Thursday, October 25, 2007

Bipolar Fibromyalgia?

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?

22 comments:

Freya said...

I don't have FM but I do have osteoarthritis (since I was 12, most likely linked to the Stickler Syndrome in my family). My pain fluctuates according to temperature but I have noticed the last couple years it seems to correlate with my mood swings as well, becoming most painful during my depression. Interesting article, thanks for sharing!

Anonymous said...

I do have FM and to say because it predominantly affects women it is associated with mood disorders. Bipolar is a separate illness and the symptoms of each are NOTHING ALIKE. As a doctor I think you are pretty ordinary if you can't recognise FM from bipolar. It's comments like this that put back the real science and research into FM and CFS conditions.

Anonymous said...

I have Bipolar Disorder, Fibromyalgia, and Chronic Fatigue Syndrome. I have met so many women with ALL of these conditions, in my mind there is NO QUESTION that they are connected in some people!

Anonymous said...

I am unfortunately a 'victim' of bipolar, fibromyalgia, and I'm a Visual Artist to boot. I wonder myself sometimes if there really isn't some sort of correlation there??? I'm also a woman who struggles with all of this daily. I so wish more was understood about all of this =( I wish you all well~Thanks

Anonymous said...

Wow, I am so happy to find this thread. I was diagnosed with fibromyalgia 4 years ago after numerous visits to doctors who told me there was nothing wrong with me "sore muscles, have a magnesium bath and you'll be fine"... yeah it would be great to be able to get out of bed to get to the bath! I have had the craziest moods since as long as I can remember and 4 unexplained psychotic episodes that my childhood Dr. once put down to "She has been eating too much sugar". I am also a psychology student and in light of my studies have realised how similar my mood patterns are to that of Bipolar I disorder. (I once took out a $7000 loan, got a $5000 credit card, quit my job and bought a round the world ticket all in a period of 2 weeks... the trip lasted 2 weeks instead of the 3 months it was supposed to, I spent every cent on the card and the loan, and spent 6 months sleeping off my misery trapped in a ridiculous foreign exchange program that I had enrolled myself in, and had to work for my host family to make my monthly credit card payments).
All of this, and I have only just concluded, after a recent depressive episode, that I may have bipolar disorder. What supprises me is how well I have covered my behaviour from my family and friends for so long.

I knew there was a relationship between Fibro and bipolar, I was even considering making it my thesis topic... can bipolar sufferers be good psychologists? That is my true fear in seeing a Dr. and getting clinically diagnosed :(

Anonymous said...

I am also a closet "Bi-Polar" who has fibromyalgia. Although I am not in fear of occupational conflicts as the reason for not getting diagnosed(responding to the psychology major), I am surely afraid of the medications. Yikes. Your story about being in an exchange student program to pay off the debts made me laugh and giggle. I hope you don't mind, but that was funny stuff! But let me guess...when you tell people the story, they just (instead of seeing the manic episode) see this infinitely interesting individual :) I am only laughing because I could be your twin here. Hugs, anonymous.

Anonymous said...

Hi EVERYONE!! Wow, same here EXACTLY. .21,F.but I am in SOOO much pain all over I cant even sit still to write somthing long. Which..if I could I would ask U all more!! how do U cope with your fatigue? I just started myofacial release tx.I think I may also have bi-polar..I have Fibro & cfs, and more..
Has n e 1 been unable to go to college ,or work b/c the symptoms?

Anonymous said...

