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Arthritis and Bipolar Disorder

Nanette Oiboh

Feb. 14, 2020

Studies reveal that people with rheumatoid arthritis are at a greater risk of developing bipolar disorder than the general population.
Specifics vary across studies, as does conjecture about the cause, but an analysis of several research filings state that people with RA are nearly 3 times more likely to have bipolar disorder.
Many researchers surmise that inflammation is the cause. RA is an autoimmune disorder, and neurologists are beginning to believe that even BP may be an autoimmune disease .
At 56 I’m at an age where everything suddenly hurts, especially my joints.  As this pain has spread to my hands and my knuckles have disfigured it’s time to get checked out for arthritis.  I mean, I already have osteoporosis, which may be a result of my bipolar disorder or long-term use of anticonvulsants.  Why not RA, too (then there’s always hypochondria, which I wrote about here )?
Some of the data is contradictory.  One study states that the average person with BP and RA is a 41-year old woman.  Another only finds a relationship between the diseases in people under 19 and over 75.  But a meta-analysis of a number of studies implies that the co-morbidity holds across populations, and the most common clinical features that co-occur with RA are psychiatric.
It’s easy to point to stress as the common factor between the conditions, or even an inflammatory diet.  But there may be a smoking gun lurking behind the data and the results.
That smoking gun is smoking.
It’s well established that smoking is a contributing factor to RA.  And any trip to a psych ward or the patio around the entrance of a building where a support group is meeting will quickly show that many people with bipolar disorder smoke.  68.8% of people with bipolar disorder currently smoke, and 82.5% of people with BP have smoked at some point during their lives.  Of those who currently smoke, the average number of cigarettes smoked per day is 30.
So when it comes to the co-morbidity between BP and RA, maybe it’s not the BP at all.  Maybe the true culprit is heavy smoking.
Medical research is hard, and drawing distinctions between correlation and causation is even harder .  Just because diseases seem to occur together in lots of people doesn’t mean that one causes the other.
The best way we can mitigate co-morbidity is to live as healthy a life as we  can.
If you want to prevent or manage RA, you can’t decide to not have BP.  But you can manage stress, eat an anti-inflammatory diet and, above all else, stop smoking.
BP is difficult enough.  We don’t have to make it more difficult to live with by making choices, like smoking, that invite other health problems into our lives.
Arthritis and Bipolar Disorder
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