How can bipolar disorder affect me physically and mentally?

Most people diagnosed with bipolar disorder have already been living and coping with the symptoms long before their diagnosis. In most cases, once their treatment begins, they begin to feel better. However, everyone is different, and the experience of living with bipolar disorder is mixed. Many describe it as both physically and mentally painful, affecting every aspect of their lives. For some, the illness involves recurrent episodes of mania and depression, known as Bipolar I. Others will develop a milder version of mania, known as hypomania, which alternates with the depression, known as Bipolar II. In some, the mood shifts will occur more frequently, with four or more of these episodes within one year, known as Rapid Cycling Bipolar Disorder. Research indicates that the disorder may be more accurately characterised as a spectrum disorder, with many variations. How one person experiences the disorder will not be the same as another.

The mania of bipolar disorder can lead to risk-taking behavior, aggression, and hostility, so it may put one in physical danger. The depressive phase of bipolar disorder can also affect the body. It can lead to problems with sleep and appetite, and even to thoughts of suicide.

A number of medications used to treat bipolar disorder may also have significant effects on the body. For example, they may lead to problems with the thyroid or kidneys, weight gain, or sexual side effects.

John Preston, PsyD

Untreated or inadequately treated bipolar disorder (BD) has been shown to cause significant health risks. Top of the list is vascular disease (leading to heart attacks or strokes). The risk of death from these disorders in BD patients is twice that seen in age matched peers that do not have BD. The main culprit appears to be toxic levels of the hormone cortisol seen during depressive episodes. This is called "hypercortisolemia". Chronic high levels of cortisol scar the interior walls of arteries and play a role in developing atherosclerosis (what used to be called hardening of the arteries). Over a period of many years this can take a significant toll and set the stage for heart attacks and strokes.

Other disorders that are caused by or intensified by BD hormonal changes are: osteoporosis, respiratory diseases and infections. Once again, chronic, high levels of cortisol cause immuno -suppression. This can lead to poor immune responses to infections such as the flu or a cold. But also immuno-suppression is dangerous if a person develops a severe infection such as pneumonia. The rates of death from infections are 3 times the number compared to those who do not have BD.

Hypercortisolemia also has been shown to cause brain damage. This is seen in untreated or inadequately treated BD. It does not affect the brain globally. Rather it selectively damages parts of the frontal lobe (anterior cingulate) and the hippocampus. Both of these brain structures play a crucial role in regulating emotion. With significant and progressive damage, this leads to more severe BD symptoms. Also damage to the hippocampus can result in memory problems. Fortunately some bipolar medications can protect and help to repair some of this damage (especially in the hippocampus). The drugs that do this are: lithium, Tegretol, Depakote, Lamictal, and Seroquel. All of these drugs increase BDNF: a protective protein.

Migraine headaches, obesity, and type II diabetes are also 3 times more common in BD. To complicate matters, 2/3 rds of the drugs used to treat BD can cause significant weight gain that contributes to obesity and type II diabetes.

All of the aforementioned disorders are significantly less common in people who receive adequate treatments for BD. Aside from the enormous personal suffering seen in BD, these health risks are significant. Managed care and HMOs should look closely at these statistics when making decisions about funding treatment for psychiatric disorders!

Jeanne Morrison, PhD
Family Medicine
For reasons we do not understand, people with bipolar disorder are at increased risk for certain illnesses, including thyroid disease, migraine headaches, heart disease, diabetes, obesity, and others. People who have bipolar disorder may also be more likely to abuse drugs and alcohol, possibly because they are attempting to self medicate the condition. Bipolar disorder also seems to occur alongside certain other mental conditions, such as anxiety and post-traumatic stress disorder.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.