Understanding Bipolar Disorder and Its Overlap with Autism
- kaitlynboudreault
- Oct 14
- 9 min read
Have you ever experienced a period of intense elation, energy, activity levels, and concentration? After this, did you have a period of sadness, hopelessness, and loss of interest in activities?
If this resonates with you, you may be one of the approximately 40 million people globally who experience bipolar disorder.
Alongside this diagnosis of bipolar disorder, autism is a fairly common co-occurrence that can result in other traits, including difficulties with social skills, speech, behaviour, and communication.
The exact prevalence of the co-occurrence of autism and bipolar disorder is not entirely known.
One reason for this is the fact that the two neurotypes share overlapping traits. As a result, professionals may have a difficult time determining which of the two someone has, which can lead to misdiagnosis. More research is being done to understand the link between the two.
Despite the lack of knowledge on the prevalence, support is available if you are currently experiencing the symptoms of autism or bipolar disorder. A neurodiversity-affirming therapist in Ontario, Canada, can help.
In this blog, we’ll delve into what bipolar disorder and autism are, how these two experiences intersect and differ, and some effective coping strategies for navigating both.
Autism is a form of neurodivergence and neurodevelopmental difference that impacts the way individuals experience and navigate the world.
Common autistic traits may include:
Differences in social communication and interaction
Challenges interpreting tone, facial expressions, or social cues
Engaging in repetitive behaviors or movements (stimming)
Strong need for routine or predictability
Highly focused interests or specific preferences
Sensory sensitivities (e.g., to sound, light, texture, or temperature)
Rejection sensitivity or difficulty managing unexpected change
Since autism exists on a spectrum, this means that each autistic individual can experience different combinations of their traits and differences in the severity of these traits.
In addition, autism has largely been viewed in the past through a pathological lens as something that needs to be fixed when it is viewed through a medical model.
But as we shift toward a neurodiversity-affirming model, autism should be seen as a natural variation in brain neurology. It is this diversity in brain structure and function that makes the world stronger. Many autistic individuals view their experiences from an identity-first lens, emphasizing the fact that these traits are not something to cure or fix.
What Is Bipolar Disorder?
Bipolar disorder is a mental health condition and form of neurodivergence that is characterized by extreme mood changes that shift between extreme highs and extreme lows.
The periods of emotional highs are known as mania or hypomania. Whereas, the periods of extreme lows are known as depressive episodes. Each of these episodes involves a variety of symptoms.
For example, during a depressive episode, you may feel sad or hopeless, or you may lose interest in the activities that you once found enjoyable.
On the other hand, if you are experiencing manic or hypomanic episodes, you may experience periods of extreme elation, excitement, energy, activity levels, and concentration levels. Irritability may also be common in manic or depressive episodes.
Hypomania Versus Mania
The differences between hypomania and mania will also experience the differences between bipolar I and bipolar II.
Mania involves a period of elevated mood and increased energy. These symptoms are more severe and can also include reckless behaviour, grandiose beliefs, and impaired judgment. These experiences usually significantly impair an individual's ability to function in their day-to-day life.
Hypomania is a less intense form of mania that still involves the experiences of an elevated mood, increased energy, and enhanced productivity, but the symptoms are less severe to the extent that the impairment on your daily functioning is not as full-blown as it is in mania.
Types of Bipolar Disorder
Bipolar disorder consists of two primary types known as bipolar I and bipolar II. These types can be characterized as follows:
Bipolar I: Defined by at least one manic episode and one depressive episode.
Bipolar II: Characterized by at least one major depressive episode and one hypomanic episode.
The Connection Between Autism and Bipolar Disorder
Autistic individuals are more likely to experience symptoms of bipolar disorder than the general population.
In fact, there was one study specifically that found that autistic individuals between the ages of 17 and 43 years old were 9.34 times more likely to be diagnosed with bipolar disorder.
The exact cause for this high rate of co-occurrence is still being explored. However, researchers believe that there is a strong genetic component between the two. This means that if you have a family member who has bipolar disorder or is autistic, you are more likely to experience
There is also ongoing research to determine if there are shared neurobiological underpinnings, including irregularities in neurotransmitter systems that regulate mood and behaviour within these two conditions.
The connection between these two conditions underscores the importance of determining how the traits of autism and bipolar disorder overlap and how they differ.
