Bipolar symptoms from a medical condition

What it is

Occasionally, manic or depressive states are the direct physiological result of another medical condition. An overactive thyroid can mimic mania; stroke, multiple sclerosis, traumatic brain injury, certain brain tumours and some infections can all produce mood disturbances that resemble bipolar episodes. This is why a first presentation of mania, particularly later in life or with physical symptoms, warrants medical assessment.

Identifying a medical cause reframes the whole situation: the priority becomes diagnosing and treating the underlying illness, which may resolve the mood symptoms entirely.

How it is treated

The first step is treating the medical cause: correcting the thyroid, managing the neurological condition, treating the infection. Medication to stabilise mood or manage acute symptoms may be used alongside while the underlying treatment takes effect, guided by the specific medical situation.

As with psychosis from a medical condition, this category underlines how inseparable physical and mental health are, and why mental health belongs within general medical care. A new manic or depressive state is not only a psychiatric question; it is a whole-body one.

Mood symptoms from a medical condition in the African context

This matters here for a practical reason: some of the medical conditions that can produce manic or depressive states, including HIV, infections affecting the brain, thyroid problems, and the effects of brain injury, are present across the region, and a sudden change in mood or behaviour, especially a first episode later in life or alongside physical symptoms, is often understood first as bewitchment or a spiritual event rather than assessed medically. The safe and useful approach is the same as elsewhere in good medicine: treat a new manic or severe mood state as a whole-body question, look for and treat any medical cause, and remember that finding one may resolve the mood symptoms. Mental and physical care belong together, not in separate worlds.

What families can do

• Treat a new manic or severe depressive state, especially with physical symptoms or a first onset later in life, as a reason for prompt medical assessment, not only a psychiatric or spiritual one.
• Mention all physical symptoms, illnesses, and medicines to the clinician, since these help find a medical cause.
• Support treatment of any underlying condition that is found, alongside any mood treatment.
• Keep the person safe during an acute episode, and seek urgent help where needed.
• Spiritual support can continue alongside, but should not replace medical assessment.