Bipolar and OCD: Is there a link?

Bipolar disorder and OCD can severely affect a person’s quality of life and cause considerable distress. Therefore, it is important to have a proper diagnosis and begin treatment.

When both conditions co-occur, doctors may decide that the priority is to treat bipolar disorder symptoms because of their potentially harmful nature.

Treatment for bipolar disorder

People with bipolar disorder have the condition for life, even though individuals can go years between episodes. Therefore, treatment focuses on long-term mood stabilization and should continue even if the person is experiencing no symptoms at that time.

Psychiatrists may use a combination of psychotherapy and medication to treat bipolar disorder.

Medications may include:

  • Anticonvulsants: Antiseizure medication may help control mood changes. Options include sodium valproate injections (Depacon), carbamazepine (Tegretol XR), and gabapentin (Gabarone).
  • Antidepressants: Although these medications may help with depression relating to bipolar disorder, they cannot help with mania. Options include serotonin, norepinephrine, and dopamine.
  • Antipsychotics: Medications, including prochlorperazine (Compazine) and molindone (Moban), may help psychotic episodes.
  • Benzodiazepines: Aprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan) may help ease insomnia and anxiety.
  • Lithium: This mood-stabilizing medication is the gold standard for bipolar disorder treatment, as it can reduce the risk of suicide.

Psychotherapies that may help with bipolar disorder include:

  • cognitive behavior therapy (CBT)
  • interpersonal and social rhythm therapy
  • family-focused therapy

Treatment for OCD

Doctors frequently prescribe selective serotonin reuptake inhibitors (SSRIs) as a first-line treatment for people with OCD. This antidepressant increases serotonin levels in the brain.

However, doctors are cautious when prescribing SSRIs if the individual also has bipolar disorder, as it can trigger a manic episode in someone with a preexisting bipolar disorder.

Therefore, doctors may suggest other combinations of antidepressants, mood stabilizers, anticonvulsants, or antipsychotics.

Antidepressant medications for OCD may include:

  • fluoxetine (Prozac)
  • fluvoxamine
  • paroxetine (Paxil, Pexeva)
  • sertraline (Zoloft)

Therapies, including CBT and exposure and response prevention, are the mainstay of OCD treatments.