Mother and Caregiver: The Diagnosis
The Diagnosis
My daughter has been hospitalized at least 15 + times over the past 4 years. My
husband and I have been the ones to bring her there 90% of the time. She has called an
ambulance on a few occasions and her older daughter has taken her a few times.
The following is a brief description of the disease of lupus and bipolar disorder my
daughter was trying to live with. The combination of these 2 illnesses makes it even
harder to establish a chemical balance through medication in the body.
Lupus & Bipolar Disorder
Is There a Relationship?
By Kimberly Read & Marcia Purse, About.com Guide
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
Systemic lupus erythematosus (aka Lupus and SLE) is an autoimmune disorder that can cause chronic disease throughout the human body. The exact mechanism which causes the disease is unknown, but as the immune system turns against its own body, all of the major organs such as the heart, lungs, and kidneys are affected. The musculoskeletal, circulatory, integumentary and nervous systems also develop dysfunction. (A.D.A.M. offers more information about this disease.)
It is the problems caused in the nervous system that lead to the question of a link between lupus and bipolar disorder. Dr. John Hanly (2004) writes, “Involvement of the nervous system by systemic lupus erythematosus is one of the most profound manifestations of the disease and encompasses a wide variety of neurologic and psychiatric features.” Of the array of neurologic features, it is the diffuse symptoms in the central nervous system that most closely resemble bipolar disorder:
Anxiety
Cognitive Dysfunction
Mood Disorder
Psychosis
A study of neuropsychiatric syndromes in lupus by Brey et al (2002) found that 40% of their participants struggled with mood disorder and another study found an incidence as high as 57% (Sibbit et al, 2002). However, these symptoms, which parallel those of bipolar disorder and may be treated with the same medications, actually do not indicate a diagnosis of bipolar disorder in and of itself. In other words, there is currently no empirical research to support that bipolar disorder is specifically caused by SLE. These two differing disorders simply have an overlap of symptoms.
Perantie and Brown (2002) write, “The role of the immune system in psychiatric symptoms has been an area of much interest for years … Medical illnesses including HIV infection, systemic lupus erythematosus, and Cushing’s disease are all associated with psychiatric symptoms. In addition, high dosages of prescription corticosteroids (ef, prednisone and dexamethasone) are associated with mood changes, cognitive deficits, and even psychosis. However, the role of the immune system in mediating the psychiatric disturbances with each of these conditions is not clear.”
Posted February 14, 2006
References
Brey, R.L., Holliday, S.L., Saklad, A.R. et al. (2002). Neuropsychiatric syndromes in lupus: Prevalence using standardized definitions. Neurology, 58, 1214-1220.
Hanly, J.G. (2004). ACR classification criteria for systemic lupus erythematosus: limitations and revisions to neuropsychiatric variables. Lupus, 13, 861-864.
Perantie, B.S. & Brown, E.S. (2002). Corticosteroids, immune suppression, and psychosis. Current Psychiatry Reports, 4, 171-176.
Sibbitt, W.L. Jr., Brandt, J.R., Johnson, C.R. et al. The incidence and prevalence of neuropsychiatric syndromes in pediatric onset systemic lupus erythematosus. Journal Rheumatol, 29, 1536-1542.
Understanding the illness above and the emotional roller coaster she was living
with her only defense was to try to escape.
