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Patient Perspective Piece: Bipolor Disorder and The Bipolar Thyroid Connection

Post Published: 10 July 2010
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Category: Guest Bloggers, Patient Perspective Piece: Bipolor Disorder and The Bipolar Thyroid Connection
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Note: I asked Peggy, a friend and colleague, to please write a piece for us on Dear Thyroid about Bipolar disorder. Some of our community members have Bipolor disorder. Additionally, Bipolar disorder can present as a psychiatric disturbance in thyroid patients. Please welcome Peggy with open glands. Peggy – Thanks. You’re a peach.

(Written by, Peggy Pendleton, Writer, Artist, Bipolar Patient)

Show me a woman with a real serious shopping compulsion and I’ll show you a bipolar woman.  If that woman’s mother found her life’s greatest pleasure shopping, I’ll show you the closest genetic link, though there will be many in the lineage of that family. It’s probably the most under-diagnosed of the mental illnesses and yet it seems everyone’s bipolar these days. It’s one of the few genetic illnesses with two genetic markers, which means that if there is one bipolar person in your family, there will be many more, diagnosed or not.

Compulsion (mania and psychosis) and the complete absence of compulsion (depression) are the two poles of bipolar disorder.  With compulsion comes boundless energy.  The joy of having both energy and the purpose of compulsion feels great and no one in a slightly manic swing will want to come back to earth.  The compulsion to shop takes me when I’m transitioning into hypo-mania.  That’s when I have boundless energy and feel a strong sense of well being and optimism.  “Money’s like a river; it has to flow.  Spend it and more will come.”  It’s the “zen like” place where I have absolute faith that it will all work out and I need those Gucci high heeled boots. It would be great if I used that energy to clean my closet and scrub all the floors since I don’t have enough money to quite pay all my medical bills.  The impulse to shop, especially shopping without a list (for things I don’t really need) should be a signal for me to check in with my therapist and see if I need an appointment with my shrink for a med check. Problem is, it feels so good.  Hypo-mania is like the very best drug.  This is how life is supposed to feel.  I feel charming, but I’m probably a little too intense, a bit too loud for most people.  It might be that’s when I start thinking that my sex drive isn’t dead after all.  Another red flag for those with bipolar disorder is an intense and perhaps inappropriate sexual appetite that might lead to disastrous sexual encounters.  Yes, encounters with an S. Yes, without protection. Yes, with much younger men. Yes, possibly married younger men. Yes, maybe married to your sister.

A lack of impulse control and a high tolerance for chaotic disorder is a another symptom of someone in the hypo-manic phase of the illness.  All these things might seem to you like personality. And yes, there might be a narrow line between being a charming, flirtatious, fast-talking smarty-pants, but then if you have no boundaries at all, and you feel compelled to fuck your sister’s husband, you are probably at risk of driving the bullet-train that is your “personality” off the cliff.  We can be incredible drama queens.  We can be very destructive and self-destructive.  But then our lives have probably been quite trying, not to mention embarrassing for our families.  As children we are the ones who get bullied and abused.  We may be the family’s scapegoat.  We might be the child who is sexually abused.  And as we grow into our teens we will likely become the ones who cut ourselves so we can feel something, so numbed by stress and psychic pain are we.  That’s not to say that every child who is bullied at school and abused at home is going to be bipolar.  But a high percentage of female bipolar adults had that kind of childhood. We are the vulnerable ones, no matter how brash we may seem.

So what does this have to do with you?  You have a thyroid problem, not bipolar disorder.  But so do a lot of bipolar patients.  Bipolar disorder is under-diagnosed, and if diagnosed, often kept secret.  And in the early stages of depression you do feel sick.  Depression may begin with a strange fatigue, a headache that won’t go away, a low grade fever that lasts for weeks.  You ache all over.  These symptoms have sent me to the doctor many times, and each time tests have been run and one of the things they check is my thyroid.  Before any doctor diagnoses depression other things have to be ruled out.  And in the testing phase, they may find a thing or two.  I once had a one-time sugar spill in a urine sample.  This was so perplexing to my doctor that she had a complete endocrine work up done.  I was hoping that it would be an endocrine problem, anything but another depression.  But there is nothing wrong with my endocrine system.  I do have heart problems, but they have never been mistaken for bipolar symptoms.  Depression is serious.  It can’t be dismissed as just laziness.  If you’re the only one in your family who’s ever been seriously depressed, it might be that other members of your family tend to be a bit on the manic side.  If mania is the predominant side of bipolar disorder for those in your gene pool, chances are those folks will never be diagnosed.  Because who ever thought dynamism was a bad thing? Those who mostly swing towards mania are energetic, fun in a breathless sort of way, and productive powerhouses.  They are often greatly admired.  And they can be mean, so woe to the depressive bipolar child who lives in a family of manics, for there will be no sympathy there.  We just seem terribly lazy to the rest of our lunatic relatives.