Hello to all, I found this thread in a search about possible connections between FM and Bipolar disorder. My mother has been diagnosed with FM for over 10 years. She had so much pain that she was forced to leave her well paying job and after that had been cut off of her health benefits by her health insurance company. Her way of life and our family's had altered dramatically in the years to follow Her changes in medications kept her from being active and she spent a lot of time sleeping the pain away. There was an obvious link to her depression as a secondary symptom to the pain. She is taking antidepressants for these symptoms.
The main reason for my concern is that in the past year she had a few extreme manic episodes to where she was definitely more than just depressed. We had some family problems that might have contributed to her breakdown. She had become delusional and very manic. She was put into three different psych wards within 4 months for this behavior. We did this because we felt helpless and had no other way to ensure her safety without her being watched. She was diagnosed as bipolar from every doctor while in these hospitals. She would seem to get better and be released and then would get worse. She was put on anti psychotics while there and would have to be forced to take them. Before all of this she had been taking many different prescriptions for her pain by her pain specialist, primary physician and her psychologist, including Lyrica alongside Neurontin, Wellbutrin, Morphine, Alprazolam. With these manic, psychotic attacks she was obviously confused and had her meds all out of whack as well. When trying to contact her doctors for help, we were denied by patient confidentiality agreements. They really offered no help beside recommending her being put into a psych ward for observation.

After a few months my mother seemed to get better, without noticeable manic behavior. She began seeing her doctors again and was embarrassed by her behavior. She supposedly tried to investigate why this had happened. Her doctors did not try to investigate into it from what I know and dismissed what had happened. My mother had seemed fine too. Though now her manic symptoms are acting up again, with delusional behavior like talking to herself for hours, hearing God/spirit/alien voices, causing increased irritability and lack of sleep. She is becoming more recluse and is excusing her lack of concentration from feeling to much pain from her FM. I also know that she is trying to hide this from us so that she will not be put back into a hospital.

I am afraid that she will lose control again, she had ran away, harmed herself and had heard voices to kill herself. I have other acquaintances and friends who have loved ones who suffer from bipolar disorder and have the exact same experiences. Some have come very close to killing themselves.

I apologize for this long post, there is so much more I can share. I am just trying to find answers and advice. Thank you and I wish you all well!

Anonymous said...

I have FM, and have suffered from depression most of my life. But i am confused because i have server moods, i could feel stable one minute then i am triggered by what poeple say or a situation. I dont have intense manic episodes (shopping sprees, bright colours, ect.)But i do at times when im excited or irritated talk fast, move from one topic to another and get fustrated when others try to talk. So its more then depression, but good my moods just be from my FM or could i have a mental disorder? I am so confused and i dont want to be put on a mood stabilizer if i dont have a mental illness. Does anyone have any ideas or suggestion? thanks

Don said...

I think that the reason that more women than men are diagnosed with Fibro is that more women will admit that they have a problem.

I have suffered Fibro for over 25 years, along with osteoarthritis. I have been told to do everything from take time off to "join the Merchant Marines" (my personal favorite....)

No one wanted to believe that I could possibly hurt day and night, when I am asleep, when I rest, when I work hard. It had to be just in my head.

Well, that is possibly true, but the depression and the pain are insurmountable, and the things that do work require continuous weekly and expensive treatment (try brain based therapy, it worked for me while I could afford it).

So, I am just left here in Limbo; at least I no longer have hope. That would really be a drag if you felt there was hope someday that you could feel better.

Anonymous said...

I have had FM for 9 years now. I say my mood is driven by my pain. Not my pain driven by my mood. When I am drained and hurt - I am depressed. And when I feel good - I am in a good mood.

When will people and doctors start understanding that we do not choose this.

Michelle said...

Believe me or not - I asked a psychic WHAT THE HELL WAS WRONG WITH ME!?
I'd been diagnosed with Fibro - then a pain specialist said he believed Fibro was diagnosed a lot of the time by 'lazy physicians' who didn't want to look for alternative causes of pain. So after a full body scan we found arthritis & degenerative discs in my neck and degenerative and bulging discs in my lower back, blood tests etc - diagnosis - degenerative fascia disease complicated with STRESS in the big capitals for emphasis not yelling. But - and here's the but - I still believe I have fibro - but not in the extreme forms some of my fellow sufferers have. I take diazapam when I'm feeling......well, not normal....my dr prescribed first Kalma after what I would call a psycosis moment caused by an antidepressant I was on to try and control the pain, which ultimately brought back all my anxieties and panic attacks at the worst possible times. As a mum of 4 young boys and being 40 - with hormones raging up and down I thought I was going barmy. I'm talking yelling constantly, doing things like spending money on online games almost daily - not once in a while which was normal. So I consulted a psychic. He said to look at the connection of bi-polar and fibro. HE stressed he was not a doctor...and not qualified to make a diagnosis. He suggested I suffer a mood disorder - depression ( which if you have fibro and the sleep issues that go with it, stress, lack of support etc etc you are going to be depressed). To Quote "You are suffering from a mood disorder, possibly depression, but most likely Bipolar Disorder. I am being shown that there is a physiological link between the degenerative muscle / joint conditions that you akready have and Bipolar disorder.

