giddykitty, I'm also sorry to read that you were so sick as to need the ER.

I have definitely heard of people who get headaches, or even migraines, when mania is coming (or maybe comes), like bluebicycle mentioned. That has not been my usual experience, though.

I definitely see how anxiety can play a part, like HALLIBETH mentioned. Probably the only time I have felt at all ill is when anxiety has been part of past manias, which are usually cases of only mixed manic episodes. I suppose when they are the case, for me, I do notice an increase in gastrointestinal distress (heartburn, indigestion, diarrhea). I believe I recall hypomanic/manic periods when I kept Tums/Alka Seltzer on hand. It didn't really bother me THAT much, though, but I believe there was a correlation.

Actually, something I know is the case when I am manic is that I have an even higher tolerance to pain, than usual. It is not unusual for me to accidentally injure myself when manic (falls, twisting my ankle, accidental cuts, etc.) Or if mixed manic, I may get a bit violent towards myself (punching walls, slapping myself, etc.) and it can be rough. I'm a strong lady! I can even more easily tolerate illnesses, like chest colds, without as much distress. Once I was in such a manic frenzied fury that I decided to run down a very steep hill. Obviously, it was a bad idea! I fell so hard that both of my knees and lower legs swelled up, my arms were scrapped, and I had a black eye. It barely bothered me. My right knee is still not quite the same as before that.

I also agree with bluebicycle that different people with bipolar disorder experience things differently. Part of it could be the unique "flavor" of their illness (characteristics), but also the tendencies of an individual person.