Bipolar disorder appears to be more common in people with multiple sclerosis (MS) than in the general population.
MS is an autoimmune condition that affects the brain and spinal cord, damaging nerves and leading to a wide range of symptoms.
Although depression is common in MS, bipolar disorder is less studied. Some research suggests that people with MS may have a higher risk of bipolar disorder, though the exact reasons remain unclear.
Read on to learn what the research says about bipolar disorder in MS, including what might be driving the link.
Research suggests a possible link between MS and bipolar disorder, with people who have MS being at higher risk of developing bipolar disorder.
According to the
An analysis of 23 studies involving 68,796 people with MS found that:
- Almost 3% of the participants with MS had bipolar disorder at the time of the study.
- The lifetime risk of developing bipolar disorder in those with MS was 8.4%, meaning they may develop it at some point.
- Bipolar disorder was slightly more common in women (7%) than in men (5.6%), but the difference wasn’t significant.
- Bipolar disorder was more common in the Americas than in Europe.
One study looked at how brain changes might be linked to bipolar disorder in people with MS. The researchers used brain scans to compare 61 individuals with MS — 15 with bipolar disorder and 46 without. They found no major differences in overall brain size, white matter, or outer gray matter.
However, the participants with bipolar disorder showed small differences in brain areas that help control emotions and motivation.
More research with larger groups is needed to better understand these connections.
The exact cause of MS is unknown, but several factors may contribute to its development:
- Immune system dysfunction: The immune system mistakenly attacks the protective covering of nerves (myelin), leading to nerve damage.
- Genetics: Having a family history of MS may increase your risk.
- Infections: Researchers have linked certain viruses, like the Epstein-Barr virus, to a higher risk of MS.
- Environmental factors: Low vitamin D levels and a lack of sunlight exposure may play a role.
- Smoking: Smoking seems to be associated with an increased risk of developing MS and faster disease progression.
- Geography: MS is more common in regions farther from the equator, possibly due to differences in sunlight exposure and vitamin D levels.
Although there is no cure for MS, some treatments can slow disease progression and help manage the symptoms.
Disease-modifying therapies
These medications reduce the frequency and severity of relapses and slow MS progression. They are most effective for relapsing forms of MS.
Examples include:
- injectables, such as interferon beta-1a (Avonex) and glatiramer acetate (Copaxone)
- oral medications, such as fingolimod (Gilenya), siponimod (Mayzent), and dimethyl fumarate (Tecfidera)
- intravenous infusions, such as natalizumab (Tysabri), ocrelizumab (Ocrevus), and alemtuzumab (Lemtrada)
Symptom management
A healthcare professional may also recommend treatments to help manage specific symptoms, such as:
- Muscle spasms and stiffness: Medications like baclofen (Lioresal) and tizanidine (Zanaflex), as well as physical therapy, may help manage spasticity.
- Fatigue: Medications like amantadine (Gocovri) can help, as can certain lifestyle changes, such as regular exercise and energy conservation strategies.
- Pain and nerve issues: Medications like gabapentin (Neurontin) and pregabalin (Lyrica), as well as physical therapy, may help with nerve pain.
- Mobility issues: Physical therapy, assistive devices — like canes and walkers — and occupational therapy can help improve movement.
Managing mood changes
Mood changes like depression, anxiety, and mood shifts are common in MS due to nerve damage, immune system activity, and the stress of living with a chronic condition. High dose steroids, which doctors often prescribe to treat MS relapses, can also trigger mood changes.
The following treatments can help manage mood changes:
- Antidepressants and mood stabilizers: Medications such as selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors can help with depression and anxiety.
- Cognitive behavioral therapy (CBT): CBT is a type of talk therapy that helps people cope with stress and emotional changes.
- Exercise and mindfulness: Activities like yoga, meditation, and deep breathing exercises can improve mental well-being.
- Support groups and counseling: Connecting with others who have MS can provide emotional support and coping strategies.
If you have MS and think you might have bipolar disorder, it’s important to talk with a doctor as soon as possible.
Symptoms to watch for include:
- mood changes
- periods of high energy or restlessness
- difficulty sleeping
- feeling unusually sad or hopeless
You might also notice changes in motivation or decision making that seem out of character.
Mood changes in MS can result from the condition, medications, or other factors. A doctor can help you understand what’s happening and find the best treatment to manage your symptoms and improve your quality of life.
The following are answers to some frequently asked questions about MS and bipolar disorder.
Research suggests a possible link between bipolar disorder and MS, with people who have MS being at higher risk of developing BD.
People with MS may be more likely to develop mental health conditions such as depression, anxiety, and bipolar disorder.
Research suggests a possible link between MS and bipolar disorder, though researchers don’t fully understand why.
Mood changes in MS can have many causes, including the condition itself and its treatments. Getting the right diagnosis is key to finding the best treatment and improving your quality of life.