For example, mood fluctuations characteristic of bipolar disorder may sometimes be misinterpreted as typical behaviour for autistic individuals. This may result in the individual not being diagnosed with bipolar disorder as they should be.
When Autism and Bipolar Disorder Co-occur
When someone is autistic and has bipolar disorder, there are traits of each condition that can overlap.
Some overlapping experiences may include changes in sleep, emotional regulation challenges, impulsivity, and fluctuations in energy or motivation. These overlapping traits can complicate a diagnosis.
However, the reasons behind these traits and how they manifest often differ between autism and bipolar disorder. Here are some key distinctions between autistic traits and those that appear when someone is autistic and has bipolar disorder:
Mood regulation: Autistic individuals without bipolar disorder may experience emotional dysregulation due to sensory overload or social stressors. These shifts are typically situational and stabilize once the stressor is removed. In contrast, bipolar mood episodes are longer-lasting and cyclical. They also often happen without a clear external trigger.
Energy levels: Autistic burnout or shutdown may resemble depressive symptoms, but they are usually tied to overstimulation or exhaustion. Bipolar depression, however, tends to involve a prolonged low mood not necessarily connected to sensory or social demands.
Speech and activity patterns: During mania or hypomania, speech may become pressured and rapid, and activity levels may dramatically increase. In autism, increased talkativeness or repetitive interests may occur during periods of comfort or enthusiasm but are not driven by manic energy.
Sleep changes: Autistic individuals may have chronic sleep difficulties related to sensory or routine disruptions, whereas bipolar-related sleep changes are more episodic and linked to mood cycles.
Self-perception: Elevated self-esteem or grandiosity during mania differs from the confidence fluctuations autistic individuals might experience based on social acceptance or burnout recovery.
Impulsivity: Autistic impulsivity often stems from sensory seeking, executive functioning challenges, or difficulty with inhibition. Bipolar impulsivity during mania tends to involve high-risk behaviours and poor judgment under the influence of elevated mood.
Social Interaction: Autistic individuals tend to experience challenges with social interaction and understanding social cues, and have a preference for routine. Conversely, during a manic episode, someone with bipolar disorder may exhibit excessive social engagement and energy, a decreased need for sleep, and impulsive risk-taking behaviours.
Interest and Focus: Both autistic individuals and those who experience mania may have a list of uncompleted projects, but these are usually for different reasons. For autistic individuals, this could be due to autistic inertia. This involves a freeze response that autistic people experience when trying to start a task. Whereas individuals experiencing mania may engage in increased goal-directed activity based on impulse, which can lead to uncompleted projects.
In essence, when both autism and bipolar disorder are present, careful assessment is essential to understand which symptoms belong to which condition and how to best support the individual.
How to Recognize Mania in an Autistic Person
If you or someone you know is autistic and you believe that you may also be experiencing bipolar disorder, there are some signs to look for that may help you understand how these two conditions show up together. The common signs to watch out for include:
Increased Energy: Spikes in energy around special interests may be common in autistic individuals. But notable spikes in energy levels or activity that you normally would not experience as an autistic individual could be a sign of bipolar disorder.
Racing Thoughts: You might experience thoughts racing through your head. When you try to get these thoughts out, your speech may be incoherent.
Impulsivity: Engaging in risky behaviours or behaviours that don’t fit your personality. This often occurs without considering the consequences.
Changes in Sleep: A decreased need for sleep. You may appear energized even if you did not get 7-9 hours of sleep.
Intense moods: Rapid shifts in mood that seem out of proportion to the context may suggest manic episodes.
Moreover, if these symptoms have been there since your autism appeared, it may not be mania. But if these symptoms are the result of a sudden shift or change in mood or behaviour, you may be experiencing mania or hypomania, which are characteristic of bipolar disorder.
What to Do If You Suspect You May Have Bipolar Disorder as an Autistic Person
If you suspect that you or someone you know may have bipolar disorder alongside your autistic traits, the first step would be to note your symptoms down. You want to have a journal of your mood changes, behaviours, and sensory experiences.
Take this journal to your primary healthcare provider (a doctor or a psychiatrist), as it can provide them with key insights and patterns that can be helpful for determining a clear diagnosis for you.
Alongside potential medications and other treatments, your doctor may be able to refer you to a therapist who is knowledgeable about both autism and bipolar disorder. For instance, neurodiversity-affirming therapy respects your neurodiversity and will acknowledge the unique traits of autism while also addressing your mood challenges in a supportive manner.
