People with bipolar disorder are prone to experiencing manic or “mixed” episodes. While this is common knowledge, what’s less understood is how these episodes affect your body?

When your mood is in a consistent fluctuation between manic and depressive emotions, your body has a hard time adapting. For example, while you’re in a depressive episode, you’ll experience low energy. On the other hand, if you’re in a manic episode, your energy levels suddenly skyrocket. ¹

It’s important to consider how these variations play a role in your body. If you can identify how your body adjusts to these rampant changes, you may have a better chance of targeting specific symptoms.

Common Physical Symptoms of Bipolar Disorder

Bipolar disorder is diagnosed when medical professionals identify experiences of manic episodes. These are phases of high energy, usually resulting in difficulty sleeping. You may also experience irritability, restlessness, and increased sexual desire.

Medical professionals may also observe depressive episodes. Opposite from manic, these phases make you feel as though you’re lacking energy and need more sleep. You may also feel hopeless and depressed.

Our bodies have a natural reaction to what’s going on inside our brains thanks to the gut-brain connection. ² Bipolar episodes are an easy way to identify some of these changes.

For example, during a depressive episode, you’re more likely to experience changes in your appetite. More specifically, you’ll eat more than normal or less than normal. During manic episodes, your body feels like it has so much energy, you’ll develop symptoms such as shaking.

Before we continue, it’s important to note two things. The first is that our bodies also have a lot of influence on our psychology. A healthy diet and regular exercise can relieve symptoms of bipolar disorder.

Secondly, you may experience both manic and depressive episodes simultaneously. As such, it can be difficult to determine exactly how your body is reacting.

Central Nervous System

The majority of bipolar disorder symptoms play a role in your brain. Due to this, your central nervous system (CNS) is one of the most affected body parts. Your CNS incorporates both your brain and spine and comprises a network of nerves that control various elements of yourself. These include: ³

• Aggressiveness
• Concentration
• Feelings of guilt
• Forgetfulness
• Hopefulness and hopelessness
• Interest in activities
• Irritability
• Moods
• Overactivity and hyperactivity
• Provocative attitudes
• Sadness and depression

Though bipolar disorder can have an effect on many aspects of the CNS, it’s been found to play a strong role in concentration. During manic episodes, you’ll find your mind racing with thoughts out of your control. Or, in a depressive episode, you find your thoughts are slowed down and difficult to formulate.

These effects are within our CNS and it’s the brain’s way of influencing activity throughout the body. A lack of concentration could lead to physical feelings such as restlessness or insomnia.

In turn, your sleep also may be affected due to bipolar disorder’s inhibition of the CNS. This effect varies from person to person. Some claim they have difficulty sleeping while others experience too much sleep. ⁴

You may find it beneficial to practice exercises or mindful habits (such as meditation) that help to ease the CNS. It’s also been found that certain dietary habits can have a positive effect on CNS regulation. ⁵

Cardiovascular System

Many people who experience bipolar disorder often struggle with a form of anxiety. This can include a generalized anxiety disorder (GAD), a paranoid disorder, or a social anxiety disorder (SAD).

Anxiety has strong implications for our whole physical health. Yet, one of the most affected areas is our cardiovascular system. Common effects include: ⁶

• Heart palpitations
• High blood pressure (rare)
• Increased pulse
• Rapid heartbeat

These effects aren’t too much to worry about in the short term. However, if not treated properly, an overstimulated cardiovascular system can lead to: ⁷

• Heart attack
• Heart failure
• Kidney Disease/Failure
• Sexual dysfunction
• Stroke
• Vision loss

If you’re struggling with both anxiety and bipolar disorder, medical professionals need to treat both at the same time. If one mental health condition goes treated while another doesn’t, the untreated illness holds the potential to bring back symptoms of the treated one.

Endocrine System

The endocrine system is your brain’s way of regulating message signals through hormones. Bipolar disorder can disrupt these signals and cause abnormal hormone fluctuations. ⁸

More specifically, bipolar disorder changes a person’s libido. During a manic episode, you may notice your sex drive feels hyperactive. In a depressive episode, you may find that your sex drive is significantly reduced.

Due to these hormonal effects, you may also find your body weight fluctuates. Especially during a depressive episode when you may experience a decrease in appetite and, in turn, a loss in weight. ⁹ Still, some people experience the opposite: an increase in appetite and gain in weight. ¹⁰

Gastrointestinal System

Your gastrointestinal system is important for three main functions: the transportation, digestion, and absorption of food. Due to the anxiety of bipolar disorder, your gastrointestinal system may be harmed by: ¹¹

• Abdominal pain
• Diarrhea
• Nausea
• Vomiting

These effects may occur alongside a panic attack. As a result, you may also begin to sweat and breathe rapidly.

Though there are various medications to help regulate your gastrointestinal system, the best thing you can do is consume healthier foods and drinks. Through healthy dietary practices, we naturally give our body what it needs to function properly.

