Q:  Mitochondrial Diseases & Bipolar Disorder

Hello, 

I am a 51yr old who has ultra rapid cycling bipolar. I have been extremely ill most of my life and a muscle biopsy reveled red staining which would indicate mitochondrial disease. I have never had a regular job since extreme confusion has always been a problem for me. I am on a typical bipolar mix of meds which does not include lithium. We live in rural B.C. and the last time I saw a psychiatrist was about two years ago when I ended up in the hospital for a week. There does not seem to be a doctor in our area who understands my condition which is both very physical and mental. 

Do you have any suggestions on how I might be able to get better help for this horrible condition. 

Sincerely,
Irene

Dear Irene --

There are numerous mitochondrial diseases. So I'm not sure exactly what you're dealing with.  But frankly, it probably does not make much difference, as follows. 

I have one patient in my practice who also apparently has a relatively rare mitochondrial problem.  In treating her, and looking around in the psychiatric literature for guidance, I have discovered that there is basically no research to guide us.  So we end up treating the symptoms just as we would if the mitochondrial problem was not there. Then we try to figure out how to adjust treatment as needed to get a better response -- not knowing if the difficulties we are working around are coming from the mitochondrial problem or elsewhere.

Mind you, a connection between mitochondrial diseases and bipolar disorder has been clearly established.  I just had another look at a literature search on pub med, entering mitochondrion bipolar. In the last year, there have been several more articles published on this topic. But none of them specify how to adjust treatment accordingly. 

Sorry not to be of more help here.
 

Dr. Phelps




Published July, 2008