5 Physical Disorders and Bipolar 1: Risk of Migraine, Thyroid Issues, and More | MyDepressionTeam

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5 Physical Disorders and Bipolar 1: Risk of Migraine, Thyroid Issues, and More

Medically reviewed by Ifeanyi Nwaka, M.D.
Posted on May 31, 2023

Bipolar 1 disorder is a mood disorder characterized by rotating periods of elevated mood — manic episodes — followed by episodes of depression. Treating bipolar disorder involves a thoughtful combination of medications combined with psychotherapy (talk therapy).

While addressing the psychiatric symptoms of bipolar 1 disorder is an essential component of mental health management, physical health shouldn’t be neglected. People with bipolar disorder are at increased risk for certain physical conditions that require attention from a health care provider.

Commonly used medications in the treatment of bipolar disorder include mood stabilizers such as lithium, antidepressants, and antipsychotics. Side effects of these medications — as well as family history — can be risk factors for some bipolar disorder comorbidities (when the same person has multiple health conditions).

Furthermore, there can be an overlap in symptoms of bipolar disorder and other health conditions, which may make it hard to tell them apart. If you’re experiencing symptoms of any of the following medical conditions, you’re not alone. Here are five physical comorbidities to look out for that are commonly associated with bipolar disorder.

1. Migraine

Up to 40 percent of people with bipolar disorder also experience migraine. The most well-known symptom of migraine is headaches, but there are many more to look out for. Symptoms of migraine can also include:

  • Visual disturbances such as an “aura” (seeing light streaks or flashes)
  • Sensitivity to noise or light
  • Nausea or vomiting
  • Pain on one or both sides of the face
  • Dizziness

While there are at least 10 types of migraine, the major categories are:

  • Migraine with aura, in which visual disturbances appear before a headache
  • Migraine without an aura, with headaches that primarily affect one side of the face

All types of migraine have the potential to be debilitating and profoundly impact one’s quality of life.

You can work with your doctor to create a migraine treatment plan. Part of this is learning what triggers your migraine attacks — such as stress or loud noises — and avoiding them. You may also have medication to treat your migraine during an episode or a preventive medication you take daily.

Some medications, such as anticonvulsants, can be used to treat both migraine and bipolar disorder. Diagnosis of both conditions is necessary to establish a proper treatment regimen, so let your doctor know if you think you’re experiencing migraine headaches.

2. Underactive Thyroid

An underactive thyroid — also known as hypothyroidism — is a disorder in which the thyroid gland can’t make enough thyroid hormones to meet the body’s needs. Studies show as many as 12 percent of people with bipolar disorder may also have thyroid disorders. Only around 5 percent of people in the general U.S. population have hypothyroidism. This means that hypothyroidism is more prevalent for people with bipolar disorder than for those without it.

It’s important to note that decreased thyroid activity can be triggered by taking the mood stabilizer lithium, so be sure to discuss possible symptoms with your psychiatrist as well as your primary care physician.

The symptoms of an underactive thyroid are:

  • Tiredness
  • Lack of energy
  • Decreased heart rate
  • Weight gain
  • Dry skin
  • Intolerance to cold
  • Hair loss

Notably, tiredness and lack of energy from hypothyroidism can mimic the depressive symptoms of bipolar disorder.

Hypothyroidism can be diagnosed by a health care provider. To receive a diagnosis, you’ll receive a blood test to check your levels of certain hormones. The test will check for hormones produced by the thyroid and hormones that stimulate the thyroid. Synthetic thyroid hormone is an approved and effective treatment for underactive thyroid. It’s important to note, however, that overstimulating the thyroid during episodes of mania can worsen symptoms.

3. Diabetes

People with bipolar disorder are more likely to have type 2 diabetes than the general population. Individuals with both conditions tend to have a harder time controlling both their bipolar disorder and diabetes than if they were only managing one of these conditions.

Diabetes is a condition where the body doesn’t produce enough of a hormone called insulin, and some cells don’t respond strongly enough to the insulin that’s there (insulin resistance). Cells need insulin to process sugars because that’s their major fuel source. Because every cell in the body needs sugar to function, insulin resistance can be very dangerous and should be taken seriously.

The major symptoms of diabetes include:

  • Frequent hunger and thirst
  • Sudden weight loss
  • Tiredness
  • Increased urination
  • Numbness and tingling in the hands and feet
  • Blurry vision
  • Sores that won’t heal

Weight gain and weight loss can be symptoms of bipolar disorder as well, so keep that in mind when identifying symptoms.

There are many treatment options for diabetes. These include certain medications as well as lifestyle changes such as increasing exercise and nutritious eating. People who have both diabetes and bipolar disorder are more likely to have health complications from diabetes. It’s best to see your health care provider regularly. They may order blood tests to check for early signs of diabetes, or they may help you come up with a treatment plan to better manage your blood sugar levels.