Bipolar disorder can be managed quite well with the right drugs.  But finding the right drug might take a bit of trial and error.  And once the right drug is found compliance is often a problem.  Few bipolar drugs are weight-neutral.  I carry forty pounds of drug weight.  Zoloft makes me lose weight, but I tend to get a bit manic on it.  Wellbutrin can help you quit smoking but made me psychotic.  Most bipolar drugs keep me from dreaming, and for me, dreaming is one of life’s little miracles.  So I’m willing to trade being thin for being able to time-travel in my sleep.  For most women the weight gain may make compliance problematic.  For men, just admitting that they have a problem that needs medication is astonishing in itself.  Men experience bipolar disorder differently than women.  Or at least they shop for different things like cars and boats and tools and such.  Men may be violent when manic. The high of a manic stage can manifest as aggression for both men and women, but men express their aggression more often with fists, and most bipolar men think having an insatiable sex drive is the ideal anyway so what’s the problem there?  Inappropriate sex?  Are you kidding?

I’ve been in a lot of group therapy for bipolar disorder and I have never seen a man in any of those groups. And it’s not because they were women-only groups.  Men don’t seek treatment unless repeated incarcerations find them negotiating further jail time for therapy and enforced drug treatment.  A lot of men would rather do jail time than admit they have a mental illness and have to take drugs that take the thrill of risky compulsions out of their lives.  Because the compulsion for risky sexual behavior is a lot more fun than feeling just normal.

We still live in a time of shame when it comes to mental illness.  Many of us just self-medicate to try to feel normal.  We smoke cigarettes (which are a mild antidepressant) and drink too much.  We smoke pot and drink too much.  We do meth so we can have the energy that depression takes away, and drink too much.  We will try damn near anything to feel “normal,” except take an antidepressant or anti-psychotic that will stigmatize us as crazy and make us gain weight.  But remember, along with a high degree of creativity we also have the highest rate of suicide for any illness.  It is our leading cause of death before the age of fifty.  After that we’re the real experts on the illness.

Peggy – To find out more about Peggy, please read her fabulous blog: Utah Savage

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14 Responses to “Patient Perspective Piece: Bipolor Disorder and The Bipolar Thyroid Connection”

  1. Quin Browne says:

    I read Peggy’s blog on a fairly regular basis… her trip though the Valley of Bi-Polar echoes my own in many ways…and, she makes me remember I’m not alone.

    My mother is an untreated bi-polar…she refuses to acknowledge that she is one. Her shopping trips are legendary, her mania is soul sucking. My son is also bi-polar, and accepts it–although not enough to medicate.

    I’m sure my thyroid issues enhance my bi polar behavior… I medicate both issues and try and hope nightly the medicines will work.

    I can say bi-polars are never dull, seldom stupid and vastly entertaining… I can also say we are exhausting to be around.

    Meh.

    Thanks for this, Peggy… I continue to admire you much.ly. This post pretty much explains why.

  2. Gina says:

    wow, finally someone who understands. ive been diagnosed bipolar for a lil over 6 years. i have been on a rollercoaster in life. im well controled now but in the begining i atytempted suicide twice and was deamed disabled because i couldnt handle daily stress, i had a breakdown at work one day and i havent been back since. some days i can get out of bed with a smile and others i just cry. i just got diagnosed with thyroid cancer about a month ago and knowing that i have issues with my thyroid as well as emotional issues im really trying to stay afloat this time.

    my husbands family doesnt belive in mental illnes, so when i broke down they said i was seeking attention. when they found out i had issues with my thyroid, we have a nurse in the family that knows everything,lol.. they all decided i was not bipolar as diagnosed i was unstable because of my thyroid. i hate their ignorance. i cant stand them…my family on the other hand understands me. my father killed himself 10 years ago, he was diagnosed with scitzophrenia( i know i spelled that wrong, sorry). my mother is also bipolar but not on medication for reasons of her own. my lil sister has psycotic moments and refuses treatment ,shesh thats for weak people…my side of the family is full of mental illnes on both mom and dads side, so naturally it hit me. i take 2400mg of lithium daily and 800mg of carbamezapine daily. some times i take 20mg of doxipne if im really having trouble sleeping. i had a pshyc dr that had me on a combo of 8 meds as well as 10mg of ativan daily, i was so lost then. im much better now for the most part, i dont see that dr anymore thank goodness. i keep myself educated and im involved in groups as well as therepy, it keeps me grounded. i look at this bit with my thyroid as a chance to start over. we are going to evaluate my meds post op and see what needs to be changed if anything at all.

