Bipolar Is about Physical Pain Too

I was describing the physical pain of bipolar disorder to a friend of mine and she acted surprised. She said, with great shock, “It physically hurts?”

Yes, bipolar disorder is about physical pain as much as it is about mental anguish.

Physical Pain and Bipolar Disorder

I have a big problem with the physical pain of bipolar disorder. I tend to be depressed, of course, and that’s where the physical pain comes in for me.

Bipolar and depression isn't just about mental anguish, it's also about physical pain. Here's what the physical pain of bipolar feels like.What happens to me is this:

I sit on my couch, writing on my laptop, watching television, brushing my cats and so on. I spend hours doing this every day as I work at home, mostly, as a writer and social media consultant (when I’m not speaking). When I get up from the couch to get a glass of water, I stand upright and walk the few paces to my kitchen and the pain of depression hits me like a brick, fucking wall. I mean, really. It feels like I’m being, physically, tortured. The pain is in my muscles and joints. I almost cry in the few minutes it takes me to do what I have to do and get back to the couch. It’s not like when I’m sitting the pain isn’t there, it’s there, but it’s bearable. When I get up, the pain of bipolar becomes absolutely unbearable.

I Can’t Explain the Physical Pain of Bipolar

I can’t explain the physical pain of bipolar disorder. Maybe I wouldn’t even believe in it – if I didn’t have to live with it all the time, I don’t know. But what I do know is that I do have to live with it. What I know is that the physical pain of bipolar and depression is real.

Physical Pain in a Mood Disorder Makes No Sense – Or Does It?

In one respect, this makes no sense at all, after all, bipolar is a mood disorder, not a pain disorder. While depression hurts, that pain is emotional. Isn’t it?

On the other hand, the physical pain of bipolar does make sense when you consider that bipolar disorder is a brain disorder. A brain disorder. Brain. The thing that processes all the signals from your body. Of course if your brain is misinterpreting emotional signals, there is no reason that it wouldn’t misinterpret physical, pain signals as well.

Handling the Physical Pain of Bipolar Disorder

I wish I had some sage advice to give you on the dealing with the physical pain of bipolar disorder, or perhaps, something shiny and happy to say with regards to the disappearance of said symptoms with some magic technique – but I don’t. What I know is that when the depression is worse, the physical pain is worse too. And I know that the best I can do is to ignore it. Meditation and deep relaxation techniques do help too – momentarily. And I know that lying still feels better. And I know that distracting myself from the pain (like when I’m out with friends) helps too. But none of those things are even close to a magic bullet. And when I’m severely depressed, I know I won’t just be crying because of some mood disturbance, I’ll also be crying because my bones ache.


About Natasha Tracy

Natasha Tracy is an award-winning writer, speaker and consultant from the Pacific Northwest. She has been living with bipolar disorder for 18 years and has written more than 1000 articles on the subject.

Natasha’s New Book

Find more of Natasha’s work in her new book: Lost Marbles: Insights into My Life with Depression & Bipolar. Media inquiries can be emailed here.

  1. I have always suspected that the pain is related to muscle atrophy, which of course will have an affect on bones and joints as well. During long periods of depression many people are not getting any kind of exercise, of course this is almost impossible when you don’t feel like getting out of bed or leaving the house. I always encourage active friends who are well to make me go walking with them. I remember trying to go on a 5k walk after a long period of inactivity and I could barely do it, I felt even weaker when I saw senior citizens doing laps around me. it took a little while for me to even build up strength again. The pain diminishes over time (unless of course you have permanent injury) if you are able to be somewhat consistent with some kind of physical activity.

  2. Pain can also exist because of thyroidism. Everyone who’s on psychiatric medication should check their thyroid levels. Not only by blood tests, but with a doctor who checks the symptoms. I was diagnosed with bipolar 3 years ago, and with a slow thyroid this summer. Now I am on Levothyroxin only, and have stopped all psych meds, and I feel better than ever.

  3. I have co existing things that add to pain but the bipolar
    Does make it worse. Everything can be going fine, and boom. Pain worsens
    And my mood too. I know its all connected. No one can tell me different
    Cause its been this way for 43 years or more. Mental/physical. All connected. Sometimes u don’t know what triggers what. Or which comes first. Hugs to u all going through this.

