PTSD and bipolar disorder have some overlapping symptoms, including disturbing thoughts and depressed mood. However, their cause and symptom patterns set them apart.

Bipolar disorder and post-traumatic stress disorder (PTSD) are two serious mental health conditions that are sometimes challenging to tell apart. That’s mainly because they can give rise to some of the same symptoms, such as disturbing thoughts, a deeply depressed mood, difficulty concentrating, and suicide attempts.

Yet PTSD and bipolar disorder are two distinct mental health conditions, and arriving at a correct diagnosis is an important step in creating an appropriate treatment plan. Complicating the process of diagnosis is the fact that some people are living with both conditions at once.

In the United States, about 1 in 5 adults live with a mental health condition. Of the estimated 52.9 million people with a mental health condition living in the United States, 1 in 11 people will receive a PTSD diagnosis at some point in their lives.

Another 2.8% of U.S. adults have received a diagnosis of bipolar disorder, which seems to develop when a person is genetically susceptible and may be due to biochemical changes in the brain.

How can you tell the two conditions apart, and what should you do if you think you have PTSD, bipolar disorder, or both? Read on to find out.

PTSD is a trauma- and stressor-related disorder affecting some people who have experienced or witnessed a traumatic event, such as war, a natural disaster, an accident, sexual violence, or terrorism, or who have been threatened with death.

PTSD can affect people of all ages and from any culture. In the United States, 3.6% of adults receive a diagnosis of PTSD each year. According to the American Psychiatric Association (APA), Black people, Native Americans, and Latinos have higher rates of PTSD than non-Hispanic white people.

Complex PTSD (CPTSD)

CPTSD is a condition related to PTSD that has become more widely recognized by mental health experts in recent years. Instead of one single traumatic event causing it, CPTSD stems from multiple traumas that occur over a period of time, such as months or years.

Examples of ongoing traumas known to lead to CPTSD include:

  • torture
  • kidnapping
  • domestic abuse
  • being enslaved
  • experiencing war

PTSD is a different experience for every person who has the disorder because it arises from traumatic experiences, which are unique to each person.

However, some symptoms are more common than others. People with PTSD may experience:

  • disturbing feelings
  • intrusive thoughts
  • distressing memories linked to the traumatic event that first sparked or contributed to the disorder’s occurrence
  • avoidance of people, places, situations, and other things that trigger feelings associated with the trauma

A person with PTSD may have repeating nightmares or memories of the event. While rare, some individuals with PTSD or CPTSD may experience flashbacks of the traumatic event. A sight, smell, emotion, event, or person may trigger flashbacks.

During a flashback, an individual with PTSD relives some part of a traumatic event. More vivid than a memory, a flashback can feel very real.

People with PTSD experience avoidance, or trying to keep away from situations, people, places, and other possible triggers of their trauma.

This avoidant behavior can severely impair a person’s ability to carry out their lives. It can prolong PTSD by helping a person avoid facing their fears.

Those with CPTSD may experience any of the symptoms of PTSD along with these additional symptoms:

  • challenges in forming and maintaining relationships
  • difficulty or inability to regulate emotion
  • dissociation, or feeling disconnected from your emotions, body, or the traumatic experience
  • distorted view of an abuser
  • diminished sex drive
  • negative self-image
  • loss of connection to the world and others

Life can be full of ups and downs. But for the lives of people with bipolar disorder, those highs and lows are much more extreme and can make it harder to navigate everyday life.

There are four types of bipolar disorder. Bipolar I disorder and bipolar II disorder are the most common. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) defines the criteria for diagnosing the different types of bipolar disorder in the following way:

Bipolar I disorder

To have bipolar I disorder, an individual must experience manic episodes, which the DSM-5-TR defines as:

  • shifts in mood or behaviors that are different from the person’s typical behavior
  • these mood shifts must occur most of the day, most days during the episode
  • these mood shifts last at least 1 week or are so severe that the person needs hospital admission for care

People with bipolar I disorder generally have depressive episodes as well, but having depressive episodes isn’t necessary for a bipolar I disorder diagnosis, and an individual can’t have another condition that may explain these symptoms.

Bipolar II disorder

An individual with bipolar II disorder also has high and low moods, but they’re more likely to have depressive symptoms, while their manic symptoms are usually less severe. These less severe manic episodes are called hypomania.

To receive a diagnosis of bipolar II disorder, an individual must have:

  • had at least one episode of major depression
  • had at least one episode of hypomania
  • no other condition that could be causing their symptoms

Cyclothymic disorder

Cyclothymic disorder is similar to bipolar I and II disorders in that an individual has mood shifts, but these mood shifts are less extreme.

An adult with cyclothymic disorder must have had episodes of both hypomania and depression for at least 2 years, while children or teens must have had episodes for 1 year to receive a diagnosis of cyclothymic disorder.

Bipolar disorder not otherwise specified

Bipolar disorder not otherwise specified is a more general category that describes an individual who has symptoms of bipolar disorder, but those symptoms don’t fall into the other diagnostic categories.

According to a 2019 review, rates of suicide attempts are high among people with bipolar disorder, ranging from 20% to 60%. Up to 20% of people with bipolar disorder ultimately die by suicide.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

As with PTSD, CPTSD, and so many other mental health conditions, the symptoms of bipolar disorder aren’t uniform for all people and may vary in severity from person to person.

While each type of bipolar diagnosis gives rise to different patterns and symptoms, the defining symptoms of bipolar disorder generally include:

Manic episodes

These episodes are defined by:

  • extreme elation
  • irritability
  • jumpiness
  • racing thoughts
  • less need for sleep
  • rapid speech
  • grandiose thoughts or actions
  • increased appetite for food, drinking, sex, and drugs

Some episodes may become so severe that they cause psychosis, which is serious and may require hospitalization.

