Bipolar disorder is a mental illness in which individuals suffer the emotional pain of severe depression and manic episodes. Research has revealed that those who suffer from bipolar disorder are also more likely to experience types of chronic, physical pain. Physical pain by itself is often a symptom of anxiety and depression. Muscle aches, chest pain, gastrointestinal cramping and other types of pain can coincide with bipolar disorder. Aside from the emotional trauma of depression and mania, these symptoms can add to the burden, especially because they are often resistant to traditional pain treatment methods.

Fibromyalgia is characterized by chronic musculoskeletal pain and occurs in approximately 5% of the population. Those with fibromyalgia experience dull muscle aches all over the body and often suffer from memory and mood issues. A reason mood issues may accompany fibromyalgia is because 25% of people with fibromyalgia also have concurrent bipolar disorder.

Treating those who have fibromyalgia and co-occurring bipolar disorder can be complicated because selective serotonin reuptake inhibitors (SSRIs), which are often used to treat fibromyalgia, can actually induce manic symptoms in those with bipolar disorder. 

Further, osteoarthritis and rheumatoid arthritis are linked to bipolar disorder. Arthritis results in sever swelling, stiffness, and in some cases bone loss or bone spurs. Rheumatoid arthritis is an autoimmune disease that occurs in about 1% of the population, and osteoarthritis occurs in about 14% of people over 25 and 34% of people over 65.

Studies have shown that people with rheumatoid arthritis are more than twice as likely to have concurrent bipolar disorder than the general public. Further one study revealed that those with osteoarthritis are three times as likely to have bipolar disorder. Researchers theorize that perhaps the inflammation that occurs in arthritis is linked to or exacerbates bipolar disorder. Inflammation can cause increases in serotonin and dopamine, which can in turn trigger mood episodes or psychosis in bipolar disorder.

Lastly, migraines are also associated with bipolar disorder. Migraines, which effect roughly 16% of the general population, are severe headaches that are usually accompanied by dizziness, nausea, and visual changes. When looking at bipolar disorder patients, 25% also suffer from migraines. Certain medications, such as Depakote, have been shown to treat both mood and migraines, although bipolar disorder must be considered the primary illness.

Chronic pain is difficult to deal with even when a person is otherwise healthy, so adding pain to a debilitating illness like bipolar disorder can be ever more troublesome to deal with and to treat. The relationship between bipolar disorder and chronic pain appears to be symbiotic, wherein one perpetuates the other. Thus, mental health professionals treating bipolar patients should assess for chronic pain and consider its role in treatment and recovery.