  4. I have had really bad cramping and pain in all of my muscles. Needing me to take advil or if possible I take robaxicet. It lasts for a week or so. It has happened maybe 8-10 times. Maybe more over the last few years. A few of the times I had used drugs in a bipolar hypomanic episode. I thought it was from being dehydrated or something… Usually after I crash after months of being kinda up. I thought really it was from using drugs for a couple of days. But today it is happening and has been for a few days. I need to use heating pads ton my tjighs and neck/back. The thing is my life is great. I was kind of “up” but not hypomanic. My life is great. But I moticed I was gaining weight while eating the same for a week or more. I did not do any drugs. I am actually quite healthy and looking after myself well.

    It was and always was the bipolar 2. For frigs sakes. It is unbelieveable that my body just does this! I have got better at not letting my bipolar “energy” changes affect my mood or attitude as much as it used to. I am happy as I write this… Just it is crazy. Until right now I really thought having painful awful cramps, tightness, soreness in my muscles was symptoms of using stimulants, or my medication or something I did when I was up and then I crashed down. I thought it was symptoms of what I did while hypomanic. Or just bad hanits in general… Like lying on my stomach with my back arched using my phone. Or bad eating or dehydration…It was never that.. It was purely the bipolar itself. For frigs sake! Damn! That is what happens when my mood changes… My metabolism changes, my body just gets so painful. Like it is eating itself. It only lasts a week or 10 days. Bad news that I am getting this on July 1st. Usually it is october. It is so seasonal.

    I can’t believe how dramatic it is. I started thinking of my bipolar 2 more as an “energy” disorder… Then a mood one. I do get depressed… But that is not inevitable (at least I tell myself that). The body change is. And now I am on a low dose of one drug after a miserable 5 years of different drugs and combinations of drugs that realky messed me up physically… And did not really treat me to be functional. Now my medication seems ideal as it has ever been. At least the side effects from
    It are minimal.

    I still am having a difficult time accepting this. Blaming myself for causing this temporary week of pain several times a year… And Now… Everything is near perfect in my life and it is happening regardless… The same thing.

    So I guess it is another thing to not blame myself for and live with… And to deal with. And it inevitably means I am going into a low phase right now. But at least my life is good. My relationship is great, my career is looking up, my health is good, i exercise now. And it is the start of the summer… So outside and sunlight will mitigate it. So I have to just hope I will be ok. I was so pleased being slimmer then I have in 10 years… And feeling really good without being sketchy and having out there ideas and impulses. Alas now I will have less energy, slower metabolism, not feel quite as bright and cheery. But at least this freaking pain and cramps and soreness should end within a week if history repeats. Bipolar is so nutty because it always does repeat but is always subtly different when it does. I lost 30 pounds like 2 months ago and now about 10 is back.

  5. I lived for 33 years with undiagnosed Bipolar 2 and I can tell you from personal experience that yes, the perception of pain is real and it is extreme. However, there is hope. Google MBSR or mindfulness based stress reduction and then see if it doesn’t resonate with you to try. I have only been doing it for 5 weeks and the radical reduction in my anxiety and depression is nothing short of a miracle. I was barely diagnosed 2 weeks ago after 8 years of living with autoimmune responses, pain, anxiety, and fatigue that doctors could not explain. I finally diagnosed myself and then went to a neuropsychologist for testing to confirm what I finally came to know through years of despair.

    • I’d be interested in the Neuropsychologists name. Not too familiar with Neuropsychology as a field but have read much from Neuropsychiatrists and Psychoneuroendocrinologists. Know this is a bit of hairsplitting degree granting and specialist post doc naming but still interested in the name and location of this Phd. and the program he was studying under in which the degree was granted.
      I too was a late diagnosed BP-2. Initially at least self-diagnosed as well. The time period was also very similar to your own experience.
      The problem I have with most meditation and other types of psyc. techniques used for pain reduction (all really that I’ve dabbled in) are only remotely effective when full concentration is practiced. They are all in my experience, even when fleetingly effective almost useless in the real world where the conscious mind is needed elsewhere. Forgive me for my ignorance here. I’m quickly becoming an old man. WN

      • HI Will,

        Neuropsychologists are trained as clinical psychologists with additional training in neuropsychological assessment. All clinical psychologists are trained in neuropsychology. Neuropsychologists use tests to assess personality, anxiety, depression, and various types of cognitive functioning including concentration, attention, memory, executive functions etc.

