What are natural treatments for bipolar disorder?

Introduction

Previously known as manic-depressive disease or disorder, bipolar
disorder is a relatively common mental health condition
manifested in its classic form by alternating periods of mania (extreme high
energy) and deep depression. In the “up” or manic phase, people may sleep
little, talk fast, develop grand and unworkable plans, and sometimes behave
bizarrely (for example, giving away all their money overnight). In the “down”
phase, they may contemplate suicide. In many people with this disorder, the down
phase predominates, so the diagnosis may be missed. Other, more subtle versions of
the condition also exist.

Bipolar disorder is dangerous unless treated, leading to a high rate of
suicide and injury. The mineral lithium has been shown to
dramatically improve symptoms of mania and reduce the rate of suicide. Various
antiseizure medications also appear to reduce mania.

Proposed Natural Treatments

There are no natural treatments that can substitute for medications in the treatment of bipolar disorder. However, some natural treatments might enhance the effectiveness of standard treatment.

In a double-blind study reported in 1999, thirty people with bipolar disorder took either fish oil capsules or placebo for four months, in addition to their regular medications. Those taking the fish oil had longer symptom-free periods than those taking placebo. The researchers used five different standardized tests to measure symptoms, examining levels of depression, mania, and overall progress. The people taking fish oil proved emotionally healthier than those taking placebo on all but one of these tests. Another study found that ethyl-EPA (a modified form of a constituent of fish oil) was helpful with standard treatment for the depressed phase of bipolar disorder. A third study failed to find ethyl-EPA helpful for rapid cycling bipolar disorder. Overall, the evidence for benefit is not convincing. A 2012 clinical study in which a test group was given fish oil capsules with oral cytidine, which is a pyrimidine that has shown promise as an antidepressant, failed to produce an outcome that indicated it would be effective in combating bipolar syndrome.

The same researchers who conducted the fish oil study also experimented with flaxseed oil for bipolar disorder. Flaxseed oil contains alpha-linoleic acid (ALA), an omega-3 fatty acid related to the fatty acids in fish oil. In the researchers’ informal observations of twenty-two people with bipolar disorder, all but four appeared to benefit from flaxseed oil. However, lacking a double-blind study, these results cannot be taken as meaningful.

One somewhat questionable study reported that an herbal combination utilized in
traditional
Chinese medicine (called Free and Easy Wanderer) may augment
the effectiveness of carbamazepine treatment for bipolar disorder. Weak evidence
suggests possible benefits with choline, lecithin, vitamin C,
and inositol. Inositol may also reduce psoriasis symptoms caused by lithium.
However, caution is advised with inositol.

A special form of magnet therapy, called rTMS (repetitive
transcranial magnetic stimulation), has shown some promise for bipolar disorder.
Also, the use of an anion generator (an air ionizer that produces negative ions)
has shown promise for mitigating the symptoms of acute mania.

Various supplements may help reduce the side effects of antiseizure drugs. Also, despite promising preliminary indications, a double-blind study failed to find that folate enhances the effect of the drug lithium. Lithium is sometimes sold as a mineral supplement for treating bipolar disorder. However, this proposed use is based on a misunderstanding. When lithium is used medically as treatment for bipolar disorder, it is taken at doses far above any possible nutritional need. No researcher has seriously suggested that lithium deficiency causes bipolar symptoms, and low doses of lithium are unlikely to have any effect.

Herbs and Supplements to Use Only with Caution

Antidepressant drugs may cause manic episodes in people with
bipolar disorder. For this reason, herbs and supplements with antidepressant
properties might also be risky. Case reports suggest that S-adenosylmethionine,
St. John’s wort, and inositol can trigger manic episodes.

The supplement L-glutamine, while not normally considered to have antidepressant properties, has reportedly triggered episodes of mania in two people not previously known to have bipolar disorder. A ginseng product has also been associated with an episode of mania.

The supplement chromium is often sold in the form of chromium picolinate. Picolinate can alter levels of neurotransmitters. This has led to concern among some experts that chromium picolinate might be harmful to people with bipolar disorder.

It has been suggested that the drug lithium works, in part, by reducing the body’s level of vanadium. Persons with bipolar disorder should avoid using supplements that contain vanadium. Numerous herbs and supplements may interact adversely with drugs used to prevent or treat bipolar disorder. For example, people who use lithium should avoid herbal diuretics.

Bibliography

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