Bipolar disorder affects more than moods. It is now considered a multi-system condition with serious impact on the immune system.
Co-morbidities, or conditions that frequently appear in people with BP, have long been known to include cardiovascular disease, diabetes, obesity and poor response to pharmacological interventions
The frontier of bipolar research, however, is the extremely high co-occurrence of auto-immune diseases in people with BP. Some researchers even surmise that BP itself is an autoimmune disorder.
Patients with Guillain-Barre syndrome, Chron’s disease and auto-immune hepatitis have significantly higher rates of BP than the general population. Those with lupus are 6 times more likely to have BP, and people with MS are 30 times more likely to suffer from BP.
Thyroiditis plays a role in BP for many patients, and it is strongly heritable. The offspring of those with thyroiditis and BP often inherit both conditions.
The old model of diagnosing and treating BP as a psychiatric condition only, responsive to mood-stabilizers and psychotherapy, may be hopelessly out of date. The connections between BP and physical diseases, especially auto-immune disease, is too great to ignore.
Immunologists, neurologists and other medical specialists should be consulted in every new case of BP, and in every existing and long-term case.
Studies show that the addition of anti-inflammatory treatment to mood-stabilizers can significantly reduce the length and severity of depressive episodes. Research is ongoing on these therapies’ impact on mania and mixed states.
Researchers are investigating how an anti-inflammatory as simple as aspirin may positively impact those with BP.
The most significant physical factor that BP and auto-immune disorders have in common is the body’s reaction to stress. Severe stress often precipitates changes in mood and leads to increases in biochemical contributors to inflammation.
Stress management should be considered a primary, font line therapy for both BP and auto-immune disorders.
As science discovers more about the causes and co-morbidities of BP, psychiatry must keep up. More effort should be put into mind body medicine, treatments must expand to include immunology, and health insurance should adapt to cover physical therapies as well as more traditional psych meds and visits when diagnosis codes for BP are added to a patient’s records.