Some people still think of bipolar disorder as just an emotional roller coaster. The reality? Your body pays a heavy price too, and not enough folks really talk about that. While mood swings run the show, the knock-on effects on physical health are just as real—and maybe even more dangerous in the long run. If you ignore these, you miss half the picture and most of your chance for a better life. Want the details regular doctors and Google searches skip? Let’s break it down for real.
Stressed out and worn down—that’s a feeling people with bipolar disorder know too well. The condition doesn’t stay in your head; it runs riot through your whole system. All those swings between mania and depression put your body into a constant state of emergency. Your heart rate, blood pressure, hormones—they all get jerked around. The amped-up energy of mania brings restless nights, overexertion, reckless behaviors. Crash into depression, and everything slows, including your ability to move, fight off germs, or even digest food properly.
It’s not random, either. Real science backs it up. Hospital records and large health surveys show people with bipolar disorder face way more physical health challenges than the average person. Blood sugar goes haywire. Immune systems get weaker. There’s even a higher risk for inflammatory diseases. That’s why, if you live with bipolar disorder or support someone who does, you owe it to yourself to look beyond moods and pay attention to these invisible struggles happening under the skin.
One study from 2021 out of the University of Cape Town sums it up: "Bipolar disorder should be considered a multisystem disorder, requiring healthcare that integrates both mental and physical well-being."
Bipolar disorder doesn’t end at the brain. It bleeds into the arteries, the gut, and the immune system—slowly reshaping the entire body’s chemistry.When I first read that, it haunted me. It means fixing your mind alone will never be enough.
Let’s talk weight. There’s no sugarcoating it—bipolar disorder makes weight gain way more likely. Some of this comes from the illness itself. Depression saps your motivation to move or eat healthy. Mania leads to wild binges or days when meals get forgotten. Add meds to the mix (especially lithium, valproate, some antipsychotics), and your hunger signals can go haywire. Your metabolism slows without warning. Suddenly, you can’t outwalk or outsmart the scale—your clothes feel tighter, your joints ache, and your energy tanks even more.
Why does this matter? Carrying extra weight isn’t only about looks—it fuels diseases like diabetes, sleep apnea, and heart problems. Statistically, people with bipolar disorder are two to three times more likely to get type 2 diabetes. The weight gain creeps up quietly and is hard to reverse. I know people who thought they could just "try harder" to lose the kilos, but found the deck completely stacked against them. Gaining control here means tracking meds, checking thyroid levels (since some meds harm it), and getting real support—not just "eat less and move more."
If you’re struggling in this area, try not to beat yourself up. The cards are stacked, but there are ways to even the odds: small, consistent changes work better than big, punishing diets or sporadic gym sessions. Walking every day with Briony—even if she grumbles for half the walk—gives both of us a boost. Keeping food simple and tracking symptoms (what you ate, how you feel) often shows patterns your doctor might miss.
Heart attacks, high blood pressure, strokes—you might think those are things to worry about "someday." For people with bipolar disorder, the risks come early. The numbers are scary: people diagnosed with bipolar are almost twice as likely to die from heart disease compared to the general public, and the risk starts decades sooner. You read that right—decades, not years.
It isn’t just the classic risk factors like smoking or lack of exercise (although those don’t help). Chronic stress from swinging moods cranks cortisol (the stress hormone) sky high. This triggers inflammation, damages blood vessels, and raises cholesterol. Medications like lithium, while life-saving, can put extra strain on kidneys and thyroid, piling on risk factors for the heart. You can be young and still be facing clogged arteries—no exaggeration.
Doctors in Durban, where I live, often tell me they see this "ageing from the inside out." In their clinics, blood pressure checks and cholesterol screening for bipolar patients start early, not late. Coping means taking physical health as seriously as mental health: regular checkups, moving your body, dropping cigarettes if you smoke, and staying on top of meds even when moods feel "fine." Nobody is immune. My friend Manny skipped his med reviews for two years and ended up in ICU after a minor heart attack at 34. If you have bipolar disorder, no health complaint is "just stress." Get it checked.
If you ask psychiatrists what symptom really messes up bipolar disorder, most of them will mention sleep—or the lack of it. Trouble falling asleep, staying asleep, waking too early, or not feeling rested... sound familiar? For people with bipolar disorder, sleep problems are both a trigger and a symptom. Miss a night or two and mania might show up uninvited. Sleep too much during depression, and it drags you deeper into the fog.
Poor sleep does more than feed mental symptoms. Research out of Stellenbosch University found that bipolar patients who slept poorly had double the rates of chronic pain, migraines, even gastrointestinal problems. If you wake up exhausted, it affects your motivation to exercise, your ability to eat well, and your immune system’s ability to fight off bugs. Long-term, the body pays a steep price: blood sugar swings out of control, heart disease risk spikes, and emotional resilience drops off a cliff.
Dealing with this means making sleep a family priority. Blackout curtains, the same bedtime—even weekends—and routines that calm you down before bed all help. I keep electronics out of the bedroom, not because I’m some sleep guru, but because late-night doomscrolling always ends badly. Keeping Briony on a routine helps me, too—it’s surprisingly easier to follow healthy sleep when you do it together. If sleep is still impossible even after tweaks, ask your doc about sleep studies; sometimes undiagnosed sleep apnea or restless leg syndrome hides behind the usual "mood disorder" label.
Surviving with bipolar disorder isn’t just about controlling moods. You’ve got to defend your body, too. The game plan is multi-pronged, and no, it’s not all green juices and yoga (though those don’t hurt if you’re into them!). Start by teaming up with doctors who treat you as a person, not a diagnosis. Ask for full checkups at least once a year: blood sugar, thyroid, cholesterol, weight, blood pressure, liver and kidney function. Bring up weird symptoms, even if they seem small.
Diet matters, but complicated plans usually fail. Simple steps—more water, easy veggies, protein with every meal, less sugar—stick longer. Shopping lists and batch cooking on low-energy days (freeze leftovers!) keep you from reaching for junk food when you crash. Moving your body daily is crucial; walk the dog, cycle with your kids, take the stairs, don’t aim for perfect. Sleep hygiene isn’t optional. Set a cutoff for caffeine, build a wind-down routine, and treat bedtime as sacred, not negotiable.
Staying on meds is part of physical health, but note side effects. Some cause hunger (olanzapine, quetiapine), others muscle tremors (lithium). Report these pronto, not months later. Your doctor may adjust doses or change prescriptions. If you hit a slump (and you will), rope in friends, family, or local support groups. Durban has a growing community of lived-experience groups who offer accountability and swap real-life survival tips. If you spot early warning signs, act. Early help beats crisis support every time.
Tiny changes snowball. The first time Briony and I swapped chips for carrot sticks, we hated it, but a month in, the craving for junk faded. Celebrate small wins—you showed up to life, even if it was messy. "Managing bipolar disorder is like tending a garden. Everyday effort yields the strongest results," a local doctor here likes to say. He’s right. Consistency is more important than perfection. Your best tool? Refusing to get discouraged when setbacks come, because they will. Persistence, honesty with your team, and treating your body as part of your recovery—not an afterthought—makes all the difference.
Written by Neil Hirsch
View all posts by: Neil Hirsch