the hormones responsible for the feelings of hunger and satiety.
3
Patients with bipolar disorder are also very likely to experience sleep disturbances, during periods of both depression and mania.1 Both sleep patterns and energy levels can vary drastically between these two extremes, which could potentially impact eating behaviors or work to maintain disordered eating patterns.
Psychological connections between bipolar and eating disorders
Bipolar and eating disorders are all mental health disorders, and a number of psychological factors often work to drive these conditions.
One study argued that impulsivity was a shared connection between bipolar disorder and binge eating behavior.
5 The psychological trait can manifest as unpredictability in manic episodes and has also been previously linked to
binge eating symptoms.
4
Compulsivity is another common characteristic of both bipolar and eating disorders, and those in a manic episode may also experience a heightened desire for activity or exercise, which can look like the eating disorder symptoms of
excessive exercise or hyper-focus on diet.
7
Treating bipolar disorder and eating disorders
Bipolar and eating disorders often work off each other and can become deeply intertwined, so it's important to treat these conditions simultaneously. Thankfully, several types of therapy have been shown to help with both.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is generally thought of as the leading treatment for most eating disorders, including bulimia nervosa.9 The method helps people understand and recognize their disordered thought and behavioral patterns, and gives them healthier coping mechanisms to replace their unhelpful behaviors. This method has also shown effectiveness helping people with bipolar disorders.8
Dialectical behavior therapy
Dialectical behavior therapy (DBT) was designed specifically for patients with borderline personality disorder, another condition that involves extreme mood swings, and has also been found to help those with bipolar.10 It functions similarly to CBT, but with added modules to help patients learn skills like mindfulness, distress tolerance, and emotion regulation. DBT has also been found to help patients with eating disorders.11
Potential treatment complications
While therapy is the primary approach to treatment for most eating disorders, bipolar disorder is often treated with medication. But these drugs can have side effects which can be triggering for patients with comorbid eating disorders.
For example, some common long-term medications for bipolar disorders have been associated with weight gain.5 It's possible this may further influence someone to adopt extreme measures for losing or maintaining weight, though scientific research on the connection is limited.
Some common bipolar medications have also been linked to an increased risk for binge eating, which can make binge eating behaviors worse or even help develop binge eating disorder.12 Additionally, some medications that help with mood stabilization can contribute to weight loss, which may also not be appropriate for patients exhibiting eating disorder behaviors.12
Finding the balance between treating these two conditions can be tricky, but it's an important step toward long-term maintenance of these conditions.
Finding help for an eating disorder
If you or a loved one are struggling with bipolar and eating disorders, it's important to get help. Both of these conditions can have deep and lasting impacts on mental, physical, and emotional wellbeing, and don’t go away by themselves.
Seeking out treatment specialists is especially important in comorbid cases, thanks to the many considerations involved in addressing both conditions. If you're already seeing a therapist, psychiatrist, or other mental health professional, you may want to start by asking them about potential programs that can help. Your primary care physician is another good source of information and further help.
Remote treatment is an option
Our team of experts come from diverse medical backgrounds and understand the many nuances of treating eating disorders and comorbid conditions. This leaves us well-suited to help develop an individualized treatment plan, catered to your specific needs and medical history. Call us today to see how we can get you started on the road to recovery.
Get a free consultation
