Anxiety vs Mania – How To Tell The Difference

Anxiety disorders can occur along with bipolar disorder and there is some overlap in the way anxiety and mania look that it's not always clear which it is. Why does this matter? Because one of the ways people can remain stable with bipolar disorder is to recognize early signs of either depression or mania so that you can intervene early to prevent the episode from blossoming. If a manic episode is coming, that intervention is most likely adjusting your mood stabilizer. But you don't want to do that if it's anxiety.

Here's are the symptoms that look similar with anxiety and mania.
Racing thoughts
Concentration problems
Mood irritability
Inability to sleep
Restlessness or agitation

Anxiety is a feeling of uneasiness, fear or dread. It can have physical manifestations, but it starts with a feeling. Mania is state of hyperarousal, like having an internal motor where the dial has been turned up.

So in some ways, anxiety and mania can be thought of as behaving in opposite directions. Even though they share some characteristics, with anxiety the feelings converge upon you and affect you physically and with mania your physical state explodes your feelings.

References
Perugi G, Akiskal HS, Toni C, Simonini E, Gemignani A. The temporal relationship between anxiety disorders and (hypo)mania: a retrospective examination of 63 panic, social phobic and obsessive-compulsive patients with comorbid bipolar disorder. J Affect Disord. 2001 Dec;67(1-3):199-206.

Keller MB. The long-term clinical course of generalized anxiety disorder. Journal Clin Psychiatry. 2002;63 Suppl 8:11-6

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[reallifepsych]

So well said! “A manic person has a fire hose of words, while the anxious person suffers quietly.” Thanks for the helpful videos!

[daron]

Anxiety just keeps you overwhelmed with negative thoughts all the time. when i see other people look relaxed and normal, I think, is it only me who’s suffering so much?!

[gledwood]

I had a friend who said she couldn't sleep because she often had "racing thoughts." But her (anxiety) racing thoughts were totally different from my (bipolar) racing thoughts. Hers were oppressive thoughts that wouldn't leave her alone. Mine were the opposite of oppressive. They ran away from me, skedaddling in all directions, the very opposite of oppressive and intrusive thoughts that won't go away. Mine went away far too fast. And if I did start worrying about something like "where's my keys?" the thoughts would constantly leap from one thing to another until I was thinking about things like tomato sauce, window cleaning and space exploration instead.

[pipersecretp]

THESE are the videos we need right now.

[ashleyrhy]

"With mania, you don't have much need for sleep. You may only get two hours of sleep because you were up reorganizing your shelves."

😳Not me playing this in the background at 2:30am reorganizing my bookshelf knowing full well I have both therapy and work later today

[phettywappharmaceuticalsll]

You’re breakdowns of mental health issues are the best on the web

[Shay_TheUnpopularOpinion_]

You’re a beautiful person! And I love that you’re African American doing this. It’s just nice to see someone who looks like me be in this career ! I’m learning a lot from you💕

[petermcgrory]

I fear I've felt many a manic episode, but combined with depression is just horrible & dark.

[oliviagreen]

Ohhh Dr Tracey, where were you 20+ yrs ago when I was misdiagnosed with either schizoaffective disorder or bipolar disorder, depending on the treatment professional at the time?😖
I took antipsychotic meds for yrs, kept telling them they didn't really work, and they just kept giving them to me. Finally had an EXCELLENT therapist almost immediately realize I have CPTSD. I can't help but feel frustrated and angry that I was misdiagnosed for so long, and took meds I didn't really need that caused a lot of physical health issues😣😖

[lmadden]

I wish you were my therapist 😔.. You're very intelligent. I'm losing hope with Doctors around me.

[caroline]

Now I understand what happened to me during the last summer. I was full of energy... I didn't feel tired even when I walked for hours, and my head was full of ideas and thoughts... then suddenly I had panic attacks. It's kind weird: always I am in my hypomanic episodes, I end up having panic attacks.
Thank you for these videos... I understand better what I feel... I mean, sometimes you give me the words to describe what happens in my head... so then, I can explain it to my psychiatrist

[gail.chaoticautonomic]

I am having a manic episode right now and it's becoming depressive because of my anxiety...this really helped me make sense of that, thank you so much! I also have HEDS, fibromyalgia and chronic fatigue so its all fun and games! 🙃😰💜

[michelleonardo]

One of the best explanations about "mania" that I've ever heard. Super didactic! Thanks for sharing.

[glorfla]

Your videos give me confidence to continue my day. Understanding who and why I am just me. And that's ok.

[violetlove]

Oh my goodness! Everytime ive been asked if i had racing thoughts i said no. When in reality the worries won't shut off!! Thank you for this video because now i understand what they meant by racing thoughts.

[graceross]

You have a gift for explaining the nuances of mental illnesses! I especially love the metaphors you used in this video.

[foreveryactionthereisacons]

I once had a shrink try to commit me because she said I was suicidal.. but wasn't suicidal. I was living in the projects and got bedbugs again, so had to wash, clean, repack everything before I moved to a better apartment building. She also took me off Klonopin in a month. I was on it for 3 yrs. I tried to report her to the State medical board and couldn't find her. She back working in the hospital... God have mercy.

[janeshamcghee]

I am so glad I found your page this morning I could cry ! I thought I was loosing my mind . I’ve been so anxious for the last week I’ve recently stop my antidepressant and I’ve had brain zaps, dizziness can’t sleep ! So anxious and I couldn’t describe it . You’ve helped me more with these videos then my doctors have . You’re amazing ! Thank you so much !

[rachelwethers]

I can totally see why Doctors can frequently struggle with misdiagnosing Bipolar with ADHD+Anxiety, and vice versa, especially for kids and teens.

[stolenrelic]

Thank you for this! I have complex PTSD, ADHD, and panic disorder.

I worried I had bipolar a couple times because there is a family history of it, but there's always a catalyst to feeling depressed or excited or anxious, and the feelings usually only last a day. The exception is anxiety, which sometimes lasts for days on end.

My service dog helps me to ground myself. He notices when I'm spiralling, and gets into my lap so I can put my face into him and close my eyes.

I block out everything and focus on his smell, how his fur feels on my face, how his breathing sounds, etc.

This is one of many things he helps me with. A service dog has changed my life.

I rely on him so heavily that I get scared about the idea that he'll one day not be with me.

It's been worse since my retired service dog passed away in June. She retired gradually when I acquired him, as he was trained to do things like get my meds/interrupt panic attacks/wake me up from nightmares/etc. and it was a smooth transition.

Even though he took over her duties, she was still there. She was still a big part of my life. She still slept in my bed every night, etc. For the last several years of her life, she was on BID medication, and was very old when she died. We both still miss her, and I know that's okay. The memories I have of being with her are good. She lived a very happy life. I realize though that her simply being there still helped me feel safe and I have another problem now.

I'm terrified of something happening to my current service dog. I don't know how to exist without a service dog. There's a base level of anxiety I didn't used to have now about his mortality. He's six years old now.

Sometimes, it gets worse and I just start panicking when I think about how he won't be able to help me, and I can't imagine existing without being nonfunctional without him.

Ironically, he tries to interrupt these anxiety attacks, and does helps calm me down eventually, but the base anxiety seems to always be there now.

Even if I try to think in a purely logical way without the emotions that I love him and every dog is an irreplaceable individual—even then, even if I try and think, "If he gets CHF like she had, we can train another puppy, " I then make myself panic more because I was able to take some time off work to train him and that's might not be a possibility again. It isn't right now.

Do you have any advice about what to do about this?