Immunology And Bipolar Disorder

The immune system is the body's defense system. It protects the body from outside threats such as bacteria and viruses that cause infections. When the body comes under attack, immune cells such as T-lymphocytes, B-lymphocytes and immune proteins known as immunoglobulins attack the intruding bacteria or virus, hopefully defeating illness before it can become entrenched. Typically, an observed elevation in immune cells and proteins is an indication that the body is fighting an infection. Several studies have described abnormal fluctuations in the immune system which vary according to the state of bipolar illness. For example, T- and B-lymphocytes, IgG (immunoglobulin G), and IgM (immunoglobulin M) are increased in bipolar patients. This observation would lead to the conclusion that the bodies of individuals with bipolar disorder are fighting an infection. But it is unclear whether these findings are the cause or result of natural body responses to mood peaks and troughs or the use of medications. In addition to measuring immune system components in the study of bipolar disorders, infections have also been investigated for their contribution to bipolar symptoms.

A simple infection by bacteria or viruses, a retroviral infection, or immune dysfunction can precipitate bipolar illnesses. Several varieties of brain infection have been known to cause either manic or depressed states. Bacterial infections such as syphilis and Lyme disease have neurological manifestations that can cause bipolar-like symptoms. At the same time, viral infections such as Epstein - Barr virus (EBV) and Herpes Simplex Virus (HSV) have been associated with bipolar disorder.

In the case of EBV, researchers have not been able to confirm that infection is a necessary step in developing bipolar depression. However, case studies documenting patients who had no history of bipolar disorder prior to EBV infection leads some researchers to continue considering EBV infection as a possible causal pathway.

While there is a definite connection between HSV infection and reduced cognitive functioning in bipolar individuals, there is no solid evidence suggesting that HSV infection caused bipolar disorder to occur. It is known that lithium, the primary medical treatment for bipolar disorders, inhibits the growth of HSV in laboratory situations, but exactly how this inhibitory role might function with regard to bipolar disorder is not known.

It is possible that neither EBV nor HSV themselves cause bipolar symptoms, but rather initiate a dysregulation of particular brain and body systems that ultimately lead to mood disorder onset. There are some researchers who believe that HIV (the virus that causes AIDS) may cause bipolar disorder, but it unknown whether manic-depressive behavior observed in AIDS cases is a result of the psychological impact of having a serious disease such as AIDS or if the disease itself causes the behavior.

A retrovirus is a special kind of virus, which causes infection by inserting its own DNA into the genes of its host. By altering the body's basic genetic machinery, a retrovirus can have a disproportionately large impact on the host's body. For example, HIV is a retrovirus which causes numerous symptoms across multiple body systems. If a retrovirus inserts itself into the genes in the ovary (egg) or testicles (sperm), it is conceivable that this virus can then be passed down from generation to generation. Thus, a person could have been infected by a bipolar-causing retrovirus in the late 1800's and passed it down to all of their children, grandchildren, etc. A specific retrovirus has not been identified in conjunction with bipolar disease, but more genetic studies may reveal that a retrovirus resides on one or many of the chromosomes thought to be involved in bipolar disorder. The pieces of the bipolar and infectious agent puzzle are not yet complete and further research is necessary to clarify this aspect of bipolar disease.

Another aspect of the immune system that is involved in bipolar disorders is that of autoimmunity. Autoimmune diseases result when the immune system becomes confused and can no longer distinguish between the body's own tissues and those which belong to an outside threat. As a consequence of this immune confusion, the body starts attacking itself. For example, in rheumatoid arthritis, the immune system attacks the joints, causing a disabling and painful inflammatory condition. The disease leads to destruction of the joints as well as systemic tissues throughout the body including the skin, blood vessels, heart, lungs, and muscles. Although currently there is no evidence linking bipolar disorders directly to an autoimmune condition, autoimmunity against the thyroid gland is well established. Graves' disease is the most common form of hyperthyroidism. It is caused when the body produces antibodies against the thyroid that have the effect of stimulating the thyroid into overproduction of thyroid hormone. In Ord's thyroiditis and Hashimoto's disease, a variety of antibodies against the thyroid gland cause hypothyroidism. Given that mood changes are associated with thyroid hormone imbalances, it is conceivable that thyroid autoimmunity is connected to bipolar disorders. However, as is the case with infectious diseases, there is no clear evidence that autoimmunity is necessarily involved in bipolar disorders. This new area of research will be interesting to monitor in the coming years.

Comments
  • Rachel

    If Bipolar Disorder is so common, why can't doctors provide a cure to give pregnant mothers to help their unborn babies come out into the world as happy little clams? Some children are born like that, some aren't.

  • Anonymous-1

    I think a thyroid disorder such as Hashimoto's Disease may actually be accountable for many misdiagnosed cases of Bipolar Disorder as Hashimoto's alternates from Hyperthyroid to Hypothyroid very frequently individuals such as myself. All people diagnosed Bipolar should be screened for Thyroid Antibodies to further understand the difference of cause of these of two Disorders. Autoimmunity is the key.