4. Cardiovascular Disease and High Blood Pressure

High blood pressure — known as hypertension — can cause cardiovascular (heart) disease. As many as 20 percent of people with bipolar disorder have high blood pressure, and up to 10 percent of people with bipolar disorder have cardiovascular disease.

Both antidepressants and antipsychotic medications, which are commonly prescribed for bipolar disorder, are associated with side effects like weight gain, insulin resistance, and high blood pressure. Most people with high blood pressure don’t notice any symptoms, but it’s easy to have it checked at your doctor’s office.

Having high blood pressure can increase your risk of heart attack and stroke. People with bipolar disorder have an increased risk for health problems and even death caused by cardiovascular disease. Because of these risks, it’s important to manage this condition with your health care providers in both psychiatry and primary care. There are medications and lifestyle changes to improve heart health.

5. Asthma

People with bipolar disorder are also at increased risk of having asthma. Asthma is a medical condition where the airways in the lungs become inflamed and narrowed. This limits the amount of air that reaches the lungs. The major symptoms of asthma are wheezing, shortness of breath, tightness or pain in the chest, and coughing.

Environmental triggers, such as pollen and dust, can worsen symptoms. Additionally, symptoms of asthma can interrupt sleep and day-to-day life. While there’s currently no cure for this condition, treatment options are available that can alleviate symptoms. Be sure to tell any clinician about your bipolar diagnosis before being prescribed any asthma medication. Steroids can be used in the treatment of asthma, but they can also worsen a manic episode.

Speak With Your Doctor

While the medical conditions we’ve covered here are common in the bipolar disorder community, they’re not the only physical illnesses you may experience. Other conditions to keep an eye out for are:

  • Forms of arthritis
  • Epilepsy
  • High cholesterol

Likewise, many other psychiatric disorders are common with bipolar disorder. These include:

These mental illnesses can also have major physical symptoms associated with them, such as heart palpitations, liver failure, and decreased responsiveness to certain medications.

If you think you’re experiencing any physical health issues, discuss any symptoms you’re having with your health care provider. Managing or preventing the comorbid conditions discussed in this article will give you a better chance of feeling better and living longer. Make sure each doctor you see knows about all of your diagnoses to guarantee yourself the best support.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression and related conditions and their loved ones. On MyDepressionTeam, more than 13,000 members diagnosed with bipolar disorder come together to ask questions, give advice, and share their stories with others who understand life with depression and bipolar disorder.

Are you living with bipolar 1 disorder and another health condition? How do you manage your symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. Psychiatric and Medical Comorbidities of Bipolar Disorder — Psychosomatic Medicine
  2. Migraine — National Institute of Neurological Disorders and Stroke
  3. Comorbid Bipolar Disorder and Migraine: From Mechanisms to Treatment — Frontiers in Psychiatry
  4. Hypothyroidism (Underactive Thyroid) — National Institute of Diabetes and Digestive and Kidney Diseases
  5. Comorbid Medical Illness in Bipolar Disorder — The British Journal of Psychiatry
  6. Thyroid Functions and Bipolar Affective Disorder — Journal of Thyroid Research
  7. What Is Diabetes? — National Institute of Diabetes and Digestive and Kidney Diseases
  8. Interactive Relationships of Type 2 Diabetes and Bipolar Disorder With Cognition: Evidence of Putative Premature Cognitive Ageing In the UK Biobank Cohort — Neuropsychopharmacology
  9. The Relationship Between Bipolar Disorder and Type 2 Diabetes: More Than Just Co-Morbid Disorders — Annals of Medicine
  10. Symptoms & Causes of Diabetes — National Institute of Diabetes and Digestive and Kidney Diseases
  11. Chronic Somatic Comorbidity and Excess Mortality Due to Natural Causes in Persons With Schizophrenia or Bipolar Affective Disorder — PLOS One
  12. Cardiovascular Disease and Hypertension Among Adults With Bipolar I Disorder in the United States — Bipolar Disorders
  13. Cardiometabolic Effects of Psychotropic Medications — Hormone Molecular Biology and Clinical Investigation
  14. About High Blood Pressure — Centers for Disease Control and Prevention
  15. Changes You Can Make To Manage High Blood Pressure — American Heart Association
  16. Multimorbidity in Bipolar Disorder and Undertreatment of Cardiovascular Disease: A Cross Sectional Study — BMC Medicine
  17. What Is Asthma? — National Heart, Lung, and Blood Institute
  18. Asthma Symptoms — National Heart, Lung, and Blood Institute
  19. Significantly Higher Prevalence Rate of Asthma and Bipolar Disorder Co-Morbidity — Medicine
    Posted on May 31, 2023
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    Ifeanyi Nwaka, M.D. earned his medical degree from the American University of Antigua College of Medicine. Learn more about him here.
    Hannah Actor-Engel, Ph.D. is a multidisciplinary neuroscientist who is passionate about scientific communication and improving global health through biomedical research. Learn more about her here.

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