Since my early career research focused on the search for biomarkers, particularly red blood cell Li-Na countertransport levels in bipolar patients and alcoholic patients, and many of my bipolar patients also had clinical complaints consistent with what is now called fibromyalgia; and my mid-career research focused more on the epidemiology and mental health aspects of HIV infection, through the Multicenter AIDS Cohort Study (the MACS), it is interesting to see other researchers interested in immune function in both affective disorders and fibromyalgia. Have you or any other researchers following your research also seen similarities in the immune profiles of patients with bipolar disorder and fibromyalgia and the state-dependent changes in immune markers?
David, I fully agree that there is a connection between affective disorder and conditions characterized by fatigue and chronic pain, including fibromyalgia, chronic fatigue syndrome, and cancer-related fatigue. And there is plenty of evidence suggesting that the immune system is a mediator. However, I would add to this the role of sleep, particularly REM sleep. It is well known that REM sleep suppression can rapidly reverse depressive symptoms, so one should ask if too much REM sleep (which is determined by our sleep behaviors) might cause depressive symptoms, including fatigue (see attached poster on fibromyalgia and sleep). Since sleep affects the immune system, and vice versa, I submit that the starting point for these conditions may be excessive sleep, especially morning sleep. A hypothesis for why this relationship may have evolved, can be found in the attached poster on cancer fatigue.
All the best,
Henry Olders
Poster Does getting up late cause cancer fatigue?
Poster Fibromyalgia symptoms and sleep patterns
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