Exploring Potential Autoimmune Causes for Unexplained Psychiatric and Neurological Symptoms in a 31-Year-Old Male
**Age and gender:** 31, Male **My diagnoses:** I have been diagnosed with Type 1 bipolar disorder, which began when I was 13 and confirmed at 17 years old. Additionally, there’s an enigmatic condition that emerged at 24, causing a plethora of psychiatric and neurological manifestations, many of which are challenging to articulate. This condition shows no response to over 30 psychiatric and epilepsy medications I've attempted, resulting in ongoing struggles with my health. **Current medications:** I am prescribed 450mg of Extended Release Lithium Carbonate every 12 hours, alongside 10mg of Abilify once daily for managing my bipolar disorder. My lithium levels are at 0.5, which is considered on the lower side, although the Abilify seems to enhance its effects. **Non-prescription supplements:** I take 360mg of Omega-3 Fatty acids twice daily to support my brain and cardiovascular well-being, along with 1000 IU of vitamin D3 every 12 hours to address a mild deficiency. **Family medical history:** My maternal lineage includes several autoimmune challenges; my mother and one of her first cousins are both affected by rheumatoid arthritis. Another cousin had an undiagnosed autoimmune condition, and her brother suffered from encephalitis. My aunt has been diagnosed with psoriatic arthritis along with psoriasis, and her daughter has scleroderma. I once experienced mild psoriasis, localized on my elbows, but it resolved without treatment. My mother is on long-term Prednisone therapy due to severe rheumatoid arthritis starting at age 35, and she experiences significant exacerbation of her symptoms if she weans off the medication. My paternal grandfather also has a history of Type 1 bipolar disorder. Interestingly, I’ve noticed that Lithium treatment causes dandruff, with the Immediate Release form seemingly producing more severe symptoms than the Extended Release version at the same dosage, raising questions about any connection to my previous psoriasis. **Background:** At age 24, while navigating the Washington D.C. metro, I encountered a bizarre episode characterized by symptoms reminiscent of schizophrenia — such as hallucinations involving faces emerging from ads — along with signs akin to Parkinson's disease, including cramped, tiny handwriting and a rigid expression. This episode was quite alarming. Over time, symptoms alternated between intensifying and subsiding repeatedly. I have experienced a wide array of psychiatric and neurological symptoms over these seven years, yet nothing has fully alleviated my distress. Despite trying over 30 different medications, spanning various classes — including antipsychotics, epilepsy treatments that double as mood stabilizers, and a handful of antidepressants — there has been negligible improvement. Episodes of symptoms persist without any sustained remission, merely cycling through phases of worsening and temporary relief. Given my extensive family history of autoimmune diseases along with the cyclical nature of my symptoms, I am beginning to suspect an autoimmune origin behind my condition. **Request for guidance:** What steps should I take next? Is it advisable for me to consult a rheumatologist, potentially one at a research institution? Would they conduct necessary tests or consider immunosuppressive therapy to see if it could enhance my mysterious condition? Alternatively, could a neurologist assist with this, or should I primarily seek rheumatological expertise? My past evaluations by psychiatrists and neurologists, including EEGs and MRI scans, have revealed only minor abnormalities, such as slight hippocampal asymmetry, leaving me searching for answers. Any recommendations would be greatly appreciated.
Answers (1)
9/7/2025, 1:40:50 PM
OpenHealth AI
It's understandable that you're feeling overwhelmed by your symptoms and the lack of clarity regarding your health condition. Given your complex medical history, the extensive family history of autoimmune diseases, and the cyclical nature of your psychiatric and neurological symptoms, exploring potential autoimmune causes is a logical next step.
Explanation
Your symptoms and family background suggest there may be an underlying autoimmune disorder contributing to your distress. Autoimmune diseases can sometimes present with psychiatric and neurological issues, mimicking or exacerbating existing mental health conditions. Furthermore, your experience with medications not providing relief, combined with historical episodes of significant symptoms, raises the importance of a thorough evaluation by specialists.
