Can anyone relate to feeling bipolar-ish???

[Pyrrhus]

The 2015 report by the US Institute of Medicine/National Academy of Sciences, which looked at 9,000 publications on ME/CFS in coming to its conclusions, did not at all list "emotional lability" as a symptom of this disease. They were very clear in explaining that this is a complex, multi-organ system disease, and not a psychological problem.

Psychological symptoms can be caused by biochemical imbalances of various types, including under or overmethylation, zinc and copper imbalances, food allergies, amino acid deficiencies, microbiome imbalances, and a number of other issues.

Everything you say is 100% accurate. In recent years, the symptom of "emotional lability" has been left out of diagnostic criteria, precisely because it could be misinterpreted as suggesting a psychiatric cause for ME.

But if you read the original 1959 papers, all the authors made it quite clear that the "emotional lability" occurred in people with no prior history of "emotional lability", and that "emotional lability" is clearly a symptom, not a cause of ME.

So yes, mood swings and irritability can be symptoms of ME, even if we don't like to always acknowledge them. And they may well indeed respond to correcting biochemical imbalances, as I have experienced myself.

 

[leokitten]

As others have said, emotional lability and irritability are very common in ME, but totally unlike bipolar.

Aerobic exercise can be helpful in bipolar, and the swings between mania and depression are not connected to exertion at all, whereas with ME there is no mania, and the temporary lability and irritability is directly triggered and increased by exertion and gets better with rest.

For many like myself, it generally only happens just before a crash. For me I know I’ve really, really overdone it and a crash is coming when I become more emotional and irritable, on top of all the other neurological and other physical ME symptoms that greatly increase pre-crash. So this is VERY different than bipolar, there’s basically no comparison.

For me the lability and irritability feel like a direct consequence to my head and upper spinal cord screaming like they are going to explode and that I MUST stop and shutdown all stimulation right away. It’s very physically painful. It feels like intense neuroinflammation that is causing my brain and body to go haywire.

 

[Treeman]

Aerobic exercise can be helpful in bipolar, and the swings between mania and depression are not connected to exertion at all, whereas with ME there is no mania, and the temporary lability and irritability is directly triggered and increased by exertion and gets better with rest.

I acknowledge what you have said above. I also have to consider if you have both conditions that aerobic exercise would be no help. I would have to contemplate that having both illnesses could mask a clear diagnoses of either illness.

Fatigue is also a symptom of bipolar, so I've read and maybe irritability in bipolar could also be caused by the exercise at times, rather than a biochemical imbalance . I think what's interesting is that there is a school of thought that both illnesses are theorized by some to be caused by a root infection. Could we be looking at a spectrum of illnesses?

 

[leokitten]

I acknowledge what you have said above. I also have to consider if you have both conditions that aerobic exercise would be no help. I would have to contemplate that having both illnesses could mask a clear diagnoses of either illness.

Fatigue is also a symptom of bipolar, so I've read and maybe irritability in bipolar could also be caused by the exercise at times, rather than a biochemical imbalance . I think what's interesting is that there is a school of thought that both illnesses are theorized by some to be caused by a root infection. Could we be looking at a spectrum of illnesses?

Fatigue is a very common symptom of so many diseases, and most neurological disorders, so I think the connection is tenuous. There is no PEM in bipolar, and honestly the symptom profile is so different between ME and bipolar that I just don’t see the connection. In addition, many neurological disorders have emotional lability and irritability as one of the symptoms.

Of course someone could have both distinct ME and bipolar, but that is rare. I personally think there is little connection between the two disorders other than they are diseases that affect the brain primarily, the former ME being neurological, the latter bipolar being psychiatric. I do agree that in this day and age the line between what is neurological and psychiatric is more fuzzy as we understand psychiatric disorders better (like why aren’t all psychiatric disorders where we understand some of their biological basis neurological?)

