Q. I've noticed that I am almost always sick when I am manic with extreme sinus and ear congestion. Also get headaches which feel like brain is swelling or I'm wearing a hat that's too tight. (I'm Bpd and rapid cycling bipolar among other things). Often my physician puts me through two or more courses of antibiotics before the sinus/ear "infection" goes away. Of course I can't take decongestants and antihistamines: learned that on my own, the hard way, like most every thing else about these disorders.

My mother and her mother both had similar mental diagnosis's (my grandmother was hospitalized in a mental institution for 17 years and died there while in her 30's) and I remember my mom having constant sinus trouble. When I am mentally healthy I rarely get sick like this. Is there something besides a compromised immune system and stress to account for this?

I have this weird idea stuck in my head that the chemicals causing the rapid cycling are somehow clogging up my whole head. Ridiculous, I know, but you never know.

  A. There are a number of studies indicating that mania and depression compromise parts of the immune system. Not a total compromise, but enough that you might get ill more easily.

As far as decongestants, I have good luck with Claritin and Zyrtec in my manic patients. They are both once daily, and dry you out pretty well. Antibiotics are not my forte, and I would go with whatever covers most nosicomial infections that your internist offers.