The global battle against Covid-19 has brought to light many immediate health issues, but there’s an emerging concern that needs attention: the potential link between Covid and bipolar disorder. While the pandemic’s physical toll is well-documented, its impact on mental health is still being explored. Recent studies suggest that the SARS-CoV-2 virus may be linked to the onset of bipolar disorder (BD), a serious mental health condition characterised by extreme mood swings.
The global impact of Covid
The Covid pandemic has affected over 2.2 billion people worldwide, with nearly 38 million deaths attributed directly or indirectly to the virus. While advances in detection and vaccination have helped manage the virus, the long-term consequences on mental health are profound. Many people have reported experiencing psychiatric disorders such as anxiety, depression, and post-traumatic stress disorder (PTSD) after contracting Covid.
Understanding bipolar disorder
Bipolar disorder is a complex mental health condition that involves recurrent episodes of depression and mania or hypomania. These mood swings can significantly impact an individual’s quality of life and carry an elevated risk of suicide. Despite extensive research, the exact causes of bipolar disorder remain unclear, though factors like inflammation, genetics, and environmental stressors are believed to play a role.
Manic episodes post-Covid
Recent scientific literature has highlighted cases of manic episodes occurring after Covid infection. Manic episodes, characterised by elevated mood, increased energy, and sometimes psychotic symptoms, are a hallmark of bipolar disorder.
The fact that SARS-CoV-2 is triggering such episodes suggests an urgent need to explore this link further.
Case reports and studies
Numerous case reports have documented instances of new-onset bipolar disorder following Covid infection. These reports include individuals with no prior history of psychiatric disorders, suggesting that the virus may play a role in triggering bipolar disorder in susceptible individuals.
A few examples of these case reports are the Bipolar Disorder after COVID-19 Infection: A Case Report from an Ethiopian Perspective, Bipolar disorder triggered by Covid-19 infection, and COVID-19 and first manic episodes: a systematic review.
Overlapping factors: Inflammation and cytokine storms
One of the key similarities between Covid and bipolar disorder is systemic inflammation. Both conditions are associated with increased levels of inflammatory cytokines, which can affect various neurological processes. This overlap suggests that the immune response to Covid could potentially trigger bipolar disorder symptoms.
Kynurenine pathway and oxidative stress
The activation of the kynurenine pathway, a process involved in inflammation and neurodegeneration, is another common factor between Covid and bipolar disorder. Oxidative stress, which damages cells and tissues, is also prevalent in both conditions. The rapid onset of oxidative stress in Covid patients may contribute to nerve damage and changes in the brain that lead to bipolar disorder symptoms.
Structural changes in the brain and sleep disturbances
Research has shown that both Covid and bipolar disorder can cause changes in the brain’s white matter, which is crucial for nerve signal transmission. Additionally, sleep disturbances, which are common in both conditions, can further exacerbate mood disorders by affecting neurotransmitter levels and activating the body’s stress response.
Examining other factors: BDNF, HPA axis, and corticosteroids
Brain-derived neurotrophic factor (BDNF), the hypothalamic-pituitary-adrenal (HPA) axis, and corticosteroid therapy are also areas of interest. While BDNF levels typically decrease in bipolar disorder, they may also be reduced in Covid, contributing to the development of manic symptoms. Corticosteroid therapy, often used to treat severe Covid, has been linked to the onset of mania in some cases.
Implications for clinical practice
As we continue to understand the link between Covid and bipolar disorder, clinicians need to be vigilant. Recognising potential manic episodes in patients recovering from Covid is crucial. Monitoring these patients, limiting corticosteroid use to essential cases, and considering interventions like melatonin or antioxidant supplements may help reduce the risk of developing bipolar disorder or experiencing relapses.
The potential connection between Covid and bipolar disorder highlights the complex interplay of factors contributing to neuropsychiatric conditions post-infection. While the incidence of manic episodes post-Covid is relatively low, the shared pathophysiological mechanisms warrant further investigation. Clinicians and researchers should remain alert, extending follow-up periods for vulnerable patients and exploring individualised interventions to minimise the long-term mental health impacts of Covid.
As we continue to navigate the challenges of the pandemic, it’s essential to adopt a holistic approach that considers both physical and mental well-being. By doing so, we can better support those affected by Covid and prevent the development of serious mental health conditions like bipolar disorder.
Anyone wanting to arrange private and discreet consultations with an experienced psychologist or psychiatrist or is seeking treatment for bipolar disorder is advised to contact MyMediTravel, the only medical concierge that offers unparalleled links to the right medical experts around the world.
Covid-19 NewsHealth