        Neuropsychologists provide psychometric assessments to assess cognitive deficits associated with things like traumatic brain injury, alzheimer’s disease, stroke etc. They are also trained in rehabilitation for these types of illnesses.

        The psychometric tests used by neuropsychologists are only available to clinical psychologists. Generally, psychiatrists (including neuropsychiatrists) and other medical doctors are not trained in the use of neuropsychological assessments and are not able to purchase tests because to use them is outside their scope of practice.

        To be honest, I’m not sure why someone would see a neuropsychologist to assess just for depression unless there was a reason to conduct an assessment of cognitive functioning in general.

        Also the point of mindfulness meditation is not to get rid of pain but rather to accept the fact that the pain is there, without adding anything extra on top. Practicing mindfulness can help stop that struggle with thoughts and emotions and simply feel the physical sensations of pain. That’s why people often report less pain, and might be why you’ve found that it doesn’t work except for when you do it. It’s something that requires repeated practice to help it generalize to every day life.

        Mindfulness was life changing for me, and I find when I practice regularly I tend to be more in touch with what I am experiencing, as opposed to what I think I am experiencing. It helps me stay a lot more calm and I’m way less anxious and distressed.

        Hope that helps.

  6. I totally get this! I went through an entire day of it yesterday, and started wondering if Im’ BP at all… maybe Im just DEPRESSED when I start going through all of this physical pain: debilitating migraines, aching jaw, feeling like my entire body is sunburnt, etc…. I started questioning the whole diagnosis (who wouldn’t be depressed after a week of this) and decided to start logging it all…which is how I came across this blog. thank you.

  7. Very interesting to read about this. I’m not sure if I can connect my aches and pains to BP, but both mania and depression come with physical sensations. I’ve never done cocaine, but during a higher it often feels like sticky sweet (way too sweet) pain behind the eyes. Depression is more of thudding warm concrete feeling.

    The post mentions meditation, which is very good for this. The kind I like is Shavasana, which is essentially lying very still, as mentioned here. I couple this with alternate nostril breathing, even just mentally to create focus. It’s fantastically helpful for producing calm and dealing with these sensations.

    Thanks for the great post!

  8. Wow, what a fantastic place to have stumbled upon!! I have been diagnosed 5 years now with Bi-Polar disorder, I have battled with acceptance of it and have experienced mainly the manic phases with the odd depressive phase. (I was in the cycle phase a lot and want it back)
    Only recently, I would say the last 6 weeks I have slumped to a very low and depressed state, not happy and not wanting to do the things I would normally do and huge tiredness. In this state have been experiencing a lot of pain everywhere, head almost exploding , struggling to get out of bed. I am on lithium and have not reduced or stopped it.
    My question is, Is this what happens when you get low and depressed????
    I don’t know I just put everything down to menopause, but know it can’t be that.

    Kind regards and hope I have not bored you and the other readers. Merry Christmas

    • I am male, but you have accurately described what has and can happen to me with physical pain. So, it is not “just” the menopause, but it has something to do with your physical pain. I suffer from chronic pain due to being struck by a hit and run drunk driver when I was nine years old. I am now in my sixties and have arthritis from head to foot. I am also clinically depressed. It is all chicken and egg for me. Sometimes, my physical pain makes me depressed and sometimes my depression makes me far less capable of handling my physical pain in a given moment.

  9. This is very true and rarely discussed. I’m achy a lot, especially right after waking up. My back hurts like hell and I can barely move.

    Music helps a lot, it’s not magic, but it can take a considerable load off.

