Understanding Bipolar Disorder and Its Overlap With Autism: Traits, Diagnosis, and Coping Strategies
- Kaitlyn Boudreault
- Mar 7
- 7 min read
Updated: Jun 7
Do you ever experience periods of intense joy (mania) followed by intense emotional lows (depression)? Do these mood swings affect your relationships or daily goals?
If so, you may belong to the 40 million people worldwide diagnosed with bipolar disorder, and some of those individuals are also autistic.
Autism may co-occur with bipolar disorder creating traits, such as such as social-communication challenges, sensory sensitivities, and mood instability
The exact prevalence for autism and bipolar disorder is not entirely known. Because the two neurotypes share overlapping signs, misdiagnosis is common. A neurodiversity-affirming therapist in Ontario, Canada, can help support you through these experiences.
Below we'll define bipolar disorder and autism, explain how they intersect and differ, and outline effective strategies to navigate life with a dual diagnosis.
Autism is a neurodevelopmental difference and neurodivergence marked by a range of traits that vary in intensity, including:
Hyper-focus on special interests
Social-communication differences
Information-processing challenges
Importantly, autism should not be viewed through a pathological lens but rather as a natural variation in brain neurology. Many autistic adults embrace an identity-first perspective (“I’m autistic”), viewing autism as a natural brain variation, not a pathology to be fixed.
Autistic individuals often have strengths along with these challenges, often including keen attention to detail, creativity, and deep subject-matter expertise. These strengths can enrich autistic lives and the lives of those around them.
What is Bipolar Disorder?
Bipolar disorder is a mental health condition that is characterized by mood-cycling.
These changes involve
Mania or hypomania (Emotional Highs): elevated, energized, irritable, and engaging in risky behavior
Major depression (Extreme Lows): prolonged sadness, hopelessness, loss of pleasure in the activities that you once enjoyed.
Hypomania vs. Mania
Understanding the difference between hypomania and mania can help to distinguish between bipolar I and bipolar II.
Mania → More severe symptoms involving reckless behavior, grandiose beliefs, impaired judgment. and potential hallucinations. These symptoms are disruptive to your daily functioning.
Hypomania → milder form of mania, with elevated mood, increased energy, and enhanced productivity without the extent of dysfunction seen in full-blown mania.
Two Main Subtypes
Bipolar I: At least one manic episode and one depressive episode.
Bipolar II: At least one major depressive episode and one hypomanic episode.
The Traits of Bipolar Disorder
The symptoms of bipolar disorder typically fall into two different categories, depending on whether the individual is experiencing a depressive or manic/hypomanic episode.
The symptoms of a mania or hypomania episode include
Extreme elation
increased energy
Increased irritability
A distorted sense of self
Sleep disturbances
Impulsive risk-taking behaviors
On the other hand, the symptoms of a depressive episodes include
Feeling sad most of the days.
Changes in your sleep or eating habits
Weight gain or weight loss
Concentration and focus challenges
Fatigue
Thoughts of death or suicidal ideation
The Traits of Autism
The traits of autism exist on a spectrum, which means that the severity differs from person to person. But some of the common traits that an autistic individual may experience include:
Difficulty with social interaction
Communication challenges, such as trouble understanding social cues
Practicing repetitive behaviors, also known as stimming
Displaying very specific preferences
Difficulty with routine
Sensory sensitivities
Shared & Distinct Traits of Autism and Bipolar Disorder
There are overlapping traits between autism and bipolar disorder, consisting of communication challenges, sensory sensitivities, and mood instability
But there are key differences in why these challenges occur.
Challenge | Autism | Bipolar Mania/Hypomania |
Challenges With Social Interaction | Difficulty reading cues, preference for routine | Excessive sociability, reduced need for sleep |
Uncompleted Tasks and Projects | Uncompleted tasks due autistic inertia, a freeze response that autistic people experience when trying to start a task. | Goal-directed impulsivity sparks many unfinished projects |
Mood Regulation Challenges | Generally steady but can include shutdowns or meltdowns | Cyclical highs and lows with distinct phases |
Understanding these differences aids in the recognition of each and greater diagnostic accuracy and treatment. Tracking mood cycles and context is crucial.
Why Autistic People Are at Higher Risk for Bipolar Disorder
Autistic individuals are more likely to experience symptoms of bipolar disorder and be diagnosed with the condition. Research suggests a 9.3 × greater likelihood of bipolar diagnosis in autistic adults (ages 17–43).
This connection underscores the importance of understanding how the traits of autism might overlap with mood fluctuations characteristic of bipolar disorder.
The exact cause of this overlap is also still being explored. But some researchers believe that there may be
A Genetic Component: If you have a family member who has bipolar disorder or is autistic, you are more likely to experience these yourself.
Shared Neurobiological Underpinnings: Irregularities in neurotransmitter systems (dopamine, serotonin) that regulate mood and behavior.
Furthermore, some traits of autism, like difficulties in social communication and rigid thinking, may complicate the diagnosis of bipolar disorder. Mood fluctuations may also be misinterpreted as typical autistic behaviours, resulting in misdiagnosis.
