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Dr. Jim Phelps
In addition to my practice of Psychiatry, I write PsychEducation.org, a non-profit website which presents, in 10th-grade English, 300 pages of information and references on complex topics in mental illness -- bipolar disorders, brain chemistry, important brain parts, and more. This Blog presents changes on the website; important new research results; and "What I Learned Today" -- from my patients. The website is free, but the book version below is an easier read...

Monday, October 15, 2007

Fibromyalgia And Bipolar Disorder

Courtesy of a brave man who has bipolar disorder, and whose son has both bipolar disorder and fibromyalgia, here's a remarkable statistic.
Patients with fibromyalgia are twice as likely to have Major Depression as are patients with rheumatoid arthritis. (The latter, RA, was selected in this study as a comparison group because it has a relatively well-established basis in an immune system malfunction; or as the basis for fibromyalgia is still very unclear but does not appear to be a straightforward autoimmune problem like RA).

But here is the remarkable part: by comparison, patients with fibromyalgia are 153 times more likely than those with RA to have bipolar disorder.

Makes you wonder what is going on, doesn't it? The fellow who forwarded this to me wonders if exposure to antidepressant medications, in people who have bipolar disorder, might be the basis for this connection. So far, to my knowledge, there is nothing more than that striking statistic above to even raise that possibility. It does make you think, though, doesn't it?

Dr. Phelps

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14 Comments:

Anonymous Anonymous said...

Dr. Yves De Koninck, whom has done a lot of research on neuropathic pain, might have an idea about the link.

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=17182282&query_hl=2

Glen

8:54 AM  
Anonymous Anonymous said...

My personal experience is that I had fibromyalgia and bipolar disorder concomittantly (both undiagnosed) for at least a decade before beginning any antidepressants. While the connection is striking, I think determining a causative factor will be a matter of extensive study.

4:08 AM  
Blogger PsychEducation said...

Yes, definitely, there are more ways to fibromyalgia than just bipolar disorder. The latter appears to raise the risk of landing there. Whether that is bipolar disorder or antidepressant exposure or both remains to be determined. Thanks for the comment.
JP

4:34 PM  
Anonymous Anonymous said...

I was diagnosed with Fibromyalgia in my mid-twenties and did not suffer from depression at the time. Seventeen years later I was diagnosed Bipolar II and I have to admit that I had the Bipolar symptoms long long before I ever put an anti-depresent into my system. It is amazing though that a lot of people I know that have Fibromyalgia are also Bipolar.

Thank you for your insight.
Lise

6:28 PM  
Blogger Khurt Williams said...

My wife was diagnosed with fibromyalgia a few years ago and our lives were changed forever. I am developing an online community for people suffering from fibromyalgia. The online community, “You're Not Alone” ( http://fibromyalgia.ning.com ), will allow members to participate in fibromyalgia-related discussions in the Forum, share their thoughts and ideas in their blog, and post their personal photos and videos. There is no cost to join. Members of the site follow a simple process to create their profile page, which they can later customize including a profile photo and additional details about themselves. I created the project while participating in a Landmark Education leadership program. Part of the coursework was to create a project that benefits the community. When I had the opportunity to create a project that would make a difference in the community, it was only natural that my wife's illness would be the inspiration.

5:56 PM  
Blogger Khurt Williams said...

My wife was diagnosed with fibromyalgia a few years ago and our lives were changed forever. I am developing an online community for people suffering from fibromyalgia. The online community, “You're Not Alone” ( http://fibromyalgia.ning.com ), will allow members to participate in fibromyalgia-related discussions in the Forum, share their thoughts and ideas in their blog, and post their personal photos and videos. There is no cost to join. Members of the site follow a simple process to create their profile page, which they can later customize including a profile photo and additional details about themselves. I created the project while participating in a Landmark Education leadership program. Part of the coursework was to create a project that benefits the community. When I had the opportunity to create a project that would make a difference in the community, it was only natural that my wife's illness would be the inspiration.

5:56 PM  
Anonymous Anonymous said...

I'm glad I came across this excerpt about the relationship between bipolar disorder and fibromyalgia. I'm diagnosed with Bipolar II and I developed Fibromyalgia after stopping Effexor. It seemed as if my whole body crashed including my immune system. I was also diagnosed with Ankylosing Spondylitis around the same time to complicate things. I'm doing a lot of research regarding the relationship between all three. Unfortunately, I went off my lithium about three months ago and again found myself in crippling pain. I thought it was related to my A.S., a rheumatological disorder. I ended up in the hospital and was put on Cymbalta and Trileptal since I had a thyroid condition and the psychiatrist felt that it wasn't a good idea to go back on Lithium since the two compete with one another. I agreed even though Lithium curbed my Fibro but brought on a number of horrible side effects including IBS and weight gain. My pain went away almost instantly, but now about three weeks into it, I'm starting to get really irritable and I need to go off it, but I'm afraid that the pain will come back or I'll be confronted with horrible mood swings or further depressions. All I can say is be very careful of what you put into your body. I believe less is more. A lot of doctors feel like they have to offer a quick fix but there is no such thing as a miracle drug and sometimes you have to ride through the storm. I wish that my p.doc in the hospital would have just tried the Trileptal and uped my Seroquel. He said he was going to give me something for my pain and didn't mention that Cymbalta was an antidepressant. If I had known, I never would have agreed to take it, especially knowing that it was in the same family as Effexor which was a really horrendous drug to come off of. It literally did minimal benefits for my mood and changed my whole life in a matter of months.

2:55 AM  
Anonymous betteryet said...

Ah for god's sakes!! Where were you 4 years ago?
Thank you for getting the word out that Bipolar is more than raving mania mood swings. I wish I had known about Bipolar II 10 years ago, my life sure would have been different.