I also see that Bipolar is very common among people who have the degenerative muscle / joint (?) diseases that you have, but that they are often misdiagnosed or the symptoms of one condition is confused for the other. I am also being shown that this is an unexplored field in medicine, that the doctors don't really understand this connection yet, but I also sense that there has been some recent research about this connection or link between the two types of disorders, and that more doctors are becoming aware of this phenomenon."

I did look the info up - and sure enough - i have symptoms of bi-polar but MILD symptoms. I haven't had a high in a while LOL. I also think I might suffer SAD as well - not sure about that one. But interestingly enough, my GP asked if there was a history of bi-polar in my family, and apparently there is. My sister was diagnosed with it - then undiagnosed with it (go figure) probably due to her pineal gland being weird.

From the sites I've looked at - I will make an appt with my GP and ask her to look at googling the connection. I also think I need stronger diazapam or similar because the low dose i'm on doesn't "last" long. I snap like a twig once it's worn off. Antidepressants have been MAKING me suffer depression. I am depressed because of all of the hoohaa I have to go through for pain killers, lack of relaxation, pain, and anything else you can think of. My pain psych - wonderful person - did a test on me and yes - I have high depression score, but my anxiety and stress scores were way much higher indicating it's the anxiety and stress being an underlying cause of the depression.

If Bi-polar is the answer - I'm already on a drug used to treat it, but I need it in stronger doses. I want my life back and I want to be able to enjoy my children and life.

Michelle said...

Believe me or not - I asked a psychic WHAT THE HELL WAS WRONG WITH ME!?
I'd been diagnosed with Fibro - then a pain specialist said he believed Fibro was diagnosed a lot of the time by 'lazy physicians' who didn't want to look for alternative causes of pain. So after a full body scan we found arthritis & degenerative discs in my neck and degenerative and bulging discs in my lower back, blood tests etc - diagnosis - degenerative fascia disease complicated with STRESS in the big capitals for emphasis not yelling. But - and here's the but - I still believe I have fibro - but not in the extreme forms some of my fellow sufferers have. I take diazapam when I'm feeling......well, not normal....my dr prescribed first Kalma after what I would call a psycosis moment caused by an antidepressant I was on to try and control the pain, which ultimately brought back all my anxieties and panic attacks at the worst possible times. As a mum of 4 young boys and being 40 - with hormones raging up and down I thought I was going barmy. I'm talking yelling constantly, doing things like spending money on online games almost daily - not once in a while which was normal. So I consulted a psychic. He said to look at the connection of bi-polar and fibro. HE stressed he was not a doctor...and not qualified to make a diagnosis. He suggested I suffer a mood disorder - depression ( which if you have fibro and the sleep issues that go with it, stress, lack of support etc etc you are going to be depressed). To Quote "You are suffering from a mood disorder, possibly depression, but most likely Bipolar Disorder. I am being shown that there is a physiological link between the degenerative muscle / joint conditions that you akready have and Bipolar disorder.

Michelle said...

too continue because the last was too long....

I also see that Bipolar is very common among people who have the degenerative muscle / joint (?) diseases that you have, but that they are often misdiagnosed or the symptoms of one condition is confused for the other. I am also being shown that this is an unexplored field in medicine, that the doctors don't really understand this connection yet, but I also sense that there has been some recent research about this connection or link between the two types of disorders, and that more doctors are becoming aware of this phenomenon."

