Bipolar And Related Disorder Due To Another Medical Condition

Bipolar and related disorder due to a medical condition is a mood disorder that is listed under the “Bipolar and Related Disorders” section of the Diagnostic and Statistical Manual of Mental Disorders. People with this mental health condition may have symptoms of both bipolar disorder and the medical condition causing it. Because of this unique variable, symptoms of bipolar disorders due to another medical condition can vary significantly from person to person. 

Symptoms of bipolar disorder

People with this form of bipolar disorder may experience symptoms of mania or hypomania, including: 

• Intense euphoria,¹ happiness, or excitement
• Jumpiness or a sense of “being wired” 
• Experiencing a decreased desire to sleep
• Excessive energy
• Unusual talkativeness 
• Increased agitation or irritability
• Impulsive behavior, often in detrimental ways 
• Uncharacteristically risky behavior 

According to the Diagnostic and Statistical Manual of Mental Disorders, these symptoms must not be better explained by or attributable to another mental health condition. The difference between mania and hypomania is that mania occurs for at least one week and can also include symptoms like psychosis,2 paranoia, and extreme delusions. 

In some cases, symptoms of a comorbid mental health or developmental disorder can arise alongside those of bipolar disorder and its underlying medical condition. Anxiety disorders and substance use disorder commonly co-occur with bipolar disorder. These are also mental disorders included in the DSM-V as well. Attention-deficit/hyperactivity disorder is another potential comorbidity. In fact, it is estimated that one in six individuals with bipolar disorder also live with attention-deficit/hyperactivity disorder. 

Cushing’s syndrome or Cushing's disease, which can cause symptoms of bipolar disorder, occurs when the body makes too much cortisol. Cortisol helps your body respond to stress, maintain blood pressure, control blood sugar, and reduce inflammation. 

People with bipolar disorder brought on by Cushing’s syndrome may experience the following symptoms: 

• A round face
• Weight gain
• Thin legs and arms
• Easy bruising
• Weak muscles
• Fat deposits around the base of the neck
• A fatty hump between the shoulders
• Purplish stretch marks on the abdomen, hips, breasts, or under the arms

Some recent studies show that there may be a link between bipolar disorder and MS, a disabling neurological disease caused by the immune system attacking the defensive myelin sheath coating the nerve fibers in the central nervous system. MS affects people differently and can be challenging to predict, but symptoms may include:

• Blurred or double vision
• Eye pain with movement
• Weakness in the hands and legs
• Tingling or numbness in the legs, arms, face, or trunk
• Muscle stiffness
• Muscle spasms
• Bladder control issues
• Dizziness
• Physical or mental fatigue
• Mood changes
• Problems with concentration, memory, or judgment

MS can be diagnosed with a spinal tap and spinal imagery in many cases. Consult your doctor if you are experiencing symptoms. 

Traumatic brain injuries are included as potential causes of bipolar and related disorder due to another medical condition in the Diagnostic and Statistical Manual of Mental Disorders. However, research shows that bipolar disorder is a rare complication after TBI. Getting an accurate diagnosis of bipolar disorder linked to another condition like TBI may be challenging, as many symptoms of bipolar disorder overlap with symptoms following a TBI. These symptoms may include: 

• Sleep disturbances
• Cognitive deficits
• Behavioral symptoms

People with TBIs with symptoms of bipolar disorder may also experience irritability, impulsivity, and aggression.

There is limited research on bipolar or related disorder due to another medical condition. How the medical condition causes symptoms of bipolar disorder can vary depending on how the underlying condition affects the body. For example, the following symptoms of bipolar disorder (bd) due to another medical condition may vary: 

• In someone with Cushing’s syndrome, the increased cortisol may lead to symptoms of bipolar disorder. 
• TBIs can have a range of effects on the brain that can lead to mental health symptoms of bipolar disorder, including anxiety, mood swings, irritability, and changes in behavior, like aggression and difficulties with self-control.
• Multiple sclerosis causes inflammation, and some recent research links inflammation to bipolar disorder.

Treatment of bipolar and related disorder due to another medical condition focuses on managing both the symptoms of bipolar disorder and the underlying medical condition. Symptoms of bipolar disorder may resolve when the medical condition is treated appropriately. 

