Bipolar vs. Autism

Research shows that autism shares signatures with schizophrenia and bipolar disorder. But is this a case of co-occurrence, or just that of misdiagnosis?


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For those who are not familiar with bipolar disorder, this is a condition which affects MOOD. Individuals slide from feelings of intensely elevated (mania) to intensely low (depression) in a pattern of repeating episodes. Some people cycle rapidly through these moods, others follow more slow set patterns.  Bipolar individuals get “stuck” in moods, and often experience extreme negative intrusive thoughts which can lead to relationship difficulties and suicidal ideation.

In autism, individuals also experience relationship issues and mood disturbances. We too get “stuck” in emotional states and experience periods of mania and long-standing depression.  We hyper-focus, suffer irritability, intrusive thoughts and suicidal ideation.

So what’s up? Are all autistics bipolar, or all bipolars autistic?


Can bipolar and autism co-occur?

Many researchers and therapists say NO. They say that autistics are often misdiagnosed as bipolar, because of the periods of mania that many of us experience. I have to agree.  I have met many autistics who have been misdiagnosed and given medications for bipolar due to their presentations of mania, depression, anger, sadness and general confusion about the world.  In women, most often the misdiagnoses are disassociation or borderline personality disorder; in men, bipolar or schizophrenia.

An old study (which is too often quoted as the prevailing thought) showed that 27 % of autistics also have symptoms of bipolar disorder, and I reckon that’s where it stops: SYMPTOMS.  Just because you have some symptoms of the bubonic plague doesn’t necessarily mean you’re about to die from the plague.  You could just as easily have the flu, or an infection from an untreated blister.  My point is that while there are overlaps,  I think bipolar is mistakenly over-diagnosed in those with autism.

I think there’s something to be said about how autistics and bipolar individuals relate.  I can sort of see both sides, because I have bipolar friends… I think bipolar is distinctly different because there’s a much stronger lean towards negativity, and to the idea that the Self is not true, or not clear.

Christopher Baddock explains this well. He says—

“Autism involves difficulties reading others; it is an inter-psychic disorder. Bipolar, however, is …intra-psychic mentalism: in other words, [difficulty] reading of your own mind. Normally, we read our own mental states by way of sensing our moods, thoughts and feelings in relation to something, and report these to others with phrases like I feel like Y; I’m in the mood for X; or, I’m happy with Z. In bipolar disorder, these internal mind-readings become pathologically exaggerated into crippling swings… often combined with delusional ideas about the self, messianically megalomanic or suicidally self-critical as the case may be”

So, with autism, we can get to understand ourselves and learn what our authentic feelings are.  We may have intrusive thoughts (OCD), but the grounding is still us to ourselves in clarity of feeling.  When we look externally, THAT is where we struggle.  In bipolar, they look within and struggle.


What are the differences and similarities between bipolar and autism?

The symptoms of bipolar disorder fall into two overarching categories: mania and depression.  Most untreated bipolars flip between the two and rarely find any periods of “normal” or “balanced” self. A “normal” state for a bipolar individual varies, but what I know from friends with bipolar, they say it’s a place where they have control over their emotions and feel stable to get things done without feeling pulled towards a pole. So, without further ado, here’s the bipolar symptoms, based on the mood extremes–

Symptoms of a manic episode include:

  • excessive happiness, upbeat and wired
  • suddenly changing from joy to irritability to angry to hostile
  • increased energy and agitation
  • restlessness
  • exaggerated sense of self and inflated self-esteem
  • sleep disturbances
  • poor judgment and impulsive behaviour
  • being easily distracted, forgetting stuff
  • drug and alcohol abuse, excessive sex-drive or promiscuity
  • mania leading to difficulties maintaining relationships


Symptoms of a depressive episode include:

  • acting or feeling down or depressed, sad, or hopeless or worthless or VICTIM-like
  • difficulty making decisions
  • loss of interest in normal activities
  • sudden and dramatic changes in appetite
  • unexpected weight loss or weight gain
  • fatigue, loss of energy, and sleeping lots
  • inability to focus or concentrate
  • suicidal thoughts or attempts
  • disconnecting from relationships, people, things


Autism is a unique and complex disorder where symptoms vary from person to person, along with the severity of those symptoms.  In general, autism presents with:

  • challenges with social interaction and communication
  • difficulties creating and maintaining relationships
  • a tendency to prefer routine and structure
  • focus on repetitive behaviours (often undertaken leading to self-soothing)
  • displaying very specific preferences for item placement or activities

If there’s auditory processing disorder alongside autism (a common dual disability), the autistic can also present with difficulties concentrating, remembering information, and an agitated state.


As you read the two groups of symptoms– the mania/ depression from bipolar and those of autism, you’ll see they are remarkably different.  I think the overlap is seen as times where the autistic person is emotional.


Anyway, I guess it’s possible you’re reading this and you’re that one person who is legitimately bipolar AND autistic! I guess it’s possible to have both, but if you have got a bipolar diagnosis and you feel as though it doesn’t quite fit…. maybe you actually have autism?

Just a thought.