I did look the info up - and sure enough - i have symptoms of bi-polar but MILD symptoms. I haven't had a high in a while LOL. I also think I might suffer SAD as well - not sure about that one. But interestingly enough, my GP asked if there was a history of bi-polar in my family, and apparently there is. My sister was diagnosed with it - then undiagnosed with it (go figure) probably due to her pineal gland being weird.

From the sites I've looked at - I will make an appt with my GP and ask her to look at googling the connection. I also think I need stronger diazapam or similar because the low dose i'm on doesn't "last" long. I snap like a twig once it's worn off. Antidepressants have been MAKING me suffer depression. I am depressed because of all of the hoohaa I have to go through for pain killers, lack of relaxation, pain, and anything else you can think of. My pain psych - wonderful person - did a test on me and yes - I have high depression score, but my anxiety and stress scores were way much higher indicating it's the anxiety and stress being an underlying cause of the depression.

If Bi-polar is the answer - I'm already on a drug used to treat it, but I need it in stronger doses. I want my life back and I want to be able to enjoy my children and life.

Tuesday said...

I have Fibromyalgia and Type II rapid cycling bipolar disorder, as well as spinal arthritis, thyroid disease, PCOS, uterine fibroids, hypertension, and anxiety disorder.

I have written to Dr. Phelps and feel he is unique in his understanding of the entire nature of this disastrous disease; I am monster hear me roar. Mental anguish along with the most wall climbing earth shattering pain- who made up this fun combo- and why do I not see RACE FOR THE CURE campaigns for us? I am a mother, a wife, an artist, an inventor a Christian and I have no cancer diagnosis to help ANYONE in the universe around me understand why or what dying in sometimes very slow motion feels like and other times appearing to be a ok while all the while never free of the physical pain that would force a "normal" person to go section eight.

It is insulting to see Lyrica commercials depict this monster FM as a mild achy day and if you take this pill you can knead your bread again or draw your pretty designs. When the FM flare ups dig in from moderately severe to straight severe; nothing but a bi polar disorder could ever swing us out so praise GOD for the gift of the fine madness-

Give me something real medicine of 2011, mention the fevers from sheer pain and the swollen lymph nodes present during acute flares. Show me a vaccine I can protect my child with from EVER having to endure how I live.

It is a miracle people I interact with in my daily life have no idea how greatly I suffer; and then again- do any of us who Jesus suffered on behalf of really know how greatly HE suffered? Medicine can't explain that connection either that a Christian can be so loved by God, and share in great suffering while demanding to be healed! Amen.

No one knows the shame that goes along with this kind of suffering. As we eat our pills and ration them out for the day, or as we sit on the heating pad because we hope in an hour or so we can be useful with all our gifts we are greatly discouraged to find.... this monster beats all medicine, gobbles it up in a matter of time and spits it out leaving us more hopeless than the last time we felt victory.

So in my fast thinking brain which is all I have right now ( I am currently hiding out in my house due to the severe pain) I can't help but wonder what the hell kind of super germ is this?

MRSA eats up antibiotics, spits them out and says, "Next." So, what is living in us, a biologically hazardous force that no one seems to be able to balance, or have people looked past something very basic?

Oh, and I am not a doctor; directed to the doctor who left a comment that couldn't have been more patronizing which you guys tend to do (no we are not MD's but by God we are your equals if not superiors), but nothing has ever made more sense than having both- I live it, I have it- they feed off one another for your life until one burns out hopefully if you are in that lucky group and until then like Depeche Mode sings," Just hang on, and suffer well, sometimes it's hard; so hard to tell."