  10. Thanks for writing this. I’m bipolar and I have fibromyalgia. It’s the worst as the fibromyalgia treatments often make my moods worse or leave me in that terrible place where I feel nothing at all. I understand your couch bound indoor lifestyle as I live it too. There is one thing that can help my pain an anhedonia- exercise. I try to go to the gym three to four days a week. I work slowly but it’s just the fact that I’ve done it that helps. I also try to go outside for 30 minutes a day. Mostly for the sun but it cheers me up. Maybe this can help someone too. Good luck.

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  12. As others have mentioned, if you couple this with another illness labeled physical ( example : RA, Stenosis, etc) the magnification is great. ( I use these terms, physical illness, mental ilnesses, loosely to avoid the obvious oncoming bullfight at any forum about the reality base etc of bipolar. I’m not even going to go there … We’ll assume for this comment. Humor me. ) Often any comorbid physical illness will be slow to diagnosis, if diagnosed at all, because of the stigma that comes with the label Bipolar. I have a rare genetic disease that causes multiple systemic issues. My health has been a circus because the health care worker would see my mental health diagnosis and place all my symptoms as fantasy and not physical. Bipolar stigma removes the credibility of our voice to even give our symptoms. That’s frightening.

    • Yes, BP people don’t feel pain. For me seven herniated disks and a genetic disease of spine caused no pain and my Dr. as is usual in these cases refused to give me anything for pain and made me suffer. If you call the office for relief you are a drug seeker if you don’t you aren’t in enough pain. Luckily I have a good Dr. now. He treats me. Yes, he drug tests me on occasion but has learned I am not a drug addict. Reason, his daughter has BP. Seems most must see it close to understand and even then many will just blame their own “loved one”.
      If my Dr. leaves, retires etc. and I don’t find another good one and go looking or heroin. I will be labeled a drug addict. If I had had cancer and went searching for cancer drugs on the sky I would be considered ingenious. Not for severe chronic pain. This is why I do thinks my way now. The system doesn’t have my back and doesn’t care.
      The good Dr. I have now I told at first appt. that I was having bagel seeking behavior that morning, because I was hungry. WN

  13. Yes, there is pain. Tramadol helps with pain/mood/ocd
    . Find good doctors and problem solved, BAM!

    • If only so simple. Working on cars my whole life. Just get wrench and turn screw works about fifteen percent of the time. WN

  14. Thanks for this post – I think it’s really great to speak up about things like this, especially as it can be so difficult to put your experiences out there. A lot of people who are mentally healthy don’t know about a lot of the symptoms people with depression, bipolar and other disorders can get, and it’s important to make people aware of it so that they can better understand.

  15. I KNEW it!! I went to an iridologist who said they were connected and now i’m going to a GP next week to look into treatments of some kind because even my psychiatrist(who I think is crazier than I am) said “oh no they aren’t related” and I KNOW they are. I’m not sure what to expect them to find but if I can get some massage therapy out of it covered by my insurance then so be it.

  16. Interesting timing reading this post. Just the other day I was watching a program about animal behavior and it stated research has shown that the brain interprets emotional and physical pain in the same area. I’ve also read that studies show people who are depressed usually suffer more health issues (and, speaking from personal experience as someone with muscular dystrophy and chronic pain, I can say the reverse is also true: people who are suffering physically can become depressed as a result). I’ve also learned through practicing and reading about mindfulness meditation that resistance to circumstances causes pain, sometimes just emotional, sometimes both emotional and physical.

  17. yes it is physical. no one believes me when I say so. every problem with pain I have is affected by
    my moods. finally someone has explained it. it is achy joints very true. it seems to go even deeper.
    and as for swearing…you do it rarely and in this case out of frustration and anger about pain and no one “getting” it…I do not blame you. why do people tell you what u can say in YOUR blog? he is acting like he is doing you a favor. um. u are trying to help others. if he/they is/ are petty nit pickers then they should shut up and go figure it out themselves. humans! oy! thanks for exaining things I cant.

  18. I would like to ask any one reading this if they have tried TMS therapy for their depression or bipolar disorder . TMS stands for Transcranial Magnetic Stimulation. It is done through a machine. There are a number of videos on YouTube about it. Have you had a personal experience of this?

