The idea of multiple mental health conditions such as bipolar disorder and autism occurring at once may seem unlikely, but it is possible.

Autism spectrum disorder (ASD), or autism, is defined as a developmental disorder that affects how someone communicates, behaves, and interacts with others.

It’s a common condition, with an estimated 1 in 44 (2.3%) children in the United States living with autism.

Bipolar disorder is also a common mental health condition. It involves severe shifts in your mood and energy levels — like highs and lows — that can last weeks or longer.

According to the National Institute of Mental Health (NIMH), around 4.4% of adults in the United States will have bipolar disorder at some point during their life.

But how often do these two conditions occur at the same time? More than you think.

Quick definitions

  • Autism is a neurodevelopmental disorder. It exists on a “spectrum,“ and the level of support needed varies from person to person. Each autistic individual has their own set of differences and support needs.
  • Bipolar disorder is a mental health condition often diagnosed in early adulthood that causes a person to have extreme shifts in mood and energy that impact day-to-day functioning. There are three types: bipolar I, bipolar II, and cyclothymic disorder. Symptoms vary from person to person and include the presence of manic or hypomanic episodes and depressive episodes that can occur separately, at the same time, or in rapid sequence.

Jessica Myszak, PhD, psychologist, and founder of the Help and Healing Center in Glenview, Illinois, says, “Autism and bipolar disorder could both sometimes have sleep difficulties and behaviors that others don’t understand — such as behavioral rigidity, impulsivity, becoming overwhelmed, and differences in speech.“

Some additional overlapping symptoms of autism and bipolar disorder could include:

  • talking excessively or rapidly
  • increased stimming (repetitive movements or noises) or fidgeting
  • impulsivity
  • aggression
  • irritability
  • increased sensitivity to sensory input
  • difficulties with sleep
  • self-injurious behaviors
  • difficulty thinking or concentrating
  • suicidal ideation

According to a 2016 study, youth diagnosed with both bipolar disorder and ASD presented with:

  • symptoms of depression
  • difficulty concentrating
  • challenges with peers
  • suicidal ideation

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According to Myszak, one of the major differences between bipolar disorder and autism is that autism is a neurodevelopmental disorder that is present from childhood, while bipolar disorder is usually diagnosed sometime between late adolescence and early adulthood.

“Bipolar disorder is episodic and consists of periods of mania or hypomania and depression,“ she adds.

Bipolar disorder is considered a mood disorder. You can have extreme highs or extreme lows that can last weeks or even longer. Many people experience both highs and lows.

Autism, on the other hand, is considered a neurodevelopmental condition that affects the way a person communicates, behaves, and interacts with others. If you have autism, you’ll likely show certain patterns of behavior and communication.

Myszak says bipolar disorder can often be managed with medication. As for autism, medications might be prescribed to help manage certain conditions that commonly coexist with autism, such as depression, anxiety, and hyperactivity.

If you have autism, it’s possible you might live with at least one other mental health condition that can impact your emotional well-being. One such condition is bipolar disorder.

Myszak says, “For many individuals, it can be like peeling an onion — finding appropriate medications to ease attention or mood symptoms could significantly improve these conditions but make other diagnoses more apparent. Taking a stepwise approach could help a person understand how a particular medication or treatment is helping them before moving on to address another condition.“

Sonny Jane, educator, consultant, and advocate in Kaurna Land, Australia, shares their experience navigating more than one neurodivergence — a term that characterizes when a person learns, behaves, and processes differently than what’s considered “typical.“

Jane adds that “When you’re autistic with bipolar, you have the needs and differences of both autism and bipolar to manage and contend with. They’re both a part of how you experience the world, how you function and process, and how you take care of yourself.“

Being diagnosed with more than one condition simultaneously can take work to navigate. Being mindful of the needs of both disorders could help.

Autism and ADHD

Attention deficit hyperactivity disorder (ADHD) is another condition that can coexist with autism.

Like autism, ADHD is a neurodevelopmental condition that can affect the way you behave. ADHD and autism can have some similar symptoms, but they are not the same.

According to the Centers for Disease Control and Prevention (CDC), about 14% of children with ADHD have also been diagnosed with autism.

Jane says, “When it comes to autism, there are often sensitivities to sensory input which can be hard to manage when you crave constant stimulation because of your ADHD. For example, one of my biggest challenges as an autistic ADHDer is my desire for structure and organization but my difficulty in implementing and managing it.“

Navigating the differences and associated needs of autism and ADHD can be challenging, but there are various support services and coping skills that could be useful for both diagnoses.

Autism, ADHD, and bipolar disorder

While it might be unlikely to have more than two conditions at one time, it is possible.

Jane mentions that they are able to live with all three conditions. They say that navigating life with all three conditions means recognizing your triggers and symptoms.

“For a person who is navigating multiple types of neurodivergence, the most important thing is to recognize and understand the correct diagnoses,“ Myszak says. “If one condition is causing the greatest amount of difficulty, that should be addressed first.“

A 2021 review suggested that the overlap of bipolar disorder and ADHD isn‘t unlikely, with an estimated 1 in 6 adults with bipolar disorder also having ADHD.

Jane says, “A common trigger for a manic episode is disrupted sleep, and a part of ADHD is hyperfocusing. If I’m hyperfocusing on something and I forget to sleep, I’ll often end up triggering a manic episode. So, it’s really important to be aware of the intersections and to have strategies to manage them in place.“

Learning to manage and cope with any mental health condition or neurodevelopmental disorder can take time. If you have two co-occurring conditions, it can be even more challenging.

But with the right specialized treatments and support tailored specifically for you and your needs, you can learn to manage both conditions.

It’s important to remember that a mental health professional is the only one who can diagnose any of these conditions, as well as provide therapy and other supportive services if needed.

“To support someone who has multiple types of neurodivergence, it’s crucial to find professionals who are familiar with all their conditions,“ Myszak says. “This includes physicians, psychiatrists, and therapists.“

If you’re not sure where to start seeking help, you can check out our find help page for resources and guidance.