Spotting Mania in an Autistic Person
If you or someone you know is autistic and believed to also be experiencing bipolar disorder, there are some signs of bipolar disorder to watch out, including:
Increased Energy: Notable spikes in energy levels or activity that you normally would not experience.
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 behaviors or behaviors that don’t fit your personality, often 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 new or cyclical, seek a professional assessment.
What to Do If You Suspect You May Have Bipolar Disorder as an Autistic Person
If you suspect you may have bipolar disorder alongside your autistic traits, the first step may be to note down and track the symptoms that you experience.
Keep a journal to track mood changes, behaviors, and sensory experiences. This can provide insights and patterns that may be helpful in discussions with professionals.
Once you have a sense of the symptoms you are experiencing, consult with a healthcare professional for support.
Finding a therapist who is knowledgeable about both autism and bipolar disorder can enable a more nuanced treatment approach. For instance, neurodiversity-affirming therapy respects your neurodiversity and will acknowledge the unique traits of autism while addressing mood challenges in a supportive manner.
Getting an Accurate Dual Diagnosis
Another step you may wish to take if you suspect you may have bipolar disorder is to obtain a diagnosis.
This will involve seeing your family doctor or another medical professional who has the credentials to diagnose bipolar disorder. This may include a psychologist or a psychiatrist.
The mental health professional will conduct a comprehensive evaluation that may involve interviews and standardized questionnaires.
It may also consist of taking a detailed history of current and past moods. This may help professionals discern between the traits of autism and potential mood swings indicative of bipolar disorder.
A proper diagnosis can lead to more targeted treatment and support that honors both the autistic identity and the experiences of bipolar disorder.
Treatment: A Whole-Person Approach
There is no one-size-fits-all treatment approach. Treatment typically involves a holistic approach that combines therapy, lifestyle changes, and medication.
Medication: Lithium or antipsychotics that help you manage your mood. These medications usually also involve careful monitoring from a medical professional to make sure that all your vitals remain stable.
Neurodiversity-affirming therapy: Cognitive-behavioral therapy (CBT) or dialectical behavior therapy (DBT) for autistic processing styles. The therapist may use neurodiversity-affirming approaches and craft the therapeutic environment and your treatment plan based on neurodivergence.
Lifestyle supports: sleep hygiene, sensory-friendly routines, balanced nutrition, regular movement so you are able to regulate your mood.
Importantly, the treatment of bipolar disorder should be individualized (person-centered) and respect your individual needs, strengths, and challenges.
This approach is a lot like the quote, “When a flower doesn’t bloom, you fix the environment in which it grows, not the flower.” Ableism and systemic issues in society that disable neurodivergent individuals are viewed as an issue here, not the person.
Everyday Strategies for Living With bipolar Disorder as an autistic person
Now that you have an understanding of bipolar disorder and its overlap with autism, you can focus on the strategies that will support you in navigating your challenges, including:
Know your early-warning signs: everyone with bipolar disorder will have different warning signs that suggest a manic or depressive episode. When you notice these warning signs, you can implement a safety or wellness plan that you created. This will include safe people, self-care measures, and reminders for medications.
Keep consistent routines: when in a depressive or manic episode, certain environmental changes can exacerbate symptoms. Consider going to bed and getting ready for bed at the same time each night to prevent mood swings triggered by sleep loss.
Practice stress-management skills: 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. You could also consider distress tolerance techniques such as TIPP, ACCEPTS, and IMPROVE.
Communicate needs & request accommodations: Be open about your feelings and needs. Bipolar can be characterized as a disability, and you can ask for accommodations to support your needs at school or work.
Identify purpose & passions: when in a depressive episode, sometimes it can be difficult to find pleasure in things. Consider writing down a list of things that make you feel alive or that you enjoy.
Build a support network: Connect with others who understand your experiences. Regular check-ins with this network can provide emotional support and community.
Use spoon theory: As a neurodivergent individual, you may experience periods where your energy is low. The spoon theory can support you with regulating your energy levels so you don’t burnout.
Maintain a mood journal: Track your moods and emotions to identify patterns and potential triggers. Regularly reviewing your journal can help you recognize warning signs and develop strategies for managing mood changes effectively.
Set tech boundaries: Reduce exposure to screens, especially before bedtime. Designate specific times for device use and stick to them to create healthier habits. This can improve sleep quality and alleviate anxiety.
Use positive affirmations: If you are experiencing a depressive episode, your mood may be low. Repeat positive statements to yourself daily to reduce the negative self-talk.
Establish healthy boundaries: Learn to say no and communicate your limits to others to protect your mental well-being.
Cut back on alcohol & caffeine: Caffeine and alcohol may increase your anxiety, impulsivity, risk-taking behaviors, and mood swings. Consider finding alternative beverages that are soothing such as chamomile tea.
Book a Free Consultation With Blue Sky Learning
Need personalized help managing bipolar mood swings and autistic traits? Blue Sky Learning’s neurodiversity-affirming therapists and coaches are here for you.
📧 Email hello@blueskylearning.ca or click below to schedule your free consultation today.
Sources
Bipolar disorder is often misdiagnosed as depression because people don't always recognize their "high" moods as a problem. A specific Bipolar Disorder test screens for both mania and depression.