How Does Thyroid Function Affect Bipolar Disorder?
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Bipolar Disorder
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Bipolar disorder is a mental illness marked by extreme mood swings cycling between euphoria or mania to severe depression. These mood swings, which also may be called manic depression, are much more severe than normal emotions of happiness and sadness. In bipolar disorder, the extremes of mania and depression alternate with periods of more even moods. Some people with bipolar disorder have long periods of stable disease whereas others have shorter periods of moderate mood, called rapid cycling bipolar disease. During manic episodes, behavioral changes such as sexual promiscuity, restlessness, insomnia, irritability, risk-taking or overspending will occur. During the depressive phase, people with bipolar may become lethargic, lose interest in activities they previously enjoyed and become suicidal.
Thyroid Function and Bipolar Disorder
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Thyroid function has a complex relationship with bipolar disorder. Thyroid disorders can cause mood changes and symptoms of an underactive thyroid, or hypothyroidism, can mimic depression. Thyroid disorders are often misdiagnosed as depression, and thyroid function should be tested before bipolar treatment begins. People with bipolar disorder also have been found have a higher incidence of thyroid dysfunction, especially women. Thyroid disorders are more common in people with rapid cycling bipolar disorder than in classic bipolar disorder. Hypothyroidism complicates treatment because it increases resistance to treatment. Thyroid dysfunction may also be caused by bipolar treatment. Lithium is known to cause hypothyroidism, and regular thyroid testing is recommended during lithium therapy. Lithium-associated hypothyroidism will reverse when lithium treatment is stopped, but thyroid supplements may be prescribed along with lithium.
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Thyroid Function
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The thyroid is a small gland that secretes hormones that regulate metabolism, decrease cholesterol and facilitate mental processes. Low thyroid levels can cause depression; high levels can cause anxiety. Thyroid supplementation can help stabilize fluctuating moods and may boost the effect of antidepressants. Thyroid supplementation has been suggested as a treatment for bipolar disorder, but it is still unproven. Excess thyroid hormone can cause arrhythmia and osteoporosis.
Treatment
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Bipolar disorder is a lifelong condition with no cure. Treatment goals are symptom management and mood stabilization. A combination of medications and psychotherapy is most effective. Bipolar disorder is difficult to diagnose because the pattern of mood swings must be observed over time and people in the manic phase feel euphoric are unlikely to realize they need therapy. Medications are effective, but often several must be tried before the right combination is discovered. Treatments include mood stabilizers (lithium, valproic acid or lamotrigine), atypical antipsychotics (olanzapine [Zyprexia], quetiapine [Seroquel], risperidone [Risperdal], aripiprazole [Abilify] and ziprasidone [Geodon]) and antidepressants (fluoxetine [Prozac], paclitaxel [Paxil] or sertraline [Zoloft]).
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