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Panic Attacks and Bipolar Disorder

Fear is the defining emotion of the moment.  It drives decisions and keeps people on edge, infusing every action and relationship with anxiety.

It was already bad before the coronavirus.  Climate change and the run-up to a negatively charged election darkened people’s outlook.  Increasing costs of healthcare and education had families questioning their ability to keep up.  Panic, suddenly, seemed reasonable.

In times of high anxiety, we look to people and institutions we can trust.  But even trust has failed us.  Information from the government and the media are suspect, and stalwarts like the church, hell, even the Boy Scouts, no longer assure safe haven.

And now issues like quarantine and infection seem imminent, and a rush on stores and lack of testing paints a grim picture.

I have bipolar disorder and I have had panic attacks.  All this anxiety can aggravate both conditions.  Especially since I’m not exaggerating about the current threats facing our world.

15 – 20% of people with bipolar disorder also have panic disorder.  This rate is 10-20 times higher than the general population.

60% of people in mixed-state episodes report anxiety at such a high level that panic attacks are common.

I remember a particularly difficult time when my moods were swinging wildly.  I took my grandmother to mass and settled in for the safe feeling of a ritual I memorized when I was a kid.

During the homily the priest made a joke about one of the apostles being bipolar.  It seemed the stained-glass windows shattered and the lit candles began to swirl about the altar.  My clothes constricted, I began to sweat and I gasped for air.

I told my grandmother I’d be right back and ran into the parking lot.  As my breathing settled I called my brother-in-law and asked him to come pick up Grandma.  I just walked scared.  Even the birds singing in the trees seemed threatening.

My doctor prescribed clonazepam for the anxiety, but I began to abuse it.  People with bipolar disorder and panic disorder have significantly higher rates of substance abuse and are at extreme risk of suicide.  I attempted.

According to a report published in the Psychiatric Times, only valproic acid provides effective treatment for co-morbid bipolar and anxiety disorders.  Lithium may also be effective, but the research is not complete.

People with early-age-at-onset bipolar disorder are most at risk of developing a panic disorder, although panic disorder is not uncommon across the lifespan.  Even geriatric BP patients report increased levels of anxiety and an unusual number of panic attacks.

Mindfulness-based therapies can help minimize or even avoid the symptoms of anxiety, but panic disorder seems to have genetic components.  If you suffer so, don’t let people tell you it’s all in your head.

Panic disorder is a real medical condition with a biological basis.

Outlook and stress can influence the onset of panic attacks.  In an environment like the one we have today it becomes harder to deal with the stress of daily life.  You can’t get away from it, and it only aggravates things to hide your head in the sand.

Seek reliable sources of information and increase contact with your doctor and/or therapist.  Practice meditation if it helps and up the frequency of exercise.  Keep working.  To isolate now will only fuel the damaging anxiety that our world seems to demand.

Rest in even fleeting moments of relapse.  In people with bipolar disorder the frequency of panic attacks plummets between mixed-state episodes and episodes of depression.  They’re uncommon during episodes of pure mania.

It always gets better until it doesn’t.  Then it gets better again.  Reach out to people you trust and people who care.  The challenges we face today are best approached together.

Panic Attacks and Bipolar Disorder

George Hofmann

George is the author of Resilience: Handling Anxiety in a Time of Crisis, from Changemakers Books. Visit George's site or join the Facebook group Practicing Mental Illness

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APA Reference
Hofmann, G. (2020). Panic Attacks and Bipolar Disorder. Psych Central. Retrieved on September 22, 2020, from


Last updated: 10 Mar 2020
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