Getting a Diagnosis
Once you suspect you may have bipolar disorder, you may also wish to obtain a diagnosis.
This diagnosis can be completed by a medical professional who has the credentials to diagnose bipolar disorder. This may include a family doctor, nurse practitioner, psychologist, or psychiatrist.
The mental health professional will conduct a comprehensive evaluation with interviews and standardized questionnaires that will take a detailed history of your current and past moods.
A proper diagnosis can lead to more targeted treatment and support that honours both the autistic identity and the experiences of bipolar disorder.
What to Expect from Treatment
Treatment for bipolar disorder is not a one-size-fits-all approach. It typically involves a holistic approach that may combine therapy, medication, and lifestyle changes.
Medications for bipolar disorder can consist of mood stabilizers such as lithium or antipsychotics to help to manage your mood. Because some of these medications can impact your vitals, a medical professional may carefully monitor your vitals while you are on these medications.
In addition to medications, you may go through psychotherapy, which may involve dialectical behavioral therapy or cognitive behavioural therapy.
These therapeutic approaches can help you develop skills that can support you in managing your mood alongside your medications. The therapist may use neurodiversity-affirming approaches and craft the therapeutic environment and your treatment plan based on neurodivergence.
Furthermore, you may also engage in lifestyle changes to regulate your mood, including implementing routines that support regular sleep, balanced nutrition, and physical activity.
Importantly, the treatment of bipolar disorder should be individualized (person-centered) and respect your individual needs, strengths, and challenges.
Strategies for Autism and Bipolar Disorder
Now that you are aware of what bipolar disorder and autism may look like when they occur together, you can explore strategies that can support you in navigating the challenges involved with this concurrent diagnosis. These strategies include:
Becoming aware of your warning signs: everyone with bipolar disorder will have different warning signs that suggest a manic or depressive episode is about to start. When you notice these warning signs, you can implement a safety or wellness plan that you created. This will include safe people you can talk to, self-care measures, and reminders for medications, among other things.
Creating a routine: when in a depressive or manic episode, certain environmental changes can exacerbate symptoms. For instance, if you are in a depressive episode, experiencing insomnia may make it worse. During these episodes, you can establish a routine to take care of yourself. Consider going to bed and getting ready for bed at the same time each night. Sleep hygiene is a huge factor in mental wellness.
Exploring stress management techniques: stress is a key factor that can exacerbate symptoms of depression and mania. Stress management techniques, such as engaging in yoga, meditation, and self-care, may be of support to you.
Communicate Your Needs: Be open about your feelings and needs with friends, family, or therapists to foster understanding and support.
Finding your purpose: when in a depressive episode, sometimes it can be difficult to find pleasure in things. Finding your purpose may help you find the things you are passionate about and improve your energy levels. Consider writing down a list of things that make you feel alive or that you enjoy. If this is too difficult, make a list of your values and beliefs and explore hobbies around them.
Build a Support Network: Connect with others who understand your experiences. Identify trusted friends, family, or support groups where you can share challenges. Regular check-ins with this network can provide emotional support and community.
Use the Spoon Theory: As a neurodivergent individual, you may experience periods where your energy is low. If you are going through a depressive episode, this may be even more pronounced. The spoon theory can support you with regulating your energy levels so you don’t burn out.
Limit Screen Time: Reduce exposure to screens, especially before bedtime. This can improve sleep quality and alleviate anxiety. Designate specific times for device use and stick to them to create healthier habits.
Set Boundaries: Learn to say no and communicate your limits to others to protect your mental well-being. Establishing clear boundaries helps ensure that your needs are met and respected.
Limit Alcohol and Caffeine: Caffeine and alcohol may increase your impulsivity and risk-taking behaviors. They may also increase your anxiety and impact your mood stability. Consider finding alternative beverages that are soothing.
Book a Free Consultation With Blue Sky Learning
Are you or someone you know an autistic individual who may be experiencing the symptoms of bipolar disorder?
Do you need personalized support to manage your mood fluctuations?
The team of therapists in Ontario, Canada, at Bee Kind Counselling can help.
Schedule a free consultation today with a neurodiversity-affirming therapist by emailing admin@beekindcounselling.com, calling 519-757-7842, or following the link below.
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