 

[Treeman]

There is no PEM in bipolar, and honestly the symptom profile is so different between ME and bipolar that I just don’t see the connection

There are many connections, here's two examples with EBV and autoimmunity/immune system mentioned in both of them, three if you consider hormone/chemical imbalance. I think I read that researches have noted viruses switching on and off gene expression, this could be something to consider also.

Ultimately I don't know, no one does, but whilst we search and the professionals search I'm keeping an open mind.

NHS; Suggested causes or triggers for CFS/ME include: https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/

• viral infections, such as glandular fever
• bacterial infections, such as pneumonia
• problems with the immune system
• a hormone imbalance

Hypothesis: bipolar disorder is an Epstein–Barr virus‐driven chronic autoimmune disease – implications for immunotherapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7133420/

 

[leokitten]

@Treeman you might have both ME and bipolar or cyclothymia. But I would caution your ME doctor to really do a detailed differential diagnosis to make sure you really have the hallmarks of ME and it’s not the just bipolar/cyclothymia.

Yes sure, if you have both disorders, your ME can make the bipolar worse and vice versa, but that doesn’t mean they share some common pathology.

I’ve had psoriasis since I was a teenager. It had been the same severity for almost 20 years until I got ME (triggered, not caused, by a viral infection). The ME made my immune system go nuts, and since then my psoriasis has been far worse. Doesn’t mean they share any pathology except the umbrella autoimmunity/immune system. I take a biologic medication for my psoriasis, which helps a lot but it does NOTHING for my ME symptoms.

Bipolar/cyclothymia can be treated by mood stabilizers and higher dose antipsychotics (for the positive symptoms). Mood stabilizers and higher dose antipsychotics will do absolutely nothing for your ME symptoms.

 

[Wolfcub]

I have good times and bad times physically. This affects my feelings. Of course it does! Sometimes I cry because I remember walking in a beautiful woods in the Autumn with all the lovely colours of the trees and the smell of mushrooms. I miss those hidden green paths and the tall cedars.
Boy....that can make me sad!
Can't go there....because (too dizzy....too exhausted....just feel like crap....it would start PEM.....etc)

So I have a psychologically sad kind of day. Depression? Possibly. Clinical depression? Probably not; more likely what's called "reactive depression" which basically means I feel a bit down because of something specific happening or not happening.

Then on a day when I have something close to good energy it's just great. My feelings open up and the heavy weight of not feeling well is briefly lifted. I know it can't last very long but I do enjoy it. I don't want the day to end. No symptoms!! Or very few of them!! I feel utterly blessed.
Sometimes I am stupid and go for a walk in a field and enjoy every moment. I always hope the "thing" has now gone away and I'll be fine. That never works out of course, but nothing seems to be able to kill my intrinsic hope. (Silly me!)

So yes, this illness can be a bit rollercoaster-ish. All to do with how the symptoms are....whether we're crashed or not...how our energy feels on a certain day. It's never steady, is it?

But it's nothing to do with bipolar disorder as such. That is a whole other thing.

I don't think we have to label and medicalise our natural emotional responses. They are normal, considering what we have to cope with.

I knew someone who was genuinely bipolar. A whole other thing. Not just feeling good one day and not great the next, for a rational reason.

 

[wonderoushope]

I had wondered if I had bipolar as it’s rife in my family and at the time I was seeing a psychiatrist to figure out why I was jumping all over the place, but kind not excited about anything a bit depressed and anxious. I also went to her because I suspected ADD (way before I got sick but seems to got heaps worse). At the time my CFS was overall quite manageable so I pretty much didn’t even correlate it with CFS.

Anyway, what helped was Cymbalta for my depression and anxiety at least. So as my mood got better. I hardly get that tense anxiety on edge feeling which is wonderful. Not long ago I got excited to do things. 2-3 months ago I went a bit crazy doing all the creative things I wanted. I thought lockdown was the perfect time to do all my creative to-do items. Not realizing my body could not handle it.