    thank you so much for writting this article. it excellent, i love it…im going to have my hubby read it later. i feel for him a bit cause he is having a hard time dealing with the crazy moods ivce been in lately. its almost like im going through a dysphoric stage. any ways thanks.

    gina

  3. Dear Thyroid says:

    Peggy;

    Thank you so much for writing this article and for sharing your education and experience of your Bipolar disorder. I am so grateful to you.

    xo
    Katie

  4. Dear Thyroid says:

    Quinny – I agree – Peggy’s very brave about living with bipolar disorder and how it impacts every area of her life. She’s a gritty, irreverent, in your face writer – about everything.

    I didn’t know that your mother was an untreated bipolar patient. I can’t imagine how that must feel for you. How do you handle it?

    I’m thrilled that your son acknowledges his bipolar disorder, but why won’t he medicate?

    When you are HYPER, I would think your bipolar disorder is in overdrive, yes? I’m sorry you’re living with this, too, my love.

    When I was thyroid psychotic, I had bipolar, rage (who doesn’t, right?!), severe depression, paranoia, delusions, and that’s literally just the tip of the psychiatric thyroid iceberg.

    When I am even slightly hyper, I present with psychiatric issues and when my antibodies are high for GD.

    This all sucks ass. THOUGH, there is a silver lining. WE HAVE EACH OTHER.

  5. Dear Thyroid says:

    Gina;

    I am SO SORRY to hear that you have bipolar disorder, too. I am so grateful that it’s under control now.

    how did you manage your husband’s family? Was/is he supportive? How are you doing with it now?

    I am so thankful Peggy wrote this post, too.

    xo

  6. UtahSavage says:

    Quin, thanks for the compliment. You’re very generous. Seems everyone with bipolar disorder has some other damn challenge as well. Hardly seems fair, does it?

    Gina, I’m glad this little post of mine made you see how much we all have in common. I too am a failed suicide and for years now I’m glad I survived. But I’m now the only living member of my small but very crazy family. My mother was an undiagnosed bipolar who was diagnosed as narcissitic personality disorder. I’ve written a novel about her and our turbulent life together called the Narcissist. I’m unpublished, but it’s posted on my sidebar if you’re interested. My mother thought I was merely moody and lazy. She on the other hand had the boundless energy of the highly productive manic. She loved, loved, loved to shop. Like I said in my post, those who swing toward the manic side seem to have the world by the tail, and in my mother’s case every too young and inappropriate man as well. I never had a boyfriend or husband who was off limits to my gorgeous and dynamic mother. I experienced her as hostile and disapproving, but everyone else thought she was fabulous.

    My biological father was diagnosed schizophrenic and was institutionalized twice. I’m told by my psychiatrist that was the standard diagnosis for those with “manic depression” who were in the psychotic phase in the 1940s and ’50s. So I too have the double whammy. My adoptive father was a pedophile, so he married my crazy mother when I was almost six. I was the prize in that negotiation. I don’t have thyroid issues, but I do have PTSD, mild agoraphobia, anxiety disorder, and so on.

    I now take 100mgs of Doxepin a night. It’s an oldy but goody antidepressant and allows me to dream now and then. I also take Neurontin in a very large dose as a mood stabilizer. I take diazepam for panic attacks and the occasional rage. And miracle of miracles, I’ve been stable for almost five years. Those five years happen to coincide with my mother’s death. And I have been manless durning these past five years. Master of my fate and captain of my own little boat. It’s been so very peaceful. Oh I do have other health problems, but they’re relatively easily treated, compared to bipolar disorder.

    Gina, if you want to talk to me, visit me at Utah Savage. Or maybe Katie will have me back again.

    Katie, Dear Thyroid, thank you for hosting me today. I’ll see you on the twitter.

  7. Linda McClure-Woodham says:

    My bipolar and hypothyroidism overlap. Actually, I believe they have joined forces to make me even more evil and insane. I, too, know of many relatives living in denial of their emotions.

