Migraine with Co-Morbid Bipolar: A New Subtype?
We’ve known about the link between migraine disease and bipolar disorder for some time. Now, however, the unique experience of the two conditions together is causing some researchers to argue that it calls for a new subtype on the bipolar spectrum: bipolar with co-morbid migraine.
This special recognition may seem strange to the layperson. Much has been written, after all, about the comorbidity of migraine disease and bipolar disorder, as well as their common characteristics: the exacerbating nature of stress on each, the family history and genetic component of both, and their cyclical and episodic natures. A distinct subtype, then, may seem unnecessary.
Studies show, however, that the 25% of bipolar patients who also have migraine disease experience a unique set of bipolar symptoms compared to those without migraine. Researchers further suggest that a full understanding of this special set of symptoms may lead to better outcomes for those with both illnesses. In particular, bipolar patients with co-morbid migraine tend to have:
- onset of bipolar symptoms at an earlier age
- higher rates of attempted suicide
- higher rates of co-morbid anxiety and panic disorders
- and much higher instances of rapid cycling.
These unique features can all affect the patient’s overall quality of life and treatment outcomes, but perhaps none more than the last symptom. Rapid cycling is a term mental health professionals use to describe bipolar disorder that quickly switches from mania or hypomania to depression or a mixed state (a state in which both manic and depressive symptoms are present). In general, a person must have at least four separate episodes of symptoms within one year to be diagnosed with a rapid cycling subtype. Some individuals, however, experience distinct episodes far more frequently, and it is this extreme instability of mood that often has the greatest effect on quality of life.
If you are one of the many people managing both bipolar disorder and migraine disease, you’re quite likely also experiencing high levels of anxiety. Your symptoms and mood may fluctuate rapidly, and research suggests it may be especially difficult to find medications that treat one set of symptoms without aggravating another or interacting poorly with other medications. If this is you, please know you’re not alone.
Approximately one in four people with bipolar disorder also has migraine disease. If you are one of the 25%, please be compassionate with yourself; you are doing the best you can each day to live well with a unique and complicated set of symptoms. Making an effort to educate yourself equally on each of the disorders or diseases you have may help you understand how each illness influences the other, in you specifically. This knowledge can then be shared with all of your doctors. After all, according to the research, the best way to treat each illness is to do it holistically.
For more information on bipolar or anxiety disorders as they relate to migraine, consider reading:
Migraine Comorbidity: Overview
How much has your migraine disease changed or evolved over time?