Holistic helpers for bipolar disorder 

My daughter has bipolar disorder and takes medication for it, but still suffers badly with symptoms. Can you recommend any holistic therapies? 

S.K., via email 

 Formerly known as manic depression, bipolar disorder affects more than 1 percent of the population and is the sixth leading cause of disability worldwide.1 A complex and chronic mood disorder, it causes extreme mood swings that include feeling low and lethargic (depression) and high and overactive (mania).  

Mood stabilizing drugs like lithium, as well as antipsychotics, anticonvulsants and antidepressants, are the usual treatments for bipolar disorder, but they come with a long list of side-effects and often fail to bring patients to long-term remission.2

The best plan would be to work with a functional medicine practitioner who can help rule out underlying conditions that could potentially be causing or contributing to symptoms, such as a thyroid disorder3 or a nutritional deficiency,4 as well as look into environmental factors.  

But here’s a roundup of the most promising holistic options for bipolar disorder. Most have been trialed alongside standard medication, but your daughter should check with her doctor about possible interactions and which treatments would be right for her. She definitely shouldn’t stop taking any medication suddenly. 

Exercise 

Exercise is well-known to have an antidepressant effect.5 And studies specifically in bipolar patients have found physical activity to be associated with fewer depressive symptoms and better functioning and quality of life.6 However, watch out if you take lithium and do vigorous exercise, as lithium can be lost in sweat.7

Make time for mindfulness 

Mindfulness-based cognitive therapy (MBCT), which combines elements of cognitive-behavioral therapy with mindfulness-based stress reduction, is showing promise for bipolar disorder. It’s been found to alleviate depression and anxiety in bipolar patients as well as improve cognitive functioning—such as memory and the ability to initiate and complete tasks—which is often impaired in bipolar disorder.8

For more on MBCT and to find an MBCT teacher, visit www.mbct.com (US) or www.mbct.co.uk (UK).

Go keto 

Preliminary evidence suggests that a ketogenic diet, which is high in fat and low in carbohydrates, could be helpful for bipolar. A study of self-reports posted online about the diet found that 85 percent of comments reported a positive impact on mood stabilization. Reported improvements, many lasting for months to years, included fewer episodes of depression, improved clarity of thought and speech, increased energy and weight loss.9

And case studies of two women with bipolar following the diet, who maintained ketosis (the goal of the ketogenic diet—when there’s a high concentration of ketones in the blood) for two to three years, reported mood stabilization over and above that achieved with medication.10

Ideally, if you want to try the diet, do so under supervision by an expert such as a ketogenic dietitian.

Avoid processed foods 

Eating processed meats, which contain nitrates to prevent the growth of bacteria, has been linked to mania. And feeding processed meats to rats has resulted in “hyperactivity reminiscent of human mania.”11

A high intake of sugar and high fructose corn syrup (HFCS) has also been implicated in mania and bipolar disorder.12

Aim to eat a whole-food diet limiting processed, packaged foods as much as possible. 

Consider other supplements 

Coenzyme Q10 (CoQ10). Oxidative stress and inflammation are thought to play a role in bipolar disorder, so CoQ10, a potent antioxidant and anti-inflammatory, may be beneficial. When put to the test against a placebo as an add-on treatment for bipolar patients, CoQ10 was found to significantly improve symptoms of depression as well as biological markers of inflammation and oxidative stress.15

Suggested dosage: 200 mg/day 

B vitamins. Low levels of folate (vitamin B9) have been linked to bipolar disorder,16 and patients on lithium who took daily folic acid supplements saw significant improvements in their symptoms compared to those taking a placebo.17 There’s also evidence to suggest that a deficiency in vitamin B12 may be a cause of manic symptoms. Case reports found that symptoms completely resolved when the deficiency was corrected with B12 injections.4,18

Suggested dosage: Get levels tested first, then supplement with an appropriate dosage

N-acetylcysteine (NAC). Some evidence suggests that this amino acid—used alongside usual treatment—can help reduce symptoms of depression in bipolar patients, possibly because of its anti-inflammatory effects.19

Suggested dosage: 1,000 mg twice/day

Opt for omega-3s 

Omega-3 fatty acids, found in fish oil, have been found to have an antidepressant effect in patients with bipolar disorder.13 In one study, those given a high dose of omega-3s on top of their usual treatment saw significant improvements compared to those given a placebo.14

Suggested dosage: Try a high-quality supplement, such as Bare Biology’s Life & Soul Pure Omega-3 Liquid, which supplies 3,500 mg omega-3 per teaspoon, and follow the label instructions.

Watch out for heavy metals 

High levels of cadmium (found in tobacco, food and drinking water) and lead (found in old paint, cosmetics, food and drinking water) have been linked to bipolar disorder.20 Reducing your exposure to heavy metals and helping your body to detox naturally may therefore be beneficial. Getting a water filter, such as the Zero Water Filter, is a good place to start, and supplements of Chlorella algae may also help.21 See the WDDTY January 2020 issue for more tips, but, again, be careful with anything that involves sweating, like sauna bathing.

See the light 

Bright light therapy, originally used to treat patients with seasonal affective disorder (SAD), appears to be effective for bipolar disorder. In a review of 12 trials, the therapy significantly reduced depressive symptoms when a light intensity of 5,000 lux or more was used.22 Check out Lumie for a great range of light therapy products (www.lumie.com).

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