Navigating Bipolar Disorder With Other Health Conditions

"I know what you have," my internist said when he saw me sitting in the waiting room. "Let me get settled and then we'll talk."

Up to that point, it had been over 4 years of testing, half a dozen doctors, and thousands of out-of-pocket payments for medical tests. Every result was the same: inconclusive.

All the doctors admitted there was something wrong, but none of them could diagnose it.

Facing another diagnosis

Then I met the internist. He promised to figure out what I had. I doubted him, but gave him a chance, and he stuck to his word. Over a weekend, he took my medical file home with him, all 3 inches of it, and spent 2 days researching each symptom.

After hours of reading, he correctly diagnosed me with Familial Mediterranean fever (FMF), an auto-inflammatory disorder that causes periodic fevers and body pain. The worst pain usually centers in the abdomen.

Chronic illness with bipolar disorder

My first thought was, "Oh great. Now I have another health condition to deal with." Little did I know that having a physical chronic illness along with bipolar 1 disorder would bring its own unique challenges.

The first issue was medication. There was a learning curve to figuring out the right dosage level, so I had weeks of digestive issues. The time stuck at home brought along a depressive episode. I couldn't celebrate finally having a diagnosis because my mind didn't want to find joy in anything.

Stigma from doctors because of my bipolar

Then there were the doctors. The first trial came when I saw a gastroenterologist. During intake, I noted I had bipolar as part of my medical history. The doctor saw my diagnosis and stopped there. He immediately thought my symptoms were delusions and told me to go back to my mental health provider.

I had a similar issue when I saw a rheumatologist and later a dermatologist. Each doctor saw bipolar disorder on my chart and treated me differently. I was no longer a patient with a physical problem, but a delusional man incapable of speaking for myself.

Popular stigmas swayed those physicians, and they let those false beliefs stop them from seeing me as any other patient.

Chronic illness medications

Another challenge of having a physical illness with bipolar disorder is that some medications can trigger or intensify bipolar symptoms. After 30 years of dealing with mental illness, I know many medications I should avoid. The challenge comes when I have to convince a doctor how a med will make things worse.

For example, I have seasonal allergies, but some allergy medications have triggered mania for me.

Isolation and stress

Some chronic illness symptoms can also induce bipolar cycles. When my physical pain is severe and I'm confined to home, I often slip into a depressive episode.

If I get a sore throat, often the first symptom of an FMF attack, I always wonder if it is the FMF or something more serious. The worry makes my anxiety skyrocket. The stress causes insomnia and things tumble from there.

Bipolar symptoms plus other symptoms

The last way having a chronic illness with bipolar disorder has caused problems is the frustration of dealing with days of illness. I often feel like the FMF is bad on the days my bipolar is behaving itself. Then my bipolar disorder goes wonky when my FMF is in check.

There are days I feel like I'm playing a no-win scenario. The aggravation causes both anxiety and depression. It took a while, but I learned how to manage both conditions, even when they show up on opposing days.

Navigating chronic illness with bipolar

What advice do I wish I knew earlier? This: Make sure you learn as much as you can about your conditions. Knowledge is power when managing an illness. That’s true for both bipolar disorder and any other illness.

It was vital for me to learn about FMF because it is a rare disease, affecting about 1 in 1,000 people. None of my doctors knew about FMF, so I had to explain the condition and how it affected me every time. I could only do this because I took time to study my illness.

Managing my health

Besides learning about the conditions, I also keep a health journal. I track the things I do or eat and the way I feel. Over time, I see patterns that help me make better decisions each day.

Tough as it sounds, things are not all doom and gloom. Living with bipolar disorder and another health condition is a challenge, but it's one I believe anyone can master. It takes time and effort, but a full life is possible regardless of any diagnosis. What helps most is learning to understand and manage the conditions.