Guest Voice: Who knew MS and bipolar disorder were connected?

I am a 63-year-old psychologist, clinician, professor, and poster child for multiple sclerosis (MS).

After more than 30 years with the disease, I’m still mobile, sometimes with a cane. My speech isn’t impaired, though my volume is, and my memory is taking a nosedive. I have no working taste buds, no proprioception, and I’m slow as molasses. Painful spasms disrupt my sleep a few times each night. These are common symptoms for many. I have other invisible symptoms, too — some annoying, some problematic — but my worst health issue is rarely discussed.

Bipolar disorder is a concomitant illness that is more prominent in the MS community than the general population. I was diagnosed with bipolar disorder at age 56, and my unpredictable moods began several years earlier. I had already suffered from mild to moderate depression on and off since I was a teen. My dad died from MS, so my fear has been focused on my MS, not my mood.

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What happened?

Psychologist Shara Sand seeks to understand the connection between her bipolar disorder and multiple sclerosis, and hopes for further research in this area. (Courtesy of Shara Sand)

Even after receiving my MS diagnosis and starting on treatment, I suffered a severe mood-related MS exacerbation several years ago. I was on several psychiatric and other medications: two mood stabilizers, an antidepressant with a dollop of valium, and Zanaflex (tizanidine) to manage muscle spasms. I was also on three cardiac medications. It was hard to tease apart whether my symptoms were caused by drug interactions, side effects, mood, or MS.

I careened between irritable rage and suicidal depression. I alienated friends and family. I started to drink heavily to manage my mood and medication side effects. It was unwise desperation that only added to my symptoms of disorientation, cognitive dysfunction, memory lapses, slurred speech, tremors, etc. I fell repeatedly, breaking a wrist and ankle.

I’m a psychologist, and I also have a psychologist, a psychiatrist, and an MS neurologist. No one could identify why I was shifting from agitated and irritable to depressed and morose. Then, another very wise and expensive psychiatrist eventually diagnosed me with bipolar disorder.

What I’m learning and trying

When none of my symptoms were lining up with what I knew of my MS body or my prior depressive episodes, I began researching bipolar disorder and MS to understand why my physical state and mood were different than I’d ever experienced.

Bipolar disorder is seen in approximately 13% of MS patients and 2.8% of the U.S. population. Research suggests a possible connection to inflammation of the gut biome, which has also been linked to MS. Bipolar episodes can cause an MS exacerbation.

Bipolar disorder is the most destructive issue I have, worse than all my other symptoms combined, and treating one condition has often caused exacerbations of the other. Fortunately, I have doctors who listened and didn’t dismiss my research and knowledge. Next, we’re going to try Tegretol (carbamazepine), which should be good for mood and spasms. That would be a two-for-one deal, so fingers crossed.

I hope my story will help others who find themselves riding a mood roller coaster along with MS. Mood disorders and MS deserve more research attention and clinical discussion. Bipolar disorder destroyed my life for several years, but I’m rebuilding it and hoping the next medication will help because there is no emotional wheelchair to help me navigate this.

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