While OCD itself doesn't directly cause manic episodes, they often co-occur (comorbidity) with Bipolar Disorder, and treatments for OCD, like SSRI antidepressants, can trigger manic or hypomanic episodes in vulnerable individuals, leading to complex presentations where OCD symptoms can seem to wax and wane with mood swings. In some rare cases, OCD symptoms might even emerge during manic episodes, but more often, OCD symptoms worsen during depression and lessen during mania.
Mania in OCD can occur either as an independent comorbidity or as a result of an antidepressant-induced switch in a patient on anti-OCD drugs. Whatever the cause may be, this comorbidity implies that there can be a host of differences in the presentation, course, treatment guidelines and prognosis.
Hallucinations are one of the key features of psychosis — seeing, hearing, smelling, or feeling things that aren't really there. In one qualitative case study, people with OCD experienced hallucinations like: Hearing voices that they were evil or that the devil would take their soul.
Some people who have bipolar disorder have OCD tendencies where they exhibit OCD traits without receiving the diagnosis during a very low or high mood. Symptoms can include dramatic shifts in mood, depressive episodes, recurring obsessions and compulsions, manic episodes, social problems, and uncontrollable thoughts.
What causes hypomania and mania?
Manic and hypomanic episodes include three or more of these symptoms:
Bipolar Disorder: Helping Someone During a Manic Episode
The 15-Minute Rule for OCD is a Cognitive Behavioral Therapy (CBT) technique where you delay performing a compulsion for 15 minutes when an obsessive thought triggers anxiety, allowing the urge to lessen naturally as you practice exposure and response prevention (ERP). It teaches your brain that discomfort decreases without the ritual, building resilience and breaking the obsessive-compulsive cycle by gradually increasing tolerance for uncertainty and distressing feelings.
The first red flag of bipolar disorder often appears as significant changes in sleep patterns, mood instability (irritability/euphoria), increased energy/agitation, and rapid thoughts/speech, frequently mistaken for unipolar depression or normal moodiness, with sleep disruption (insomnia or oversleeping) and heightened irritability being very common early signs, notes Better Mental Health.
Antidepressants approved by the Food and Drug Administration (FDA) to treat OCD include:
Severe OCD is a way of describing OCD symptoms that are more intense and frequent. Co-occurring mental health conditions, higher levels of stress, significant life changes, or changes in routine can all make OCD symptoms worse. ERP therapy helps people with OCD gradually confront their fears and resist compulsions.
An OCD episode looks like a distressing cycle of unwanted, intrusive thoughts (obsessions) causing intense anxiety, followed by repetitive actions or mental rituals (compulsions) performed to temporarily relieve that anxiety, only for the cycle to quickly restart, interfering significantly with daily life, and often involving physical signs like shaking or sweating. It's characterized by excessive worry about harm, contamination, order, or morality, leading to time-consuming checking, washing, counting, or seeking reassurance.
It has been postulated that obsessive compulsive disorder(OCD) lies in a continuum between schizophrenia and the neurotic disorders. Patients of pure OCD develop psychotic symptoms when there is a transient loss of insight or there is emergence of paranoid ideas.
As mentioned previously, the most common misdiagnosis for bipolar patients is unipolar depression.
Intrusive thoughts in OCD are accompanied by strong urges to compulse (i.e., to do something to alleviate distress associated with the obsession). Intrusive thoughts in BPD are often associated with rage and panic, as well as urges to act impulsively, including self-harm and risky behaviors.
Further studies show that earlier diagnosis and treatment lead to better long-term outcomes. For instance, untreated OCD can lead to significant issues, including relationship difficulties, struggles at work or school, and even the development of additional conditions like depression or anxiety.
Five key signs of bipolar disorder involve extreme mood shifts, including manic symptoms like inflated energy, reduced need for sleep, racing thoughts, impulsivity (spending, risky behavior), and irritability, alongside depressive symptoms such as profound sadness, loss of interest, fatigue, significant sleep/appetite changes, and suicidal thoughts, all lasting for extended periods and impacting daily life.
The first stage of a mental breakdown, often starting subtly, involves feeling overwhelmed, exhausted, and increasingly anxious or irritable, coupled with difficulty concentrating, changes in sleep/appetite, and withdrawing from activities or people that once brought joy, all stemming from intense stress that becomes too much to handle.
How many hours should a bipolar person sleep? People should try to sleep at least 7 hours per night, regardless of whether they have a condition such as bipolar disorder.
The great toll untreated OCD takes
Living in a constant state of anxiety is not healthy. It is not uncommon for people with OCD to suffer from other mental health problems, like depression, as a result of their OCD symptoms. People with OCD may isolate themselves, and prefer to be alone.
Look after yourself
Common types of compulsive behaviour in people with OCD include:
For those looking for a holistic approach to mental healthcare, mindfulness can do more than just help stop a manic episode without medication. It's also a valuable tool for treating anxiety, depression, bipolar symptoms, and other mental health conditions.
Only 22.5 % recognized that they had experienced a (hypo)manic episode, only 17.5 % had consulted a health professional for a (hypo)manic episode, and only 12.5 % remembered having received a diagnosis of bipolar disorder and had received minimally adequate treatment.
Physical/Surroundings Strategies