Medication

Some medications can help people manage the symptoms of bipolar disorder. Mood stabilizers are commonly used to treat bipolar disorder to prevent episodes or reduce their severity.

Lithium is a common medication used for bipolar disorder. Recent research shows that lithium interacts with the immune system and can have either inflammatory or anti-inflammatory effects. Because of this, the effects of lithium on immunity and inflammation can vary significantly from one person to the next, depending on their underlying disease.

Symptoms of bipolar and related disorder due to another medical condition can improve with treatment of the underlying condition. However, people with this type of bipolar disorder should work with their primary care doctor to establish a treatment plan. Don’t stop, change, or start a medication without consulting your doctor. 

Electroconvulsive therapy (ECT)

A form of deep brain stimulation, electroconvulsive therapy works by activating specific brain regions through electrical currents. According to the American Psychiatric Association, individuals with bipolar disorder who do not respond to conventional treatment may benefit from electroconvulsive therapy. 

Self-care

Self-care can be an effective way to manage stress, which can be a part of symptom management for bipolar disorder, some underlying medical conditions, and co-occurring behavioral or mental health disorders (e.g., anxiety disorders, attention-deficit/hyperactivity disorder). Ways to approach self-care include eating healthy and regular meals, staying hydrated, exercising regularly, prioritizing sleep, and staying connected to friends and family.

People with this type of bipolar disorder can work with their primary care physician to manage their physical health. However, reaching out to a therapist may help them care for their mental health, learn to navigate life with their conditions, and address symptoms of other comorbid behavior or mood disorders (e.g., attention-deficit/hyperactivity disorder). To learn more about these and other treatment approaches, some people may find online therapy through a platform like BetterHelp effective, allowing them to receive support from home. 

For people who have symptoms of bipolar disorder due to Cushing’s syndrome, the Cushing’s Support and Research Foundation offers valuable resources, including personal stories from people who have successfully treated their disease.

The American Psychiatric Association has a page and an FAQ dedicated to bipolar and related disorders, including information about bipolar I disorder, bipolar II disorder, and cyclothymic disorder. 

The Brain Injury Association of America has information for people living with the effects of traumatic brain injury, including multiple resources and first-hand accounts.

If you have multiple sclerosis, the National Multiple Sclerosis Society has helpful information, including a resource that helps you find a support group in your area.

A recent study looked at how immune dysfunction could lead to the development of bipolar disorder symptoms. Researchers examined immune dysfunction, the resulting inflammatory responses, and how proinflammatory cytokines circulate and penetrate the central nervous system. 

This research may explain why people with autoimmune disorders, including inflammatory bowel disease, lupus, and rheumatoid arthritis, have increased rates of bipolar disorder. Researchers also considered the inflammatory immune response during chronic infections, cardiovascular disease, and metabolic disorders.

The study concluded that bipolar disorder is strongly associated with immune dysfunction and that, in some cases, immune dysfunction may play a significant role in disease progression. Numerous mechanisms of the body’s inflammatory mood pathway have been identified and may show promise as future treatment targets for bipolar disorder.

Another recent study looking at inflammation and bipolar disorder came to a similar conclusion. Researchers in this study believed bipolar disorder may be associated with immune system abnormalities and that biomarkers for inflammation may be a potential target for new treatments, though more research is warranted.

9% of TBI patients develop bipolar disorder

Studies looking at mental health conditions after a traumatic brain injury (TBI) found that up to 9% of individuals with a TBI develop bipolar disorder post-injury. ¹

¹The Mental Health Clinician

Below are more key statistics about bipolar and related disorder due to another medical condition:

• More than half of people with MS experience an emotional or mood disorder, (e.g., major depression).⁴ Some recent research shows that the lifetime incidence of people with MS developing bipolar disorder is 13%.
• About 30% of people with Cushing’s syndrome experience bipolar disorder with manic or hypomanic episodes. These episodes may appear as early symptoms of the condition.
• A study found that 90% of clients with bipolar disorder reported significantly increased quality of life after trying internet-based therapy.