Skeletal and Muscular System

Bipolar disorder itself doesn’t have a direct effect on your bones or muscles. However, depressive episodes can cause problems with skeletal and muscular maintenance. ¹²

The physical symptoms of depression can appear out of the blue. For example, you may experience pain in various areas of your body even if you didn’t participate in a strenuous activity. Back pain is the most common among people with depression.

These pains can make it difficult to manage daily activities, such as cooking, going to work, or exercising. Not to mention, you may experience more fatigue and oversleep. Extra sleep can then lead to bed sores.

While doctors won’t diagnose depression or bipolar disorder solely on physical symptoms, traditional antidepressants have been found to help some in treating their physical pain.

Other Ways Bipolar Disorder Effects the Body

Beyond what’s been discussed above, bipolar may also cause:

• Drug and alcohol abuse
• Financially splurging
• Unrealistic convictions in your own abilities

Admittedly, many bipolar individuals maintain their personal and professional lives. Therefore, these physical symptoms don’t have a drastic effect. ¹³

However, if your physical symptoms are affecting you or become worse, we highly suggest you consult a mental health professional. When bipolar disorder goes unnoticed, it will continue to damage the brain and body.

References

¹ Bipolar disorder. U.S. Department of Health and Human Services. Available from: https://www.nimh.nih.gov/health/topics/bipolar-disorder

² Littrell J. The mind-body connection: not just a theory anymore. Soc Work Health Care. 2008;46(4):17-37. doi: 10.1300/j010v46n04_02. PMID: 18589562.

³ Thau L, Reddy V, Singh P. Anatomy, Central Nervous System. 2022 Oct 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31194336.

⁴ Harvey AG, Talbot LS, Gershon A. Sleep Disturbance in Bipolar Disorder Across the Lifespan. Clin Psychol (New York). 2009 Jun;16(2):256-277. doi: 10.1111/j.1468-2850.2009.01164.x. PMID: 22493520; PMCID: PMC3321357.

⁵ Gomez-Pinilla F, Gomez AG. The influence of dietary factors in central nervous system plasticity and injury recovery. PM R. 2011 Jun;3(6 Suppl 1):S111-6. doi: 10.1016/j.pmrj.2011.03.001. PMID: 21703566; PMCID: PMC3258094.

⁶ Weiner M, Warren L, Fiedorowicz JG. Cardiovascular morbidity and mortality in bipolar disorder. Ann Clin Psychiatry. 2011 Feb;23(1):40-7. PMID: 21318195; PMCID: PMC3190964.

⁷ Chaudhry R, Miao JH, Rehman A. Physiology, Cardiovascular. 2022 Oct 16. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 29630249.

⁸ Garcia-Rizo C, Kirkpatrick B, Fernandez-Egea E, Oliveira C, Meseguer A, Grande I, Undurraga J, Vieta E, Bernardo M. “Is bipolar disorder an endocrine condition?” Glucose abnormalities in bipolar disorder. Acta Psychiatr Scand. 2014 Jan;129(1):73-4. doi: 10.1111/acps.12194. Epub 2013 Sep 12. PMID: 24024599; PMCID: PMC4390128.

⁹ Daumit GL, Dickerson FB, Wang NY, Dalcin A, Jerome GJ, Anderson CA, Young DR, Frick KD, Yu A, Gennusa JV 3rd, Oefinger M, Crum RM, Charleston J, Casagrande SS, Guallar E, Goldberg RW, Campbell LM, Appel LJ. A behavioral weight-loss intervention in persons with serious mental illness. N Engl J Med. 2013 Apr 25;368(17):1594-602. doi: 10.1056/NEJMoa1214530. Epub 2013 Mar 21. PMID: 23517118; PMCID: PMC3743095.

¹⁰ Goldstein BI, Liu SM, Zivkovic N, Schaffer A, Chien LC, Blanco C. The burden of obesity among adults with bipolar disorder in the United States. Bipolar Disord. 2011 Jun;13(4):387-95. doi: 10.1111/j.1399-5618.2011.00932.x. PMID: 21843278; PMCID: PMC3157038.

¹¹ Mayer EA, Craske M, Naliboff BD. Depression, anxiety, and the gastrointestinal system. J Clin Psychiatry. 2001;62 Suppl 8:28-36; discussion 37. PMID: 12108819.

¹² Failde I, Dueñas M, Agüera-Ortíz L, Cervilla JA, Gonzalez-Pinto A, Mico JA. Factors associated with chronic pain in patients with bipolar depression: a cross-sectional study. BMC Psychiatry. 2013 Apr 15;13:112. doi: 10.1186/1471-244X-13-112. PMID: 23587328; PMCID: PMC3642018.

¹³ Greenwood TA. Positive Traits in the Bipolar Spectrum: The Space between Madness and Genius. Mol Neuropsychiatry. 2017 Feb;2(4):198-212. doi: 10.1159/000452416. Epub 2016 Dec 9. PMID: 28277566; PMCID: PMC5318923.