According to psychiatrist, Dr. Jim Phelps of PsychEducation.com, there may be an important but unexplored connection between bipolar disorder and fibromyalgia. Having been diagnosed with both, I'm aware of the overlapping symptoms, so a possible connection doesn't come as a big surprise. Nor should I be surprised that more research hasn't been done on this, particularly given that for years, fibromyalgia wasn't even recognized as a "real" disorder. Since fibromyalgia affects women to a much higher degree, it's one of many ailments that has long been considered a figment of our weak and easily excitable minds.
In his recent article, Fibromyalgia and Bipolar Disorder, Dr. Phelps, patients with fibromyalgia are twice as likely to have major depression as are patients with rheumatoid arthritis. Even more startling is the finding that patients with fibromyalgia are 153 times more likely than those with rheumatoid arthritis to have bipolar disorder!
In response to a post at BipolarWorld.net asking about the connection, Dr. Phelps replied that:
I've never seen a word in the literature about this, but I've sure seen it in practice -- over and over. So, to answer their question: yes, I see the two show up together. In fact, in virtually all the "fibromyalgia" patients I've seen, there is mood stuff too. Of course, I wouldn't be likely to see FM patients who had no mood symptoms at all! But my rheumatologist friend says he sees the overlap too. But the important point to me is that the mood symptoms are much more likely, in my view, to have "bipolar" characteristics (as opposed to unipolar): profound sleep disturbance, cyclic recurrence, irritability and decreased concentration even when little "depression" is present. Perhaps most salient: the FM symptoms seem to directly cycle with sleep, almost as though in these women -- as they are nearly all women -- the pain symptoms are just another "bipolar" symptom. i.e. the pain *cycles* along with the rest of what we might typically regard as mood symptoms. Think about it: what if "chronic fatigue syndrome", which also co-occurs with FM and bipolar, was in some people just the depressed phase of "bipolar", with it's characteristic profound lethargy and fatigue, without obvious depression? As most patients know, the "mood dial" and the "energy dial" don't always turn the same way at the same time; they're relatively independent, at least in some people. Finally, why is that there is such a predominance of women with FM? This is an obvious and crucial question. I used to think it was because sexual abuse is so unfortunately common in women. But I've seen women with no such history, nor any clear reason to suspect some "repressed memory" either. I'm working on a "hormones and mood" website where I'll try to present current research that relates to this topic.
This is fascinating. Any thoughts on this?