I’ve since crashed badly, bd bound most days for last few months, but my mood thankfully is fine, so whenever I have a moment where I think I’m doing a bit better I try and do creative things, as I’m itching to do them (but so far end up not getting far due to payback). Being bedbound is very boring and frustrating.

I do feel like CFS has added to my ADD brain getting far worse though. I no longer feel I am bipolar (psychiatrist didn’t think I was bipolar) though but do think I’m ADD and this illness has magnified my symptoms. I would of put ADD tendencies completely down to CFS, if it wasn’t for the fact I was researching it since my teens thinking I might have it. Stimulants didn’t work for me unfortunately and made me feel on edge and crash.

I am greatful my mood is still positive, upbeat though, despite being in a bad crash.

 

[judyinthesky]

"I also think this is connected to my condition because I feel/think so negatively when I'm crashing only. The "normal me" feelings/thoughts are present when I'm doing better, and then "negative me" feelings/thoughts are present when PEM arrives and it's intensity correlates to the PEM intensity."

YES. This is exactly how I feel when I have done too much. I have one question for you guys - did anyone's PEM or CFS/ME start initially with mental symptoms?
For me, before I had the fatigue, I got pancreatic insufficiency of unknown origin which put my body in a CONSTANT fight & flight mode. It was the craziest thing I've ever experienced, like I was "on" and 300% myself with everything. This also felt bipolar at times, but I think it was just the excitement of feeling normal in between those horrible states.
Then after being like that (antidepressants did not work out) for 5 months, I noticed that the less wiredness, the more fatigue set in. Like my body somehow adjusted. Anyone??
Doctors cannot put me into any category... apparently, are suspecting MCAS and other stuff.

As I usually (before getting ill, I am NOT diagnosed with CFS though but I definitely do have a weird fatigue syndrome) am quite a balanced person, physical exertion is the thing that can best get myself in a negative mood - really really negative mood that is totally unusual for me. It also feels like a nervous wiring more than depression. A rumination kind of depression more than a lethargic one. The less energy in the body, the more my nervous system would wire up.

A psychiatrist, before my pancreatic insufficiency (and thus physical reason for how I am feeling) was thinking about bipolar but I definitely do not believe that. He believed that because of the medication hypersensitivity I displayed I guess.

 

[judyinthesky]

Plus, those that feel like the original poster - what can you say about antidepressant trials? (I should do the gen test according to my doctors). I have tried them two times and they were not so good but that was in my superwired state. What puzzles me is that I do have a light form of fatigue syndrome but not classic CFS, but I certainly also don't have depression. It seems to be the way my body deals with less energy from pancreatic insufficiency, but I find myself so much in these descriptions (and I was a high energy person before that, and PEM is a big thing for me - just not that I have to lie in for days, but that I experience malaise and what you guys describe in this thread).

 

[Pyrrhus]

A related discussion:
Mood swings, emotional, irritable, treatments?
https://forums.phoenixrising.me/thr...-male-females-welcome-to-answer-though.82006/

 

[Emmarose47]

Yes thats me ....I see it as going with the territory ...when I'm feeling fairly well I have a chance at life.
When I don't feel well my world.goes dark and I have neg thinking and subsequent low mood ...
How else could it be ?

 

[kushami]

I've been looking at this a bit more and other symptoms I've found include as a co morbidity, autoimmune problems, rumination and obsessional thoughts, and argumentative,(all of which I have),

I have horrible rumination, which I recently discovered vanishes when I have normal blood flow to my brain. I was astonished. Other things, such as irritability and argumentativeness, improved too.

The only thing that didn’t budge was trichotillomania, so I guess I’m stuck with that one. It makes sense, as I’ve had that since childhood, whereas the rumination etc. started to bother me at the same time I started to get orthostatic intolerance symptoms.

(Please note that I don’t have ME/CFS, but have the same pattern of low blood flow to the brain found in many ME/CFS patients.)