Thyroid and Bipolar Disorder

[kmarquis1]

Perhaps this will be interest of you if either you or a close relative suffer from bipolar disorder (Formerly called manic depression).

First of all; I have not been diagnosed as hypothyroid, but display all the symptoms. However, I have been diagnosed as bipolar.

There are several studies that indicate a link between bipolar and thyroid related illness'.

Against recommendations, but desperate for relief of my symptoms: cold intolerance, dry skin/hair, drained of energy and insomnia, I recently began a course of Levothyroxine 50mg. It certainly helped with the incessant coldness, but after a couple of days, my mind began racing and I was writing and writing (most of it not making any sense) and realised I was going into a hypomanic state whereby all sensations were heightened and I was losing touch with reality. I'm not suggesting the medication can cause this, but may trigger it in people who already suffer from bipolar. In fact, my body reacts in a very similar way to SSRI anti-depressants.

Here is the best website I have found on this subject: psycheducation.org/treatmen... (written very concisely, easy to digest and backed up by various studies and empirical data) written by an American psychiatrist, Dr Phelps.

[shaws Administrator]

Thanks for the link and I'll watch shortly. I do remember reading several times in the past that people diagnosed with Bipolar were actually hypothyroid but most probably (if thyroid hormones were tested) their TSH wouldn't have been high enough to be diagnosed as hypo. Due also to the fact that doctors and endocrinologists do not seem to be aware of the clinical symptoms. Look at the bottom of this page

thyroiduk.org.uk/tuk/about_...

They are all apt to diagnose and treat a symptom as apart from something wrong with thyroid hormones until it reaches a high enough number for diagnosing.

[Clutter]

Kmarquis1,

It's a good site but use of thyroid medication to treat psychiatric illness in euthyroid patients is very contentious in the UK.

I was diagnosed bipolar in my teens after thyroid dysfunction was ruled out. I had annual thyroid function tests into my 30s and wasn't diagnosed with Hashimoto's until I was in my 50s. Hashimoto's wreaked havoc on my previously stable bipolar illness although my bloods were euthyroid. I had a thyroidectomy as I had thyroid cancer. Hashimoto's burned out after thyroidectomy and bipolar has been in remission since I've been optimally medicated on Levothyroxine (T4) and Liothyronine (T3).

[shaws Administrator]

Thank you for posting and it is very interesting. On one of the links within this is an excerpt:

hope you see what this means: if you stop the cycling, you might stop having depressions entirely — so you wouldn’t need an antidepressant, of any kind. And this makes bipolar treatment a lot simpler, because you can stop the cycling with “any old mood stabilizer”, not just the ones (shown below) with antidepressant effects. This allows you to choose from the entire menu. That’s good, because sometimes you’ll want that entire menu available, to pick the one with the least troublesome side effects for you.

After that step is complete, when you are no longer having cycling, then, if you are still depressed, you should consider options from the list below. Then, when you have considered these options and perhaps used one or several, then you may be one of those people who really need to add an antidepressant, with caution, to your mood stabilizers — in my opinion. (There are exceptions, including especially people who have been on an antidepressant for years and doing well, with no cycling. These people may do best to stay on their antidepressant, although even that is controversial: see Controversy 3.)

But before turning to antidepressants, there are at least 9 alternatives. Remember them as “3 columns of 3”. Well, at least 3 in each; the lists are growing, which of course is good.

Nine antidepressants that aren’t “antidepressants”

(Each of the “pill” options in this table has its own page of additional information; see Mood Stabilizers table of all the options.)

Not Pills “Natural” pills Psychiatrist’s pills

Exercise omega-3 fatty acids(fish oil) lithium

bipolar-specific psychotherapies n-acetylcysteine (NAC) lamotrigine

Light manipulations (dark therapy, dawn simulator, chronotherapy)(some wish to include ECT here as well) optimize thyroid quetiapine ( lurasidone too, soon)

Okay, I admit, dark therapy doesn’t quite belong on this list, as it does not have direct antidepressant effects, only mood stabilizing effects, but it’s such a cool idea, I think everybody needs to know about it — because some limited version of it is within reach for almost everyone. If you’re interested in how mood is affected by light, see an essay on Bipolar Disorder: Light and Darkness. You’ll see how the biological clock is affected very directly by both (and find interesting links about how the clock works and how lithium affects it; and about why blue light appears to be more important than any other wavelength when it comes to mood effects).