  19. Oh. my. gosh. This is such a great post.

    I remember being a lot younger and feeling just these big, hairy, painful emotions at times. I didn’t realize then that it was indicative of anything being wrong, I just knew that they were so much bigger than me and they hurt. Physically I would often feel the pain in my chest. It hurt a lot. I never understood why it was so inextricably linked to my negative emotions. I’m glad to know now I’m not the only one.

  20. Yes heaviness in my limbs. Sometimes it’s so heavy I don’t have the strength to move.

  21. I think it is “like” a physical pain. I usually feel a kind of constriction inside my torso. It’s unusual. Not like a panic attack which is acute. But a sort of aching sensation from the inside out. And it feels like there is an expanding balloon in my head. But I think pain is a symptom of other things caused my my behavior changes – for the most part. If I get really low I am just not good to my body until I can “shake myself” out of it long enough to do something like exercise or eat a good meal.

  22. Thank you. I will share this all over the place. So many people for some reason can not link “mental” with “brain”, like the mental art is some ethereal, invisible ball of emotion that is not connected physically to the rest of the body.

    • Yes, Isong they are one and the same. People I believe artificially split the two so things like brain cancer can be forgiven but bi-polar can be shamed. People don’t like to think they are that close to the other who is suffering. Most likely a healthy evolutionary stance. Still when they fall what hypocrisy must they conjure up. Like Ayn Rand on medicare and other gov. benefits. WN

  23. Hi Natasha,
    Thank you so much for this article. Your blog has provided me knowledge and inside into the bipolar mind. My boyfriend has bipolar and he has always talked about the pain in a way I couldn’t understand. Lately, he’s been under a deep depression and he is extremelly withdrawn. He says that in moments like these, he rather be along as he gets very irritable. We have been going out for a little over a year and sometimes I dont know how to best help to ease the pain caused by depression. I find it hard to understand that doing nothing is the best I could do for him. I have done research and read books about bipolar and how to help cope depending on the situation. But it is very hard when he pushes me away. He said that once the storm passes he will come back for me. I am not sure what to do to help. If its not much to ask, can you please write about this? What can we do to help when bipolar has you sunk into a deep depression, full of anxiety and physical pain? As his girlfreind, it is very heartbreaking when I know he is sufering – I want to help but I can’t or don’t know how to. Again, thank you so much for this blog.

    • Hi Lucy,

      Sounds like you’re a really caring girlfriend and that’s what we all want :) I see what I can do about incorporating your thoughts in a future article. For now, just know that if he is asking for space, give it to him, for a time, anyway. He wants to know you are there, even if he doesn’t want you physically there right now.

      – Natasha Tracy

    • Lucy, I am a man and once loved a “normal” woman and I am bi-polar. He probably and most likely like I did pushes you away because he loves you. His depression ans frustration he doesn’t want to bring you down. It means he cares about you. He doesn’t want to scream, yell, depress and otherwise hurt you. One thing I can tell you is he needs you far more then you can imagine and when he feels well is most likely a wonderful boy friend to you.
      Try to work with him but never forget yourself. Good luck.

  24. Yes! It is bone crushing depression. In my case, I honestly don’t know where or when the physical pain begins and the mental pain ends and vice verse. I was struck by a hit and run drunk driver when I was nine years old. I was frankensteined back together, multiple operations, multiple anasthesias, multiple medications – as a teenager, I was told I would never walk again. I got out of my wheelchair and I do walk to this day, but always with pain. I am sure that I was also concussed and my brain was scrambled! I am 63 years old and can no longer drive due to the chronic neck pain.

  25. Natasha, thank you for bringing attention to this very important issue. Physical pain goes hand-in-hand with my depression and anxiety. Headaches, tight muscles, nausea, neck pain, back pain, weakness, vertigo, and just plain feeling off. I remember when these symptoms used to signal a cold or flu (and they sometimes do) but now they alert me bad days, intensify with depression and anxiety, and linger after an intense battle through the darkness has been waged. We need to keep talking about this issue. I wish I could take away your pain, my pain, and everyone’s pain from mental illness. It’s hard enough battling the mental challenges. Physical pain makes everything that much harder. Here’s to all of us battling mental and physical pain! We are stronger than we even know. Most people couldn’t handle what we live with on a daily basis. Big hugs and love to all!

