My husband was diagnosed with RSD (reflex sympathetic dystrophy) in 1985. His bipolar diagnosis didn't come until about 5 years ago. It doesn't seem like one caused the other, but they do aggravate each other. If his pain in worse, he has more problems coping emotionally and mentally, and vice versa. The pain syndrome also comes with high blood pressure and diabetes which both aggravate the bipolar if they aren't managed well.