  • Bill

    I've had two rapid cycling manic events and both were preceded by strep throat. after the second one, mentioned it to my doctor who didn't make much of it. today 6 years later my symptoms only return in the fall and after studying PANDAS, sydenhams chorea, Rheumatic fever, epilepsy (TLE) in particluar, adhd, autism, aspergers, schizophrenia, Learning disabilities, OCD etc, I have come to believe they are autoimmune related. Age of onset being the key. there are links to rheumatic fever in them all, which some research pointing to essential proteins. One of my children has adhd which onset in 1st grade & was preced by strep. I'm suffering more adhd than bipolar. I changed my diet to incorporate higher various proteins, root foods, fungii, & I improved. These problems are not genetic as they are acquired autoimmune. Does this helpnet have studies on diseases that destroy the 'landing pads' of 'transmitted' messages? Its like autoimmunity is trying get nutrients already installed in the body. Disregulating almost every system. I would also like to say that after my first episode, i had never gotten more sick with seasonal allergies strep pnuemonia, skin problems etc. thanksfully I am much better today, I used antisizure medicines that worked very well, no lithium.

  • Patty

    I would like to be consider for the research updates of 2009. Hashimoto's 3/2009. Bipolar 1993. Noticed many minicing symptoms between the two. I could reduce medication and energy levels improved within 6 months of thyroid medications.

  • Christine

    Very interesting article

    I got my first cold sore probably by the age 10, I get at least one every year. I had mononucleous when I was 12, I remember clearly since I missed school for nearly a month. I was first diagnosed as bipolar 1 by the age of 16 and many times since then. I am now in my early 30's and for the last year they have been attempting to figure out what is wrong with me..tons of nerve pain and losing speech from weak vocal cords. The onset of symptoms started with a cold sore. Now, 8 months later with another cold sore, hives, blisters and my voice once again being lost they tell me it is probably HSV1 causing it. The question I am left with is why is my immune system not working anymore. This article sounds like something I would be interested in, my email is linked if you ever want someone.

  • Christine

    I was also diagnosed with hashimoto's in my late 20's. I have read about the connection between siblings wtih bipolar and schizophrenia..my brother is schizphrenic and our parents are still alive for any possible genetic testing. Thought I would add that :)

  • Maria Bastos

    I have spoken to a therapist specialized in Magnetism, she says she is treating successfully Bipolar condition, as a virus that infects producing Bipolarity. She claims that this illness can be cured with magnetism. she also said how related are the virus, ADD, HDAD and Bipolarity.

    This is great news.

    Dr. Dombeck's Note: I would treat this therapist's claim with *great caution* and suspicion as it may be a faulty claim. In general, no therapist's claim of treatment efficacy for a particular intervention should be trusted unless they are able to point to evidence of some reliable sort that shows that the intervention has been studied by reputable researchers and that there is data that supports the intervention. This is a high bar to meet and not all useful interventions can meet it, but it is nevertheless the bar to shoot for when evaluating treatment efficacy.

  • may

    My son has bipolar disorder, and he had many systemic strep infections as a kid, as well as rheumatism caused by strep. His strep was never just relegated to a strep throat: his infections were always systemic or in his bones before discovered. And he has always gotten hives that we cannot attribute a cause to. His psychiatrist says that her bipolar patients often have a similar medical history.

  • rhonda nickerson

    I am on such a roller coaster ride! I have bi-polar, and my son 9 also, his manic episodes happen when his strep level is high, which also puts him in the P.A.N.D.A.S. classification, and I am so confused about all of this its making me nuts! I am trying to research my family history, to see if there is anything like this, I know that my grandfather, mother, sister, me, uncle, and 3 of my kids have bipolar, where is the other coming from?

  • trish

    My dad died 4 months ago with a autoimmune disease and he was a disabled veteran and had bipolar, was wondering if this disease is what caused him to get the autoimmune disease?

  • Katie

    I was diagnosed with Bipolar when I was 19, however I've had autoimmune problems pretty much my whole life. I used to get horrible rashes on my legs when we went swimming. Then my periods were too frequent and irregular. My symptoms got much worse after having a baby. The fatigue, depression, anxiety, and lack of sleep have been unbearable at times. I'm thinking I may have

    an autoimmune thyroid disorder, but am not so sure about the Bipolar. The symptoms are very similar. I've found that iodine and kelp make my symptoms worse, but zinc and less wheat noodles seem to help quite a bit. I'm getting better sleep and my rashes are gone--yeah! I hope that helps. Best wishes with your problems!

  • Adrian

    Just to help anyone in the same situation really. I've had HIV for 12years, since I was 22. My use of anti retroviral drugs for the past five years and maybe the virus itself has caused me so many mood changes and I now recognise that there is a link. I used to be so happy, and although I've learned to live with my condition, I definitely suffer from rapid changes in my moods.

    I don't feel suicidal per se, but I get easily annoyed with things such as bad customer service or bad performance from my employees. I have a lower threshold on my tolerance than I used to, and have become very outspoken in regards to anything I deem to be an injustice.