A question for @not moses @wave and anyone else

Can severe anxiety mask bipolar ? I ask because since being on risperdal my anxiety seems to have increased/become more persistent and if my mood goes beyond level it is to mildly/moderately depressed
I hardly ever go out .

Prior to this while not exactly " manic" I felt a lot more positive and would go out with my Ipod loudly singing to myself round the high street,shops etc without a thought to other people’s reactions. I would also have days when I would be up all night blasting music out at full volume.
I also had a greater sense of humour whereas now it is like I have had a humour by pass.

Recently the urge to send silly rhyming responses to posts( some that might be considered offensive/unsupportive) has surfaced which reminds me of the mischievous streak I had in hospital many years ago.

For years I had a schizoaffective mixed type diagnosis with an occasional pdoc mentioning bipolar. Was on lithium from 1982-2002 and tegretol from 2002 -2005.
The period from 1983 to 2002 was perhaps my best period although I still had problems. Whether this coincided with lithium( levels were often quite low) or the fact my wife was reasonably well, very supportive and the primary decision maker/organiser is a matter of debate. I do know that I had less to worry about.

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Anxiety disorders, including GAD, Panic Disorder, OCD are common with Bipolar Disorder.

What do you mean by Mask - Hide?

Mood symptoms and Anxiety can co exist.
But when my moods are more stable it seems that my Anxiety or OCD is more pronounced - sticks out more.

I am on Risperdal and it has been very good at stabilizing moods - I am not on a mood stabilizer at the moment.
Mood symptoms can Mask Anxiety and Anxiety can Mask Mood symptoms - I do think it’s possible

Yes. I definitely had more “up” moods when my general anxiety was less.

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You have either schizoaffective or just bipolar with comorbid paranoid personality disorder and maybe also schizoid or something, that or bipolar with psychotic features, bottom line I think you need an antipsychotic and lithium like whoa

dude you totally have a mood disorder

as for anxiety, most people these days seem to have it, period.

When I was taken off meds (mood stabiliser and anti psychotic) and the question of going back on meds arose my pdoc was reluctant to prescribe an antidepressant because of the possible adverse effect on my moods (sign that they still saw a mood element to my illness despite having removed the schizoaffective dx or hedging their bets?) and put me on an atypical antipsychotic. I think that class of drugs is often seen as having a broad spectrum effect ie( anti depressant and mood stabilising properties as well as antipsychotic) and my psychiatric history points to depressive/mood and psychotic symptoms( as well as anxiety, impulsiveness) during the course of my illness.

It’s usually the other way around. Anxiety, however, can be the upshot of running the sympathetic branch of the ANS for so long that the parasympathetic branch can no longer “bring us back down.”

Whenever I see anxiety with bipolar, I start assessing for PTSD. In this case I would look for the autonomic imbalances associated with PTSD induced by the considerable challenges of having had sz for decades coupled with whatever cognitive distortions were preponderant.

Are you in “fight or flight” a great deal? If so, anxiety should be expected.

Now, if the risperidone isn’t getting that anxiety handled, you might discuss some PRN use of Ativan or (probably better) Klonopin on top of it, or, probably better yet, a switch to something a little more sedating among the anti-Ps, but less “stressful” than Ris. Like Seroquel quetiapine, maybe. Or Zyprexa olanzepine. Maybe even de-titrate the Ris a little and add Seroquel. There are a lot possibilities you could discuss with your prescriber.

I would also try some DBT, ACT and/or MBSR to see if you can get a conscious handle on the anxiety without having to add more exogenous chemicals to the mix.