Guest Voice: When Parkinson’s disease and bipolar disorder collide
Unfortunately, not only do the two disorders clash, but the treatments do, too
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Editor’s note: This column includes discussion of suicide. If you or someone you know needs help, the national suicide and crisis lifeline in the U.S. is available by calling or texting 988. There is also an online chat at 988lifeline.org. Internationally, find a suicide prevention helpline at findahelpline.com.
Also, this column describes the author’s own experiences with Trintellix (vortioxetine). Not everyone will have the same response to treatment. Consult your doctor before starting or stopping a therapy.
When you have Parkinson’s disease, life is hard, but when you also have other preexisting conditions like I do, it becomes even more complicated.
In my case, this neurological disease arrived in 2021, after I’d already lived many years with bipolar disorder. I experienced the early symptoms of the mental illness at the age of 19, in 1990, and I was diagnosed in 2008. But, aside from short-term sessions of psychotherapy at a local mental healthcare center, I’d never tried to treat it seriously.
I lived my entire youth with mood swings, torn apart by a vicious cycle of hypomania and depression. However, in 2023, with my Parkinson’s diagnosis, I was forced to seriously address my hypomanic bipolar disorder. Until then, neither the doctors nor I had considered that the two ailments were colliding.
Bipolar disorder and Parkinson’s disease are, in fact, two very different disorders that require opposite therapies. And, unfortunately, not only do the two disorders collide, but the treatments do, too, as they can exacerbate the respective symptoms.
I was brutally overwhelmed by this collision. Initially, I endured the fear and doubts of clinicians who should have been working to cure me. Both psychiatrists and neurologists looked at me as a “cold case.”
I still remember their scared gazes and words: “Oh, my God! You are a patient with Parkinson’s and bipolar disorder. Your two diseases can’t be treated effectively at the same time.” This is the least of how I was received in the early stages of my Parkinson’s diagnosis.
The worst was when psychiatrists clearly stated that they were unable to take care of my bipolar condition because I had Parkinson’s. Someone even told me on the phone that they preferred not to treat patients like me. I felt rejected, dejected, and abandoned, but above all, doomed to an ill-fated destiny and disappointed by their lack of courage.
The search for the right treatment
Bipolar disorder and Parkinson’s are two diseases both affecting the mind and brain. Although the exact cause of bipolar disorder is unknown, it’s believed that there is a connection between the condition and surges in dopamine levels. Parkinson’s, however, is heavily marked by the loss of neurons producing dopamine.
To ease bipolar disorder, doctors might prescribe medications that block dopamine receptors, but if you have Parkinson’s, this mechanism can exacerbate motor symptoms. Conversely, to relieve the motor symptoms of Parkinson’s, dopaminergic drugs like levodopa are prescribed, but such medications can exacerbate hypomania and mania in those with bipolar disorder.
The early months of my treatment with levodopa without bipolar medications were awful. I developed rapid, cycling bipolar disorder with racing thoughts that resulted in horrible obsessions.
I was able to move, but couldn’t live in those conditions, so much so that I seriously thought about taking my own life.
A few months later, I found a psychiatrist who agreed to provide care for my bipolar disorder even though he knew I had Parkinson’s. He prescribed low doses of an antipsychotic traditionally used to treat bipolar II disorder, which is the type of disorder I suffer from.
It was last summer, and I still remember the effect of this treatment. The medication blocked my dopamine receptors and totally deprived me of my ability to move. As a result of this medication, I experienced the cruelest effects of Parkinson’s disease; I couldn’t move my legs, my hands, or my full body. I lost my balance and posture. I didn’t have bipolar symptoms, but I had the paralysis of Parkinson’s.
Despite this worrisome condition, I didn’t lose my inner strength. After suspending the antipsychotic and recovering movement, I met a neurologist who prescribed a different formulation of levodopa, extended-release tablets, to avoid exacerbating bipolar disorder.
Simultaneously, I found another psychiatrist who prescribed me a more effective medication to treat bipolar disorder without intensifying the symptoms of Parkinson’s.
He tamed my bipolar disorder with a novel antidepressant called Trintellix (vortioxetine). This drug does not have a detrimental effect on dopamine receptors; rather, studies show that it stimulates dopamine release in brain areas affected by Parkinson’s with beneficial effects on motor symptoms.
Today, with the help of a passionate psychiatrist and scientist and the right combination of medications, I have restored a sort of balance between my Parkinson’s disease and bipolar disorder, two colliding ailments that pose a high therapeutic risk when combined.
The hope now is that my tough experience may shine a light on what it means to navigate life with co-occurring Parkinson’s and bipolar disorder. The journey has been bumpy, but Parkinson’s actually allowed me to cure a mental illness that for years had devastated my soul more than my body.
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Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to Parkinson’s disease.
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