I've had depression for years. Responded extremely well to Paxil for 3 years (15 years ago) and it made me rather energetic in a good way. Now NO antidepressant works, makes things worse. I have chronic pain, Interstitial Cystitis (Bad!), fibro, depression, hypoglycemia, sleep problems congenital spinal stenosis, and I actually forget the rest. I see plenty of doctors.

Recently I started Lyrica for pain, increased the dose to 300mg daily and am finding my sleep is better and my mood is better. Thinking about quitting Welbutrin (slowly!) since it never did much. There sure are a lot of folks calling it a horrible drug, except for the fibro and chronic pain folks. What is your opinion about Lyrica as a mood stabilizer?

I am so glad to have found this site. I sometimes read medical articles having professional terminology without too much trouble. I see you have written the psycheducation.org site in 10th grade english. This is truly a service to mankind. Thank you very much.

8:01 AM  
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Hope for the best

1:22 AM  
Anonymous FieryMaime_bp said...

hello, first-timer here. very interesting site. and, not just this blog post. the whole thing! glad to have found you!

i, as some of you, have both illnesses, and have for many years. it was just part of my frustrating pattern that when i'd finally start feeling better in my head or my body, the other part of me would go haywire. it took a long time to understand that i have a combination of a number of chronic illnesses. but, to the point, many of the medicines that i've been prescribed for one illness have been "saving graces" for others, not the "monsters". i discovered that one medicine side effect worked to clear my 3 year mouth infections and my bursitis. another medication side effect has given me a reprieve from years of nearly constant allergy attacks of acute asthma. but, right now, i'm in a pickle, because i'm still trying to recover from a nasty allergic reaction to the iodine dye in a CT scan. this reaction is of the swelling throat, mouth, lips, neck, cheeks type. very painful and uncomfortable. even the ER treatment, plus meds, haven't gotten rid of it completely.

this immune system thing has got to be the association. in fact, my allergist of 25+ years is of the opinion that what i have as a diagnosed "bipolar disorder" is actually an immune system disorder. both of my parents have horrible allergy problems. i have multiple chemical sensitivity, asthma, more allergies that i can remember. and the fiery maiming of fibromyalgia, which my mom has, my grandma had, my great-grandma had, my great-great grandma had. and that's as far as i know. (of course it was called different things - fibrositis is one of those names.) and, yes, mood difficulties are known in the family, but stigma was/is such that i'm the first to fight my way through it to seek answers. my mom can't even stand my saying the phrase, "my psychologist". it just wigs her out. and, now she's "adopted" a mutual friend, who was a couple years ahead of me in school, who was also diagnosed with BP, but he got "some excellent counseling and he's 'cured' and doesn't need any more drugs or counseling. (hint, hint.)" well, you know how that goes over! (how interesting.....)

well, i'll try again to hit the hay.

"i shall pass this way again."

FMbp

5:19 AM  
Anonymous Anonymous said...

my daughter was diagnosed with fibromyalgia when she was 12 years old. at 15 years of age she was diagnosed with bipolar disorder. we have bipolar disorder in our family but not fibromyalgia. she's 17 years old now and we still haven't found the right combination of medications to help her. she has no quality of life. i'm 55 years old and it's sad when your 17 year old child can't walk fast enough to keep up with you. she use to be an athlete--on a competetive soccer team and on the A basketball team and then the pain hit. exercising in a warm pool is hard for her now. she says she believes she's always been bipolar she just didn't understand what was going on with her, she always felt she was different. i'm a registered nurse and feel horrible giving my child medications with so many horrible side effects. we've tried depakote,lithium.she's on lamactil and abilify for bipolar also takes hydroxyzine and lorazipan for anxiety, and lyrica for fibromyalgia. anyone have any suggestions as far as medications is concerned? sometimes i wonder if i'm causing more problems with the medications. she was cutting herself before we realized she needed help--that she was bipolar.
thank you for listening. kcrn

9:29 PM  
Blogger mjbogdanov said...

"Whether that is bipolar disorder or antidepressant exposure or both remains to be determined. Thanks for the comment."
From my POV, the addition of AD's may not be the cause, but it without doubt speeds the process.

2:00 PM  
Blogger Trialia said...

Thank you for this - fascinating observations. I'm 23 and have been battling ultradian bipolar disorder (type non-specific) for 12 years (was not medicated with *anything* until I was 16) and fibromyalgia for three. It's definitely something to think about...

4:38 PM  
Anonymous Anonymous said...

hello, well, I too have the fibro/bipolar and I also have recently been diagnosed with borderline personality disorder, wow huh! i didn't realize it until i was asked by my therapist to read "I LOVE YOU, PLEASE DON'T LEAVE ME" I sure didn't like owning this one. I've been on alot of medication trying to find what is right for me. I could't take lyrica it made me too sick, so I take methadone/gabapentin for pain,it really didn't help alot until ibuprofin 800 was added, I still have very painful flareups but the rest of the time I feel I can handle it. For the bipolar and all I take Lamictal 150mg so far, still trying to adjust,believe me i've tried quite alot of meds to get here. I'm only 51 yrs old and i hurt so bad i feel like I'm my mothers age, but in my mind I feel 15 so I guess that is just the way it has to be for now. Ive been bypolar for sometime, just didn't want to deal with it, lol, and fibro came out when i had an accident in 2006. Well, needless to say I'm now disabled, i can't work because I'm still in need for alot of help and the pain in my body just won't let me. From me to everyone here, remember this "IF GOD BROUGHT YOU TO IT, HE WILL BRING YOU THROUGH IT" I hope this helps you all!
Thank you for listening to me and I hope everyone has had a nice holiday season.

11:27 AM  

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