Anonymous said...

i also am diagnosed with bipolar (on the high side of mania) have severe back issues and was diagnosed with fm. over many years of this drug and that, and way to many personal crisis issues to discuss, i have came to a few conclusions that many have been confirmed by a wonderful new doctor i am seeing. most of all ,i cannot take any drug that interacts with the serotonin levels in my brain, within no time at all i am bonkers, just plain crazy can not calm down shaking and blood pressure rockets. i do believe that bipolar and fm can be interactive, along with the cfs i feel personally that the major things are one increases the others. stress from all things makes them all worse. i also have depression symptoms of only tiredness and more apt to cry. other than that i never feel what most people describe as being depressed. have been prone to addictive nature, ( which thank God with age and more understanding i recognize and believe i keep that pretty much under control. i hope this helps someone out there because what i have been reading here has helped me. but i dont agree with the doctor that wants to separate them into individual diseases.. 30 years of going to a bunch of doctors that will just not listen to you. i hope everyone out there can find a good doctor that will take the time to see who you are as an individual. God bless

Anonymous said...

another comment...please bear with me its short...thank you Tuesday!! your comment has gave me a name and it is MONSTER. no better words have i read than yours. thanks

Anonymous said...

I've been having one intense of a year. Uncontrollable ups and downs, constant self inflicted life changes, and recently excruciating pain in my knees.

I recently visited my GP about the knee pain because it is getting more intense and "spreading." After blood work, I received a call saying "You have antibodies in your blood but it's nothing to worry about." That was it. No follow up appt, no referral, not even advice.
HELLO? I'm still in pain here!!

I then went to see my obgyn thinking maybe it's hormonal (I've had irregular periods my whole adult life) and she looked over the test results and said the same thing. However, she referred me to a rheumatologist.

This is where I am now. I can't handle the expensive doctor bills, especially with the toll this is taking on my work life. I am only able to work part time or less because I get terrible migraines. (I work on computers)

I desperately want my life back. I've gained 25 lbs in the past 3 months because I haven't been able to walk. My new husband is miserable because the woman he married 2 years ago is no where to be found. I used to rock climb, hike, MOVE. Now I'm lucky if I can walk into the kitchen for a drink.

When are doctors going to start caring about the patients they have rather than the quantity?!

Stoph said...

I have C-PTSD and possibly Bipolar II. I hurt CONSTANTLY for 14 years now and it gets worse and worse every year.

For 14 years I have been telling doctors I hurt, and for 14 years I've been dismissed. I'm 28.

Very hard not to start a drug habit when Percocet alleviates both the unrelenting pain as well as the psychological issues. I've been strong enough to resist for a very, very long time.
Bah.

There's a link between FM and childhood abuse. There's also a link between Bipolar Disorder and childhood abuse... I wonder how many on this reply thread have been harmed or otherwise have PTSD?

The status quo is that the brain is completely separate from the rest of the body. As if the same nerves and blood vessels and chemicals that run throughout the entire body suddenly STOP when it gets to the brain. It's an organ like anything else! Just because it holds our consciousness does not mean it can't have real organic problems!!!

I hurt in so many ways. It's just not fair.

I will never have children. This scourge absolutely will not get passed down to any innocent children (and future adults!) by me.

Gregsed56 said...

I too suffer from both bipolar & fibromyalgia...the onset of my fibromyalgia symptoms started at the same time I was going through a bad Seroquel withdrawal...I would absolutely SWEAR that getting off or being on Seroquel caused the fibromyalgia...of course my psyche Dr. just laughs me off...it was too coincidental to me...any thoughts? anyone else agree?

Mally Ally said...

Omygosh! I think you may be my twin!! No joke. Except you seem more proactive! Would love to be more like that. Your comment, in its entirety, are my everyday thoughts. Would love to hear more. I know this post is old but I'm bookmarking regardless.

Andrea said...

I'm SOOOO happy I came across this. So many of your stories are "me". I'm diagnosed with fm and bioolar 2. I'm tired of being tired and in pain I just want my life back. Nobody in my family or friends has a clue how bad things really are. Nobody understands :(. Does anyone know if there are any books that touch on fibro and bipolar? That was what I had started searching for. Thank you ALL for your stories I'm glad to know I'm not alone.