obsessive thoughts

Bipolar Obsessive Thoughts

May 31, 2022

Bipolar disorder is diagnosed when a person experiences periods of both mania and depression, each for a few weeks at a time. This cycle continues between manic and depressive episodes, leading to a diagnosis. Bipolar disorder can be difficult to identify because it appears similar to depressive and anxiety disorders. It can also co-occur with obsessive-compulsive disorders, making this a complex diagnosis. When someone has obsessive thoughts as a symptom of bipolar disorder, it could either be the result of a depressive episode or a co-morbid disorder.

What Are Obsessive Thoughts?

If you’ve ever been stressed about an upcoming event or an uncertain situation, you may have found your thoughts fixated on this unintentionally. No matter what you try, your mind tends to go back to the event, and you find it difficult to move on. Obsessive thoughts, or rumination, are similar to this but at a higher level. When a person is ruminating over something, there is an unhealthy obsession with the thought, feeling, or event. 

For example, if you were to walk by a group of people who suddenly stopped talking, you may think it was odd or wonder if their conversation involved you. However, this feeling wouldn’t last long, and you could move forward pretty easily. Someone who has obsessive thoughts would often have a different reaction. They could become paranoid that this group was talking about them and imagine what the group might have been discussing. The obsessive thoughts would then take over and become debilitating, making it difficult to concentrate on anything else. The key difference between concern about a situation and rumination is the interference these thoughts have on your teenager’s ability to focus or complete necessary tasks.

Rumination in Bipolar Disorder

For teens with bipolar disorder, rumination is often a symptom of a depressive episode. During a period of depression, your adolescent may frequently become stuck in a cycle of negative thinking. Negative thoughts can quickly become obsessive and spiral out of control. Fixation on a scenario or emotion can lead to more severe episodes of depression and complicate managing this disorder. This rumination can result in a higher likelihood of suicidal ideation or self-harm without proper intervention. It is rare for obsessive thoughts to occur in a period of mania but not impossible. 

Comorbid Bipolar and Obsessive-Compulsive Disorders

Obsessive-compulsive disorder (OCD) can co-occur with bipolar disorder. There is some debate over whether the two diagnoses are actually co-occurring, or if OCD is a subtype of bipolar. Regardless, treating both disorders can create a challenge for clinicians. While a number of symptoms overlap, periods of mania are usually identified by racing thoughts and an inability to focus. Manic episodes are often severe and can require hospitalization due to the potential dangers associated with decision-making in this state. This complicates treatment and requires skilled mental health professionals to help manage both diagnoses concurrently. 

Help for Teens With Obsessive Bipolar Disorder

If your teen has bipolar disorder with obsessive thoughts, our team at The Forum can help. We offer therapeutic support for mood disorders, OCD, and co-occurring diagnoses. Our services are tailored to meet the needs of your teenager and your family. For severe mental health issues, we offer an intensive outpatient program located in San Diego, California. This treatment option provides consistent care while allowing your teen to continue with school and living at home. We also offer individual therapy, family therapy, and case management to ensure your teen has all the support they need in their recovery. If your adolescent would benefit from targeted support for their mental health issue, contact The Forum at San Diego Brainworks today.


Ghaznavi, S., & Deckersbach, T. (2012). Rumination in bipolar disorder: evidence for an unquiet mind. Biology of mood & anxiety disorders, 2, 2. https://doi.org/10.1186/2045-5380-2-2

Peng, D., & Jiang, K. (2015). Comorbid bipolar disorder and obsessive-compulsive disorder. Shanghai archives of psychiatry, 27(4), 246–248. https://doi.org/10.11919/j.issn.1002-0829.215009