  26. I think this should say : “Yes, bipolar disorder CAN BE about physical pain as much as it is about mental anguish.”

    I had bipolar disorder and never, to the best of my memory, experienced physical pain as a part of it.

    • Well said. I think Nastasha has been overly defeatist for some time in her articles and people should be aware that while it may or may not help her coping with the condition, others should be selective with certain bits of advice if the problems don’t necessarily apply to them.
      I’m still far from unconvinced that there are just two types of bipolar and that only 1 in 200 suffer from it. The amount of people I see in bars and pubs who drink away their worries… only to get worse.. the proportions don’t match. There are so many reactions to life’s challenges and some people may cope better, or mask it better but still be ill almost as much as ‘offficially ‘wacky’ ‘ people.

      PS – I’m rather annoyed that I have to stick to the one name when posting here, as my IP is very obvious whereas Natasha goes under a pseudonym. She has every right to have some privacy, but I would prefer to be allowed the same thing given how much I use the net in everyday life.

  27. Yes, no coincidence I believe why chemists can’t make a non-addictive opiate that relieves physical pain and doesn’t help with mood. Much more at work here of course neurologically, psychologically, financially, politically, scientifically and so on. But I think this is in no small way why this is. My unrelenting back pain since a teenager is FAR better when I feel happy and in reverse as well as the opposite. It it a feedback system and the variables are connected in a complicated but highly correlated way. I’m guessing at some far distant time in the future some pharmacologist could isolate the two but I’m not sure that would even be a good idea. It would probably create more problems then it solves. Also no question in my opinion why for those in physical plus psychological pain opiates are more addictive then for those merely in physical pain. I think it’s additive and synergistic in a way not understood. The political and religious nuts will of course as always in areas like this define and frame this argument any way they wish. This will continue stigmas om the MI, drug addicts, pleasure seeking hedonists and so on. Some if not all humans will continue to kick those who are down. Astonished on how many people I have read recently calling Robin Williams selfish. A scum and so on. Humans really do have a tendency often to think they are safe and I and so many understand. ONE slip on an icy sidewalk can change you WHOLE life. WN

  28. You have hit the nail on the head again. I am feeling bone tired today and it isn’t anything I have done physically. I am just seriously mentally exhausted. Every time I think I am feeling better I crash again. I get my hopes up on something happening-it doesn’t happen and I crash to the ground. Thank you for writing about this aspect of bipolar. Hopefully one person who doesn’t know reads this and will be better to the bipolar person that they love.

  29. I do agree with this. I have depression and anxiety and it does take a physical toll on your body. Just the mental exhaustion can manifest in physical ways, your body works together as a whole with the brain. Anxiety can cause things like tension which lead to muscle pain or a racing heart and quickened breathing which puts stress on the chest and can cause chest pain. Digestion problems are also very real in people with mental disorders, stress has that affect for some reason. And aches and pains like you get when you have a flu. The body is complex and it is all connected together and the brain is only it’s master-head that runs everything. So it should be no surprise that a brain problem can cause all these things.

    Now I also have Fibromyalgia, but I had Depression long before that and know the pains that caused before. Now that I have developed worse Fibro symptoms, the Depression and Anxiety is still a major trigger for my pain and flare ups.

    My husband, he has Bipolar. He’s always complaining about aches and pains and especially in his depressed stages I noticed it’s hard for him to do things. Not just from a lack of motivation, but because he aches, especially his back a lot. At times I wondered if he might not have a mild form of Fibro himself (since it does seem to vary in severity) but this also just makes so much sense.

    After all, for all experts know, Fibro could be caused from Depression or vice versa. They still don’t know much about it and it does seem to be very closely linked to Anxiety and Depression. So I couldn’t agree more on this topic and think it should be discussed more.

  30. Thank you! There are people who think I am out of my mind when I talk about this. My pain manifests as migraines, nausea, chest pain and the long periods of inactivity when I’m depressed aggravates the bursitis in my hips. Physical pain caused by BPD is absolutely real in my book.