    I’m the crazy animal rights person, former job/bed/husband/hopper, once (or was it twice?) bankrupt cousin, wife, daughter, sister, niece, aunt, mother-in-law and friend (damn few left), who has been in a MENTAL hospital several times.

    I chose to have my Hashi/goitered/noduled little butterfly gland cut out of my throat. It could reduce the chance of lymphoma, the doctor said. Today, it feels like a new thyroid has taken root and sprung up in my neck. I must contact my doctor.

    I am “on vacation” at the beach, but have spent little time at my favorite place on earth. Instead, I have been horizontal for 3 days, trying to understand the swelling of extremities and just wanting to be back in my bed, covers pulled up and sleep away my depression. I will need my strength when the moon again is full and penetrates my closed eyelids, drawing me from my bed and into the world of zombies. No mood stablizer works. I am in the bipolar boat without a life jacket. I will eventually drown in one of the two poles.

  8. UtahSavage says:

    Linda, I’m so sorry and I know it must feel as if no one could possibly understand your pain, but we, who travel from the darkest night to the most garish bright and hungry light do have access to empathy like no others. We also know how difficult life inside our own madness is for us. And we have been told often enough how difficult, embarrassing, and painful it is for those who love us. I have both been driven to and have chosen to live alone. I’ve grown reclusive trying to keep the outside world from triggering my rage or unbearable sorrow. I have one friend who checks on me. She finds me saner than her difficult husband. He’s a man unwilling to entertain the idea that he too is mentally ill. Why must we feel shame that we are people with an illness no different than anyone else with a chronic and incurable illness? You say no mood stabilizer works. There are so many new ones. The one I’m on only works for me with certain antidepressants and was originally a seizure medication found to reduce symptoms in bipolar people with seizure disorders. New drugs are sometimes all that work, but I’m doing well on a very old antidepressant. I stay in close contact with my therapist and my psychiatrist, especially in difficult times. But I’m old and in a special program for bipolar patients over fifty called “The Master’s Program.” It’s a funny name for a bunch of lunatics, but we do gain a sense of mastery over this illness with enough time and curiosity. I spent years reading biographies of famous people with bipolar disorder. We’re an extremely creative bunch. I don’t know you, but I do know you can write expressively. And for me writing about my illness has been a way to understand it. Once on paper I feel it less inside me and more out there where I can see it a bit more clearly. But to be on vacation and depressed is it’s own kind of torture. I hope you can just rest and not punish yourself for feeling what you can not help feeling. And I hope you can get to your doctor soon to get that thing that feels like a new thyroid checked.

    • Linda McClure-Woodham says:

      Utah, I am sure I read your reply to my post, but my memory is just one of the things my illnesses have altered. I’m old, too. 60. I rapid cycle some days; swing so fast it takes my breath away. I have taken myself hostage in my home. Your words describe my life so well. Trying to keep the bad out. Sleep is my secret lover; we have a passionate affair, which my precious, loving husband of 34 years knows about, and does not ask that it be ended. If not for him, and my animal children, I would be just a memory and an urn of ashes.

  9. Gina says:

    i dont deal with my terrible in -law family if i dont have to. my husband and i have been together for qa little over nine years. it wasnt until easter this year thAt he saw the way they really feel about me. the women including his mother turn their backs on me and dont include me in conversation. they dont invite me to their get togethers. i usually end up hanging out with the guys which is okay cause i think the women are bitches, go figure,lol. so once he saw his mommy turn her back on me and ignore me at easter we now dont go over unless i say its okay. he now asks if im up for it. his father is a preacher, enough said. my husband grew up in the church but as far as i know this isnt acceptable behavior in any religion.. his father and i just had a major falling out about a month ago he had the nerve to tell me that im being punished for the sins of my past, this was the day i told him i had cancer. so needless to say we dont really speak anymore. he usually comes and prays with us when im having surgery, i told them i didnt want them there. i told my husband his father is not welcome at my bedside. its really bad. you ask how i deal with them, i dont anymore, they are uneducated in many things that affect me, cancer, mental illness, my relationships, shit even who i am today. i just dont hvae time for stupid people and for me they all fall into that catigory…they have the nerve to gosip about me amongst themselves and then smile to my face. my family is very disfunctional,lol but we are all genuine, sad but true.. i feel for my husband i know this puts him in a tough spot and i try not to push them away too hard because i know it hurts him inside, but he also knows i dont need the negetive energy around me either. my husband and our son and our furbabies are my everything, they are my support as well as you all now..i dont need his family to get through this, ive got what and who i need..

    thanks again, i will look you up. we do have so much in common. im sorry if i seem like a mean person when it comes to his family. when people treat you bad for so long, you know you can only take so much, this lil camel cant take anymore.

    hope you have a wonderful day
    till we meet again.
    gina

  10. HDinOregon says:

    Hello Gina,

    Thank you for writing this letter, and for educating us about bi-polar disorder. It is a devious disease!