Depressive episodes

During depressive episodes, an individual experiences lasting low or depressed mood. Other symptoms may include:

  • fatigue
  • feelings of worthlessness
  • difficulty maintaining a sleep routine (sleeping too much or too little)
  • appetite changes
  • a loss of interest in things that a person once enjoyed
  • thoughts of death

Episodes with mixed features

As with all types of bipolar disorder, mixed episodes include both manic and depressive states, but an individual may cycle between them in the same episode, or they may occur at the same time.

Some of the symptoms of PTSD are very similar to the symptoms of bipolar disorder, such as:

  • increased risk of suicide attempts
  • sleeping issues
  • paranoia
  • difficulty concentrating
  • dissociation
  • feeling restless
  • drug or alcohol misuse
  • difficulty with relationships
  • emotional withdrawal

Ultimately, the primary difference between PTSD and bipolar disorder has to do with their causes and symptom patterns.

PTSD is a trauma-related condition marked by flashbacks, anxiety, and hypervigilance, while bipolar disorder is a mood disorder involving cycles of depressive and manic or hypomanic episodes that occur independently of external trauma.

The simple answer is yes. While not everyone who experiences trauma will have PTSD, having another mental health diagnosis, including bipolar disorder, may increase the risk of developing PTSD.

It’s possible for some people with bipolar disorder to develop PTSD from a traumatizing event or events, or for a person who has PTSD to receive a diagnosis of bipolar disorder.

Only a licensed mental health professional can diagnose PTSD, bipolar disorder, and other mental health conditions.

When screening for mental health conditions, a mental health professional will look for key signs of each disorder and evaluate an individual’s:

  • mood
  • mental health histories
  • relationship status and history
  • overall health
  • daily habits
  • history of substance use

Mental health professionals may also consult other healthcare professionals to ensure that an underlying physical condition is not causing symptoms.

Mental health professionals will carefully record symptoms and take a complete history, including any traumatic events. They may also use screening tools and tests to help determine whether an individual has either PTSD or bipolar disorder.

Treatment will be based on an individual’s specific diagnosis and may include one or more of the following options.

PTSD treatment options

Treatment for PTSD generally involves psychotherapy and can be very successful at providing relief. Some common treatment options for PTSD include:

Prolonged exposure (PE) therapy

This therapy may be used during cognitive behavioral therapy (CBT) to address the avoidance common in PTSD. It helps people gradually face the trauma-related feelings, memories, and situations they usually avoid at all costs. This therapy usually occurs over a period of weeks or months.

Therapy plans are clearly explained and agreed upon. Once the person with PTSD feels safe in the therapy setting, with help from the therapist, they move from imagining frightening or stressful stimuli to facing the stimuli in real life.

Cognitive processing therapy (CPT)

This type of CBT helps an individual learn to challenge and change unhelpful beliefs surrounding their trauma. Generally conducted over 12 sessions, CPT helps people with PTSD and CPTSD build a new understanding of the traumatic events they’ve experienced. In doing this, their PTSD symptoms are reduced.

Psychotherapy (talk therapy)

Psychotherapy, including CBT, involves identifying negative thought and action patterns and learning how to replace them with healthier ways of thinking and acting.

Medications

Though only somewhat effective in treating PTSD, medications may help with some symptoms. PE therapy or CPT is often needed for marked relief in the long term.

Medications used to treat depression and anxiety are sometimes prescribed to people with PTSD or CPTSD. These medications may include:

  • sertraline (Zoloft)
  • paroxetine (Paxil)
  • fluoxetine (Prozac)

Some people benefit from long-term use of medication, while others may benefit from short-term use while strengthening healthy coping strategies in therapy.

Bipolar disorder treatment

Medication is the primary and most successful treatment for bipolar disorder, but other treatment options may be helpful along with medications.

Medications

Psychotherapy

While medications are the primary treatment for bipolar disorder, including psychotherapy may also be a helpful treatment option.

Common types of psychotherapy used to treat bipolar disorder include:

A person’s outlook will depend on their specific diagnosis, treatment, and circumstances.

What’s the outlook for an individual with PTSD?

Living with PTSD or CPTSD can feel exhausting, as a person who is affected often feels they must constantly be on guard against being reminded of or reliving their trauma.

While it’s not possible to “cure” PTSD or CPTSD, treatment can significantly help. Mental health treatment options can help a person manage their symptoms and lead a happier, healthier, and fuller life.

What’s the outlook for an individual with bipolar disorder?

Bipolar disorder is defined as a chronic (long-term) condition. However, people with bipolar disorder can and do live healthy, wonderful lives.

Sticking to a daily treatment plan can help people with bipolar disorder keep their mood more stable and reduce symptoms, including psychosis and suicidal thoughts.

What’s the outlook for people who have both?

If you or a loved one seems to have or has recently received a diagnosis of both PTSD or CPTSD and bipolar disorder, you might be wondering where to start.

Someone who shows symptoms of one or both of these conditions should consider scheduling an appointment with a licensed mental health professional. They’ll rule out any other possible causes of PTSD or CPTSD and bipolar disorder symptoms to arrive at a correct diagnosis.

When a person receives a diagnosis of PTSD or CPTSD and bipolar disorder, a mental health professional can help develop a treatment plan that will include treatments for each of the different types of disorders.

Additional specialists or healthcare professionals may be recommended.

With treatment, it’s possible to significantly reduce or manage symptoms of PTSD or CPTSD and bipolar disorder.