People with autism may have periods of irritability, aggression, pacing, hyperactivity, and loss of sleep that can look like symptoms of bipolar disorder. A psychiatrist reviews a person's symptoms and examines whether there is a cycle of changing moods over time.
While some individuals experience only the manic episodes, many affected individuals rapidly alternate between these two states and experience great irritability. As with other psychiatric disorders, studies suggest that bipolar disorder may be relatively common among children and adults with autism.
Symptoms of a manic episode
Having an abnormally high level of activity or energy. Feeling extremely happy or excited — even euphoric. Not sleeping or only getting a few hours of sleep but still feeling rested. Having inflated self-esteem, thinking you're invincible.
During manic episodes, people experience euphoria, high energy, and racing thoughts. They're easily distracted, unusually irritable, and prone to risky behavior like shopping sprees and reckless driving. They'll often find themselves talking quickly about many things at once and will go without sleeping.
While people with autism may feel depressed, autism doesn't cause depression or suicidal thoughts like bipolar disorder can. Additionally, people with autism are likely to have difficulties with speech, social situations and sensory challenges. These are not challenges people with bipolar disorder experience.
Can autism be mistaken for bipolar disorder? Yes. Some of the behaviors seen in autism (such as rapid talking, pacing, and irritability) are also present in bipolar disorder.
Because of its similarities, Aspergers and Pediatric Bipolar Disorder are very similar and can cause a misdiagnosis. The symptoms that are similar are: odd habits, compulsive behavior and spells of rage. Both disorders tend to lack the social development skills as well as the educational, behavioral and anger issues.
A common bipolar disorder symptom is mania, an extremely elevated mood state with increased alertness and energy. There are three stages of mania: hypomania, acute mania and delirious mania. Classifications of mania are mixed states, hypomania and associated disorders.
In the manic phase of bipolar disorder, it's common to experience feelings of heightened energy, creativity, and euphoria. If you're experiencing a manic episode, you may talk a mile a minute, sleep very little, and be hyperactive. You may also feel like you're all-powerful, invincible, or destined for greatness.
This cycle can range from mania to anxiety to depression and can include bouts of rage or violence. Much has been studied regarding the link between bipolar disorder and Asperger's syndrome, which have very similar symptoms (one can also be diagnosed with both).
According to literature, up to 34.8% of the patients with a diagnosis of ASD can show psychotic symptoms and, similarly, autistic traits have been reported in schizophrenia patients (SCZ) in a percentage ranging between 3.6 and 60% (12).
High levels of stress. Changes in sleep patterns or lack of sleep. Using recreational drugs or alcohol. Seasonal changes – for example, some people are more likely to experience hypomania and mania in spring.
It can be easy to spot a person's manic episode way before other symptoms become more pronounced, simply by observing the eyes. Dysphoric mania can make the eyes black due to the pupil taking over the eye. The eyes often widen as if surprised with euphoric mania and often appear mean and narrow with dysphoric mania.
The surge of adrenaline during euphoric and dysphoric states of mania causes the pupils to dilate. For those with a different-colored ring around the pupil, the ring may dominate and normal eye color may seem completely altered.
Manic episodes are not a symptom of ADHD, but a person with ADHD may experience some of the symptoms of a hypomanic episode. Although there may be some symptom similarities, the underlying causes of bipolar disorder and ADHD are different.
Common warning signs of an impending manic episode include the following: Increased energy or a sense of restlessness. Decreased need for sleep. Rapid, pressured speech (cant stop talking)
Lithium is another option for children and adolescents with ASD who present with symptoms of a mood disorder, such as elevated moods/euphoria, mania, and paranoia, whether accompanied or not by irritability.
In previous studies of children with ASD, the term 'irritability' was often used to describe severe behavioral difficulties, e.g., verbal and physical aggression, self‐injury or property destruction.