Author: Jillian LaFrance PhD
Bipolar disorder is characterized by dramatic mood, energy, and activity level shifts, which manifest as mania or hypomania (elevated mood) and depression (lowered mood), is associated with neurotransmitter imbalances (serotonin, dopamine, norepinephrine), structural and functional brain abnormalities, and genetic factors (NAMI, 2024). Individuals with bipolar disorder often experience co-occurring conditions, such as anxiety disorders, which can worsen mood fluctuations (NAMI, 2024). Irritability, anger outbursts, and emotional lability are also common.
Medications, such as mood stabilizers and antipsychotics, are used to regulate neurotransmitter activity and stabilize brain function. Glucagon-like peptide-1 receptor agonists (GLP-1s) mimic a natural hormone, primarily used for type 2 diabetes by regulating blood sugar and appetite and are increasingly used for weight loss by slowing gastric emptying and increasing fullness (Catanese, 2024).
However, understanding the connection between bipolar disorder and GLP-1s are essential, as these medications can potentially trigger or heighten mood changes, especially in vulnerable individuals. Given that clinical trials often exclude those with mood disorders, heightened awareness and monitoring are crucial when prescribing GLP-1s to individuals with bipolar disorder, it is necessary to educate both medical professionals and patients regarding potential effects.
Weight Loss and the Emotional Impact
Significant weight loss, as evidenced by my own 120-pound reduction from 285 pounds over 19 months through GLP-1 use, cardio, lifting, and food management, can trigger significant psychological and hormonal changes that can impact emotional well-being (Ingels & Zizzi, 2018). These changes, while physically beneficial, present an emotional struggle. There is a relentless stream of anxiety-driven thoughts such as “did I lose enough?” and “will I regain the weight?”, which creates a cycle of obsessive thoughts and self-doubt.
This is consistent with research indicating that rapid weight loss can lead to significant body image changes, mood alterations due to dietary stress and energy balance shifts and potentially heightening disordered eating patterns. The physiological stress of rapid weight loss can disrupt neurotransmitter balance, potentially triggering emotional instability, especially in individuals with pre-existing vulnerabilities like my own bipolar disorder, which can be simply explained as is a “faulty wiring” in the brain’s mood control system. The stress of a new diet or exercise routine can also destabilize mood, and hormonal changes associated with weight loss, which can contribute to mood swings, irritability, and emotional lability. The neurological bedrock of my bipolar disorder impacts my ability to regulate these thoughts and emotions, making well-intentioned advice sometimes feel invalidating.
This dysregulation intensifies my feelings of anxiety, and frustration, which further impacts my self-esteem and increases my vulnerability to mood swings. The struggle is a complex blend of physical and emotional challenges, where the difficulties of weight loss are heightened by the neurological complexities of my bipolar disorder, which creates a unique and deeply personal battle.
Strategies for Emotional Well-Being
Managing emotional well-being, especially when dealing with conditions like bipolar disorder or the emotional effects of weight loss, requires a comprehensive and individualized approach. A successful strategy involves a combination of medication management, psychotherapy, and lifestyle modifications (NAMI, 2024). Medication helps stabilize mood, while therapy provides tools to manage emotional triggers and develop coping mechanisms.
Mindfulness practices, such as meditation and deep breathing exercises, can help individuals become more aware of their emotional states and regulate their responses. Stress management techniques, like time management and relaxation exercises, are essential for reducing the impact of stressors on mood. Regular exercise has been shown to have positive effects on mood by increasing the release of endorphins and improving an individual’s overall well-being. It is essential to have open and honest communication with psychiatrists, therapists, and other healthcare providers for effective management.
Living with bipolar disorder while managing my weight loss with a GLP-1 medication has taught me the importance of a very personalized self-care routine. For me, sleep is important; I make sure to get seven to nine hours every night, where it can impact my mood. I have found that regular exercise is essential as well. I like to do daily 30 minute walks; they help me clear my head and find a sense of calm. I also lift weights which gives me a feeling of empowerment, control, and strength. Of course, my bipolar medication is a non-negotiable part of my regimen. Regular exercise has a positive effect on my mood by increasing t
he release of endorphins and improving my overall well-being. The GLP-1 medication adds another layer of complexity, and I am still learning how it interacts with my mental health. I am constantly paying attention to how it affects my energy and mood. It’s a bit of a balancing act, requiring me to be very in tune with my body and mind. I communicate openly with my provider.
By prioritizing sleep, exercise, and staying consistent with my medications, I am working to build a stable and fulfilling life. This entire process is a journey, and I’m continuously learning how to navigate this situation and prioritize my emotional well-being.
References
Catanese, L. (2024). GLP-1 diabetes and weight-loss drug side effects. Harvard Health. https://www.health.harvard.edu/staying-healthy/glp-1-diabetes-and-weight-loss-drug-side-effects-ozempic-face-and-more
Ingels, J. S., & Zizzi, S. (2018). A qualitative analysis of the role of emotions in different patterns of long-term weight loss. Psychology & Health, 33(8), 1014–1027. https://doi.org/10.1080/08870446.2018.1453511
National Alliance on Mental Illness (NAMI). (2024). Bipolar disorder. NAMI. https://www.nami.org/about-mental-illness/mental-health-conditions/bipolar-disorder/
Jillian has a PhD in psychology, specializing in forensics. She works with inmates who have severe and chronic mental illnesses and substance use disorders, preparing them for success after release. Jillian has a bipolar disorder diagnosis, which provides her with personal insight. She is a strong mental health advocate.
The content of the International Bipolar Foundation blogs is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician and never disregard professional medical advice because of something you have read in any IBPF content.