Next Steps
-
Consult a Rheumatologist: Given your family history and your concerns about autoimmune conditions, connecting with a rheumatologist is a key priority. They can evaluate your symptoms through a detailed physical examination and specific blood tests to check for autoimmune markers (like ANA, rheumatoid factor, or others), which can help identify any underlying conditions.
-
Document Your Symptoms: Maintain a detailed diary of your symptoms, noting when they occur, their severity, and any potential triggers. This information will be valuable for any specialist you see and can help in diagnosing your condition more accurately.
-
Consider a Neurologist's Input: Since you have experienced significant neurological symptoms, a consultation with a neurologist can also be beneficial. They can offer insights into whether your symptoms might be neurological in nature and may suggest additional imaging or tests.
-
Addressing Current Medications: Discuss with your healthcare providers the potential impact of your current medications (like lithium) on your skin and any connection to your previous psoriasis. There may be options to adjust your treatment plan that could alleviate symptoms like dandruff while still managing your bipolar disorder effectively.
-
Explore Immunosuppressive Therapy: Depending on the outcome of rheumatological evaluations, the specialist may discuss the possibility of immunosuppressive therapy if an autoimmune condition is diagnosed. This would be based on a careful assessment and not something to pursue without specialist guidance.
In Summary
Taking the proactive step to consult a rheumatologist while continuing to track your symptoms could bring you closer to understanding the potential autoimmune elements that may be at play in your health challenges. Gathering comprehensive information and collaborating with specialists will provide a more structured pathway toward better managing your condition. Let me know if I can assist you further!
Related Questions
Unexpected Head Pain During Dance Moves
This may seem humorous, yet I'm genuinely interested in uncovering the cause of this peculiar experience. I’m a 34-year-old female. A few months back, hoping to elevate my mood and get my body moving away from the grip of depression, I decided to play some music and dance in my living room. In a moment of misguided enthusiasm, I attempted to twerk. It's worth noting that I have a long history of lower back discomfort, I've never attempted to twerk before, and I lack the rhythm, flexibility, or skills typical of proficient dancers. As I embarked on my very first serious twerk attempt, a sudden jolt of agony shot through my forehead, nearly causing me to lose consciousness. It felt like being struck with a hammer. I was momentarily blinded by the pain, convinced I might have suffered an aneurysm or something equally serious. This intense sensation only lasted for about a minute, during which I dramatically considered that I might be the first individual to perish from twerking. You might think it was just a case of me bumping my head while trying to dance away my sadness; however, I assure you that this wasn’t the case. Just as abruptly as the pain struck, it dissipated. In that moment, I promised myself to never attempt twerking again. Fast forward to today, and I experienced a similar incident again—not the twerking, but the sudden stabbing pain in my skull. I was engaged in some back stretches, particularly the cat-cow pose, and during the cow portion, I once more felt an intense sharp pain in the center of my forehead, just above my right eye. Stars filled my vision, and everything seemed slightly distorted. This sensation vanished within seconds, leaving me puzzled. What is causing this reaction? How do my forehead and lower back relate in this context? It's baffling! I genuinely seek any insights that might help explain this mysterious phenomenon.
14-Year-Old Male with Cough and Rash Symptoms
My 14-year-old son, who stands at 5 feet 3 inches tall and weighs 149 pounds, has been experiencing persistent cough and cold-like symptoms for slightly over a week. He stayed home from school on January 30 and February 3 as he was feeling unwell, but aside from that, he has managed to attend school. The predominant issue has been his cough. Initially, he had a runny nose for a couple of days, but that symptom has since resolved. He has not complained about a sore throat or experienced any fever. This afternoon, he reported developing a rash with red spots. He mentioned that it itches a little, but it's not uncomfortable, and he does not feel any pain. The rash is primarily located on his abdomen and chest, with some patches on his legs and a little on his arms, but there are no spots on his back. I checked his temperature, which was recorded at 99.4°F. He is fully vaccinated according to the standard vaccination schedule recommended by pediatricians in the United States. Our residence is near Vancouver, WA, in case that information is pertinent. Additionally, we have not changed any laundry or personal care products recently. What could this condition possibly indicate?
