I was diagnosed bipolar 7 years ago at age 33. I am also a married mother of two active girls, working full time and active in school related activities.  My problem is after hectic days I am so physically worn out I feel ill, almost flu-like.  Every morning is a struggle to get going and when the weekends are filled with football games, band trips etc.. it takes almost my whole Sunday to get myself up to par.  My doctor says to accept my need to rest but it just seems odd to me that the tiredness is associated with low-grade fever, sometimes nausea and an overall ill feeling like I'm battling a flu bug.  We never attend church because of this.

Is this a common occurance with bipolar? Other than the physical I feel blessed with my life and my illness.  Could this still be my mind and body rebuilding after a debilatating bout with clinical depression 5 years ago?

Dear Carol -- 
As you can imagine, it's hard to know just how hard you're working, and therefore how much of your fatigue could be attributed to the effort you're expending: it sounds like a lot.   That is, how many of us would feel worn out by the end of hectic days of working full time, then taking care of your family, including facilitating and participating in all their activities.  

However, it also sounds like you're convinced that your degree of tiredness goes far beyond what could be explained on the basis of this activity alone.  In that respect your story sounds very similar to "chronic fatigue syndrome", a vague syndrome but not an "all in your head" syndrome.  In fact, CFS tends to run with "fibromyalgia", and FM tends to look rather like a form of bipolar disorder sometimes.  The point is, I see these three syndromes as having something to do with one another (bipolar, CFS, and FM).  

In that respect, chronic fatigue syndrome kind of looks like the profound "anergy" -- lack of energy -- that is typical of bipolar depression, just without the depression part.  

Too bad we don't have a great treatment for CFS, as if we did I'd suggest you try it -- as long as, like any purported treatment for which little evidence exists, the risks were minimal also.  And that philosophy, making sure that if the treatment has low odds of being effective that at least the odds of being hurt by it are as low or lower, leads me to one idea for you.  If you haven't been through this already, you should have a look at the way thyroid hormone fits into the treatment of bipolar disorder.  There's a treatment option there (follow that link) that has pretty low odds of hurting you, and might help; I think, on the basis of what you've described, there's a chance it might be useful.  Something to discuss with your doctor.   

What you describe is not common, in my experience; and I don't find the "slow rebuilding" theory very compelling, based on what I've seen people go through (i.e. they get better, when they're going to get better, a whole lot faster than that).  I hope you find something to address the fatigue soon.  I was impressed that you could still see the blessings despite these symptoms. 

Dr. Phelps