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The Tension Tango

Adding an anxiety diagnosis to bipolar can feel like bad news—but it’s a key step toward real relief

By Chris Swingle

Dave M. has been through the unshakable weight of depression and the reckless risk-taking of mania. But he says the sudden panic of anxiety is worst of all. It’s been a constant in his life as far back as high school, when he remembers freezing in place at the chalkboard in algebra, unable to write the answer to an equation as sweat beaded up.

Rebecca R. was diagnosed with bipolar at age 21, but her persistent worrying began a decade earlier. Among other things, she was afraid her single mother couldn’t afford rent and food—to the point that the youngster spent the allowance her father gave her on milk and eggs. Rebecca’ internalized anxieties translated to sleepless nights, painful stomachaches, and bowel problems.

Alan R. not only couldn’t open his mouth around girls in middle school, but his social phobia made him so panicky he’d have to leave. “I felt like I was crawling out of my skin,” he recalls. He turned to street drugs in high school, which he says made everything worse. After two decades in treatment, discovering that he has bipolar as well as an anxiety disorder made a real dent in his symptoms.

Research indicates that more than half of people with bipolar disorder also have an anxiety disorder. Often the anxiety strikes first, suggesting that it could be a risk factor for developing bipolar, says Regina Sala, MD, PhD, of Columbia University.

Sala led a study on the prevalence and effects of anxiety disorders in patients with bipolar, published in the July 2012 issue of the Journal of Psychiatric Research. … [end of excerpt]

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