Many people who are diagnosed with bipolar disorder also have other psychiatric situations, including anxiety disorders. But when your anxiety doesn’t quite fit into the definition of a specific, well-defined anxiety disorder, your psychiatrist might instead diagnose you as having “bipolar disorder with anxious distress.”
Having bipolar disorder with anxious distress plainly means you have bipolar disorder, plus anxiety that interferes with your life but doesn’t meet the diagnostic criteria for an anxiety disorder.
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function.
The mood episodes associated with the disorder persist from days to weeks or longer, and can be dramatic, with periods of being overly high and/or irritable to periods of persistent sadness and hopelessness.
Severe changes in behavior go along with the mood changes. These periods of highs and lows, called episodes of mania and depression, can be distinct episodes often recurring over time, or they may happen together in a so-called mixed state.
In this case, bipolar disorder is the diagnosis, and “with anxious distress” is what’s called a specified—an add-on to the diagnosis that clarifies it or elaborates on it. It was added because mental health professionals thought it was required in a variety of cases.
Symptoms
For a psychiatrist to add the specified “with anxious distress,” a patient’s condition needs to include at least two of these symptoms:
The symptoms have to be present most days of the current or most recent bipolar episode, regardless of whether the episode involved manic, hypomanic or depressive symptoms.
In so-called “anxious distress,” severity of the situation is determined by the number of symptoms present: Two symptoms mean the condition is mild, three symptoms mean its moderate; four to five symptoms mean it’s moderate to severe, and four to five symptoms with psychomotor agitation mean it’s severe.
Someone can have bipolar I, bipolar II, or cyclothymia with anxious distress.
Anxiety Disorders Are Also Possible
Even if you have bipolar disorder with anxious distress, you also can be diagnosed with another anxiety disorder. If you get panic attacks, you can be diagnosed with panic disorder, and if you’re acutely afraid of a specific object or situation (spiders or flying, for example), then you could be diagnosed with a phobia. When two or more illnesses not connected to each other are diagnosed in a single patient, they are called “comorbid,” which plainly means they happen together.