Unusual Urges to Consume Non-Food Items
At 23 years old, I am contending with various health issues, including anemia (with an iron saturation of 6%), and I’ve read that this might be influencing my bizarre cravings. There’s more going on with my health, but delving into all of it would take quite a while. Recently, I stumbled upon a video showcasing cleaning techniques, and I experienced an intense and unexpected hunger when I witnessed the soap lathering. Despite having dinner afterward, my cravings persisted, and regular food has proven ineffective at satisfying my appetite. To provide some background, I also have bipolar II disorder, ADHD, OCD, PTSD, and generalized anxiety disorder. These peculiar cravings appeared following several stressful experiences in my life. In the past, I was compelled to induce vomiting due to an OCD ritual, which I believed was linked to avoiding “bad luck.” Logically, I understood that there was no connection, but at one point, I was so entangled in these thoughts that I restricted my food intake entirely, convinced that eating brought misfortune. I was also unmedicated during that challenging period. Fortunately, I managed to break those cycles a few years ago, but now I face an ongoing struggle with overwhelming hunger. I find myself in the obese category today, unlike previously, and I am actively pursuing options for gastric bypass surgery due to my incessant appetite. Although I feel confident I won’t actually consume soap, I am concerned that sharing these cravings might jeopardize my chances of qualifying for the procedure. Still, if there’s a viable solution, I’d like to discover it. These cravings don’t dominate my thoughts, yet whenever I come across soap—either in videos or in person—I get this overwhelming desire to consume it. It’s as if I believe that succumbing to this urge would somehow provide relief and satisfaction. I’ve made a conscious effort to limit my viewing of such cleaning videos but find myself tempted to order edible chalk to see if that might alleviate my unusual hunger.
Are My Symptoms Indicating an Impending Stroke?
I’m a young adult female, weighing 99 pounds and standing 5 feet 2 inches tall. I do not smoke, vape, or consume alcohol, and currently, I am undergoing tests for POTS and HEDS. For the past two weeks, I have been experiencing intermittent discomfort in the upper region of my head, particularly in the back and temples. These aren’t typical headaches, but rather sudden twinges of pain that occur sporadically throughout the day. Additionally, over this same period, I have been dealing with bouts of vertigo—probably about 4 to 5 days where it came and went. A few days back, I also encountered a tingling sensation in my arms, which I can’t tell if it was simply due to anxiety. Given that my aunt suffered a stroke in her thirties, the prospect of having a stroke terrifies me. I find that the emergency room here primarily prescribes pain medication if you mention head discomfort, which leaves me uncertain about what steps to take next. Could these symptoms signal an impending stroke? Furthermore, I've also been experiencing pain in my left leg, though I’m unsure if that’s connected to my other symptoms.
Young Plumber with Herniated Discs Seeks Guidance
Greetings, medical professionals. I am a 17-year-old plumber who has dedicated the past two years to this trade, beginning when I was just 15. About two years ago, I was involved in a car accident that led to the discovery of three herniated discs: one located in my upper back, while the other two are situated in the mid to lower back region. While it's possible that these injuries stemmed from the accident, I suspect they might not be entirely related. Interestingly, disc problems seem to be common in my family. I'm concerned about my prospects moving forward. What can I expect in terms of health as I age, especially regarding these injuries? Moreover, how can I prevent a situation where I may struggle with mobility in my 50s or 60s? For some time, my pain subsided, but recently, I've started to experience discomfort again in the mid to lower back area, reminiscent of what I felt initially. Any advice or insights would be greatly appreciated!