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I am a 29 year old woman diagnosed with bipolar disorder type 1 and also suffer from general anxiety and panic attacks. I have only been recently diagnosed but have been ill since I was a teenager. I tend to have mixed-manic episodes, hence the name of my blog. I am a regular guest blogger for Black Dog Tribe. I am not a mental health professional. I am just writing from my own experiences with mental illness. If you wish to use any of my blog content please contact me at lababup@gmail.com. Visit me on twitter @lababup

Tuesday, 4 March 2014

Physical symtoms and their mental causes

It’s a strange thing mental health. Sometimes you don’t even realise you have a mental health condition because it only shows up in physical signs. A family member for instance had no idea that he was suffering from a stress induced depression. He went to the doctor with a list of symptoms including aches and pain, insomnia, cramps and nausea. The doctor looked at all his symptoms and told him it was a classic case of stress. I don’t think he fully believed the doctor at the time. Another example of this comes from my friend @blackdogrunner who has written about ‘warning signs’ i.e.  all the physical manifestations of his depression at blackdogrunner.wordpress.com. It is often hard to believe that a mental condition can cause so many physical symptoms.

When I am anxious all sorts of things start to go wrong with my body. My breathing goes all short, my chest tight, nausea hits me, I feel exhausted and my body aches. Sometimes I feel dizzy when I stand up and my legs feel all wobbly. With the bipolar my body is also affected in a number of ways. When I am depressed I get some of these anxiety symptoms along with an extreme feeling of tiredness and like my body is really heavy. When I am manic sometimes my legs can just feel like they need to be shaken out or something. I feel like I need to pace around and move them to stop the burning sensation that creeps up them. I can feel my chest flutter and I feel all wired up and ready to go. I sleep less, eat less and generally feel a bit wired. 

Although in some ways it is comforting to know that your physical symptoms don’t mean that you are about to suffer an untimely death, there are some downfalls too. First of all, people don’t take your physical symptoms seriously if they know they have a mental cause. Of course this is ridiculous as it doesn’t matter what has caused the symptoms, the symptoms are still real physical problems. In fact, the mental illness itself is a real physical thing too.

Another problem is that if you know your symptoms have a mental cause it can mean you feel helpless to do anything about them. There is no obvious fix. With a bacterial infection you take an antibiotic. With a muscle problem you may undergo physiotherapy. However, with mental health things are a bit more complicated. You can have so many physical symptoms it is hard to know where to begin. You can take medications or therapy to try to get to the underlying mental problem. However, you don’t know what treatment will work for you or if they will alleviate all your physical symptoms.

Why I am writing this post today is because I have been suffering from some physical problems which I had put down to my mental health issues. The problem is that because you know your mental illness causes lots of physical symptoms, you may have difficulty picking out the ones that actually have nothing to do with mental illness. I had been waking up at night not breathing and having to gasp in air. It was a terrifying experience that has repeated itself since. My family and two doctors I had contact with immediately said it was just anxiety. But this made no sense as I had not been particularly anxious and I had never had this symptom before. Finally the doctor today confirmed what I had thought: that it was probably obstructive sleep apnea which is a treatable condition.

I think there are two main points I want to make. The first is that you shouldn’t worry too much about lots of physical symptoms that you experience as part of your mental health condition. Look up the symptoms of anxiety and depression and be aware of which ones you may be likely to have. However, the second point I want to make is that if you do have a symptom that seems unusual or worries you it is better to be safe than sorry and visit your GP. They may try and put it down to stress but they should never dismiss you straight away. They should always be prepared to get a problem checked out. It is too easy for a doctor to see in your medical records that you have a mental health problem and put everything down to that. You must fight your corner and get them to check it out. It is better to be safe and to ease your mind. This in itself will reduce your anxiety.


  1. It's not only doctors who ascribe physical symptoms to stress or mental illness. I've been bipolar for most of my life, since diagnosis in my late teens after tests to rule out physical causes, including thyroid disease. Undiagnosed and untreated thyroid illness can cause severe depression, psychosis and has led to suicide.

    Nevertheless, I managed to misread signs and symptoms and failed to seek help for at least 10 months, assuming my distressing and debilitating symptoms and 13kg weight loss were due to stress following 2 bereavements and a serious car accident and were, therefore, bipolar related. You think I'd have realised that collapsing in the street with exhaustion and shortness of breath wasn't typically bipolar but I didn't.

    As soon as the lump appeared in my neck I presented at the GP's. I was diagnosed with autoimmune thyroiditis (Hashimoto's). Five months later I had surgery to remove a large nodule compressing my windpipe and causing the breathlessness I put down to anxiety.

    Histology showed the tumour was Hurthle cell carcinoma and surgery was scheduled 3 months later to remove the remaining thyroid lobe. I was lucky, the cancer hadn't spread and prognosis is good if recurrence doesn't occur in the first five years.

    The moral of the story is that having one chronic illness doesn't preclude one from having another.

    1. Thanks for your comment! It just goes to show how confusing physical symptoms can be when you have a mental illness like bipolar. You end up putting everything down to that and ignoring what most people would see as obvious signs that they are physically unwell.

      Collapsing in the street from exhaustion and not being able to breathe would have been horrible. I can imagine if that happened to me I would put it down to anxiety and bipolar too (just as I do with everything pretty much). I am sorry to hear you have had such a bad time of things both mentally and physically. It is really great that you finally got the right diagnosis and treatment.

      Having one illness does not preclude you from having another and so hopefully myself and others will remember that next time. Thanks for sharing your story.

  2. I think it's very common to ascribe physical and mental symptoms to your 'owned' illness. I'm seeing it all the time on thyroid support forums. It's particularly difficult when there are so many cross-over symptoms.

    I hope your bipolar will stabilise and episodes become less frequent. Mine has over the years although the thyroid fuss unsettled the bipolar and caused that to fuss a bit too.

  3. I had a thyroid blood test and they said it was borderline. Bipolar and thyroid problems seem to happen together a lot.

    I hope the bipolar stablises too. Right now it is constant up and downs! Just trying riding the wave at the moment and hope I don't get pulled under.