Bipolar Disorder and Pain
As I sit here writing, I’m in a lot of pain. The left side of my low back is throbbing. Often I can ease this pain by popping the back, but this time that hasn’t worked, and neither has Advil. The next step will be to put a prescription pain patch on it.
“Depression hurts,” say the Cymbalta commercials. Yes, it does, and antidepressants that, like Cymbalta, work to make more of the neurotransmitters serotonin and norepinephrine available have also been shown to relieve pain.
My questions arise from my own experience. Although I was formally diagnosed with bipolar relatively late, I see symptoms going clear back to childhood. I began to have chronic pain in my early 20s, first in my neck and head, then crippling pain in my arms that finally moved to my mid and upper back. This was diagnosed, after 9 difficult years, as fibromyalgia. Then later I injured my low back and have had trouble with it ever since, while other areas of my back flare up periodically.
One of the doctors I saw for my unexplained arm pain tested me for nerve sensitivity - the two prong test where you say whether he’s touching you with one needle or two. He said I’d scored the highest he’d ever seen - then said my pain came from hypersensitive nerves and I’d just have to live with it. I think I came as close as I ever have to wanting to die that day.
And besides good chiropractic treatment, the most relief I’ve gotten from pain has come from antidepressants. Elavil, which has the same antidepressive mechanism as Cymbalta, did wonders for fibromyalgia pain, and I only stopped taking it because I gained so much weight on it. And now here’s Cymbalta, an antidepressant that’s also approved for fibromyalgia and some other types of chronic pain.
But studies are finding that while depression makes the perception of pain worse in a patient with fibromyalgia, there doesn’t seem to be a cause-and-effect relationship between depression and pain. This leaves me wondering, though. People with depression often sleep poorly, and in some studies, sleep deprivation has induced fibromyalgia symptoms. I slept terribly for years before developing fibromyalgia. Chicken? Egg?
All I know for sure is that I’m hurting. How many of you who have bipolar disorder also have chronic pain?
Marcia wrote for HealthCentral as a patient expert for Mental Disorders.