Can OCD Lead to Bipolar Disorder? The Answer Is Pretty Simple

4 min read
Michael Cahill
By Michael Cahill

Many people who begin their mental wellness journeys aren’t sure what’s going on. You may feel like you have obsessive thoughts and can identify compulsive behaviors, but you also might feel down one day and hyper the next.

The connection between bipolar disorder and obsessive-compulsive disorder (OCD) is common enough that you could wonder, “Can OCD lead to bipolar disorder?”

The short answer is no. While there is a common overlap between the two mental health conditions, there have been no studies to suggest one results in the other. Patients who seem to experience a wide variety of symptoms may discover that focusing on one condition may improve their overall wellness.

To understand how the two seem to be connected, you first must get a clear idea of how bipolar feelings and OCD symptoms are similar — and also very different. Then, you’ll be able to work with a trained therapist who can create a treatment plan that works. 

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What is OCD?

Obsessive-compulsive disorder is a mental health condition that can impact anyone, regardless of age, gender, ethnicity or geographic location. Someone who has been diagnosed with OCD has uncontrollable, distressing and unwanted thoughts and may engage in ritualistic behaviors to alleviate their distress.

OCD can manifest very differently between different individuals. Some people have contamination fears that lead to an overwhelming urge to constantly wash themselves or items around them. Others have thoughts that lead them to believe they will harm themselves or others. Some people experience intrusive thoughts that compel them to make sure that everything is orderly and done “just right.” Regardless of the presentation, individuals with OCD struggle with thoughts and compulsions that impact their relationships, careers, schooling, health and overall quality of life.

For someone with OCD,  the anxiety and distress associated with recurrent intrusive thoughts feel manageable only by engaging in compulsive behaviors and mental acts. However, compulsions are short-term solutions and inevitably, the obsessive thoughts reappear, and the cycle starts again.

What is bipolar disorder?

Once known as manic depression, bipolar disorder can be a lifelong condition that needs to be managed. People diagnosed with bipolar disorder experience extreme mood swings that can range from hyper states of elation to deep lows of hopelessness. Depending on the type of bipolar disorder (I or II) that one has, individuals may experience periods of mania that can require hospitalization or cause serious harm (bipolar I) or periods of hypomania characteristic of elevated mood without life altering consequences (bipolar II). 

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These episodes of mania or hypomania can happen many times a year or only on occasion. People with bipolar disorder also experience major depressive episodes where they feel down or depressed, lose interest in their activities and experience other impairing symptoms of depression. 

Symptoms for bipolar disorder can include unusual talkativeness, grandiosity, racing thoughts, poor decision-making and feeling wired when manic/hypomanic. When depressed, people with this condition may have unjustified feelings of guilt and worthlessness. 

Overlapping OCD and bipolar disorder

The symptoms of bipolar disorder can sometimes feel like OCD, too. That could be because there’s an overlap in people who are diagnosed with bipolar and OCD. According to studies published in the National Library of Medicine, just under one-fifth of people who have OCD also have bipolar disorder.

This doesn’t mean that one causes the other, although another study found that bipolar disorder can make OCD symptoms worse. Interestingly, patients who entered the elevated states of mania were less likely to report other compulsive thoughts or obsessive behavioral patterns. 

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Conversely, when people were on the depressed end of the emotional spectrum of their bipolar condition, they had more OCD symptoms. However, one doesn’t cause the other, although it may seem like it. And bipolar disorder is more than just mood swings, which can be a common experience when managing OCD.

What OCD treatment can work?

Both bipolar disorder and OCD are considered serious mental health conditions that can be improved with the right treatment. Sometimes, medication targeting the bipolar condition can help alleviate OCD thoughts and behaviors. But usually, therapists recommend an OCD treatment called exposure and response prevention (ERP) therapy to help.

ERP is a behavioral treatment that’s considered the gold standard of therapy for OCD. This treatment encourages you to face the exact fears that cause you anxiety, obsession and compulsion. 

For example, if you felt like you needed to wash your hands with the hottest water and a lot of soap to feel clean, a therapist might have you put a little dirt on your finger and then work your way up to sticking your hands in mud. Together, you would allow the feelings of discomfort and intrusive thoughts to arise while refraining from engaging in compulsions such as handwashing or avoidance. With time, you can learn to lean into the anxiety and resist engaging in compulsions that reinforce the obsessive-compulsive cycle. 

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Where can you find ERP treatment?

Exposure and response prevention, despite being helpful for treating OCD, can be hard to obtain. The problem with this effective treatment for OCD is that very few trained therapists consider themselves to be experts in ERP andmany towns do not have adequate opportunities for people to get the support they need. Clinics that do provide ERP often have long wait times due to the substantial need.

Fortunately for the many people expeirencing OCD, there is NOCD. This online resource has helped 180 million people with OCD take control of their obsessions and compulsions through ERP therapy. With nearly 200 clinicians on staff, it’s possible to work directly with someone who provides the confidence you need to address symptoms and see results to help live a healthier, happier life. 

To learn more, sign up for a free call with NOCD today.

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Adriana Delgado

Adriana Delgado

Licensed Therapist, LMHC

My journey as a therapist has brought me in front of more and more cases of OCD, which has led to specialization in OCD treatment. My experience working at intensive in-home services for children & families, and intensive outpatient programs, has prepared me for even the biggest challenges. During sessions, I use Exposure and Response Prevention (ERP) therapy because it’s one of the most effective treatments for OCD, and works for any OCD subtype.

Alyse Eldred

Alyse Eldred

Licensed Therapist, LMFT

I’ve been a licensed therapist since 2017, and as an OCD specialist, I only use Exposure and Response Prevention (ERP) therapy. Research shows that ERP is the most effective OCD treatment available. I truly enjoy helping people understand themselves through ERP and I’m grateful to be part of a process that helps people gain control of their lives.

Andrew Moeller

Andrew Moeller

Licensed Therapy, LMHC

I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.

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