The Links Between Bipolar Disorder and Fibromyalgia

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On the surface, fibromyalgia and bipolar disorders aren’t very similar diseases. Fibromyalgia is a physical illness that causes joint and muscle aches, and fatigue, as well as depression for up to 90% of patients. Bipolar disorder is a mental illness with symptoms of extreme ups and downs, known respectively as mania and depression.

Fibromyalgia and bipolar disorder appear to be linked in several different ways. Up to 25% of patients with fibromyalgia show bipolar symptoms, and the two diseases share many characteristics.

A new study out of the Federal University of Ceará in Brazil examined the shared pathophysiology–how the diseases work in the body–of fibromyalgia and bipolar disorder. The researchers found that there were “remarkable” similarities between the two sicknesses.

In the study, the scientists discovered that the brains of people with either disease are very, very similar. While the causes of bipolar disorder are numerous–ranging from environmental to genetic–and the causes of fibromyalgia aren’t known, the researchers found that both bipolar disorder and fibromyalgia shared brain structures that might contribute to the cause of other illnesses.

The study also found that both bipolar disorder and fibromyalgia are characterized by “functional abnormalities in the hypothalamic-pituitary-adrenal axis.” This means that patients of both illnesses suffer from difficulties managing their hypothalamus, pituitary gland, and adrenal glands. These abnormalities can cause depressive symptoms, as well as other symptoms like cold intolerance.

Both fibromyalgia and bipolar disorder are associated with increased markers of inflammation in the blood and the brain. This causes a dysfunction in the cells of your nervous system, hormonal abnormalities, and leads to changes in your brain’s ability to regulate moods. Higher levels of inflammation also contributes to sleep disturbances.

Bipolar disorder and fibromyalgia patients both suffer from mitochondrial dysfunction. The mitochondrion, an organelle found in every cell in the human body–except red blood cells–that produces the power needed for growth and cell division, is also affected in both disorders. Because mitochondria perform so many different functions in different tissues, there are literally hundreds of different mitochondrial diseases. Dysfunction in them–found in bipolar disorder and fibromyalgia–can cause fatigue, among other abnormalities.

In addition, patients with either bipolar disorder or fibromyalgia have difficulties producing serotonin and melatonin, feel-good chemicals which help with sleep and the ability to handle pain. Bipolar disorder and fibromyalgia are also both associated with impaired neuroplasticity, which is the brain’s ability to handle new information and adapt to circumstances.

Fibromyalgia and bipolar disorder share a number of characteristics–mostly negative ones for the people who have to endure either disease. The researchers of the study urge that future studies explore these similarities, in the hopes that both sicknesses can be treated with targeted medications.

This all means that if you have bipolar disorder, you share characteristics with fibromyalgia patients–enough so that you might want to get checked out for the latter disorder. Similarly, if you have fibromyalgia, you may want to talk to your doctor about bipolar disorder. Medications which treat fibromyalgia have been found to trigger mania in bipolar patients, which means that you need to be cautious in taking medications to treat the former disease.


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