    I have a very sad experience with it. Our good friend and dear wife of my cousin, herself a physician in then East-Germany, could not get the help and medication she desperately needed, even after the fall of the Berlin wall. She, her name was also Gina, couldn’t cope anymore, and took her own life. — Why? Oh, why?

    To all (!!) who know of someone with this condition, please, please make them get the best help possible.

    (You can tell I am rather emotional about this topic).

    Gina, – I am so very glad that you have your condition under control.

    {{{{ Hugs }}}}
    HD in Oregon

  11. Bee says:

    Utah S.—This was such a powerful article. It opened my eyes to the suffering bipolar disease can cause. Many of us are ignorant of this disease and tend to let loose with the occasional “Oh, Lord, that bitch must be bi-polar” etc., when we have no business tossing that description so carelessly in their direction. I have been told that I have moments of being hyper verbal. I can suffer from depressive states; but after reading this, I doubt that mine is anything more than hormone imbalance. After reading all of your stories, I’m so proud of every one of you suffering with this illness. You are all facing it and doing what needs to be done to live another day. I’m so thankful those of you who have attempted suicide were unsuccessful.And I’m also thankful you all have been able to get past the ignorant assholes who happened to be part of your family life.Please continue to move forward and help those of us ignorant of the true bipolar manifestations better understand what you live thru daily. Thank you!

  12. Lolly says:

    Hi Peggy,

    Very interesting column and responses.
    Although I don’t have bi-Polar myself I know what it is like for family of mine on my ex’s side my niece was Dx’d at 15yrs old and recently her son at 21..He is still undergoing treatment and hasn’t come to terms with it yet.

    My questions to you is how many bi polar patients have been misdiagnosed as having bi polar when indeed it has been a thyroid diseaase, just like thyroid disease which is an imbalance of hormones Bi-polar is an imbalance of chemicals within the brain. Some of the drugs that are available to treat or control Bi-polar also carry side effectsand can efect the thyroid and render you hyperthyroid, then those symptoms can be like a hyper manic phase. One of the drugs is Lithium and i know my niece was unable to take it because it caused her to have an over active thyroid which didn’t help her one bit.

    She now take an anticonvulsive drug which has kept her stable for some years.

    I also wonder how many thyroid patients have been misdiagnosed because not all doctors look at the thyroid if you present yourself with mood swings manic like behaviour/depression and you see this in some people who have Graves disease or hyperthyroidism. They go untreated until some one has the good sense to check there thyroid and antibodies. It makes me wonder.

    Something you worte here could could be me as you discribe it. I have graves disease and not bi polar I am not in denile i don@t suffer depression altyhough this disase has had me feeling down but not for long, in my hyper phase I could have gopne on and on but my body wouldn;t let me, yet i do have uncontrollable rages at times and even worse in the hight of my hyperthyroid state. so does that make me Bi polar of symptoms of hyperhytoidism if you look at the tow words hypo mamic and hyoer manic both refer to highs and lows the same goes for thyroid disease hyperthyroid and hypothyroid one is full of energy could have psychosis anxiety tremors, sweating, increased appetite with loss of weight… HypoT dry skin,loss of appetite weigth gain depression there is similarities between being bipolar and thyroid but they are certainly two different illness but could also manifest themselves as one with the symptoms.

    This is me but it doesn’t make me bipolar..

    ” Those who mostly swing towards mania are energetic, fun in a breathless sort of way, and productive powerhouses. They are often greatly admired. And they can be mean.”

    Thank you for your column and i hope you donlt mind me expressing my view in a nice way and this is nice for me but before I go I have no intention of fucking my BIL he’s an ugly fucker.:-)

    Lollyxoxox

  13. 5dogsmom says:

    I received an email that has me confused. It came from
    Curtis Pevy and said”…perhaps you are a jerk…..should check for (wrong spelling) narcissistic personality disorder???” I don’t know why someone would write this to me. Anyone know this person?

    At this particular time of my life, being called a jerk is very hard to deal with.
    Linda

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