Bipolar disorder is a condition characterized by extremes of polarity affecting psychological and behavioral conduct. The condition is a result of neurotransmitter or brain chemical imbalances that lead to drastic shifts between expressions of depression and mania. The National Institute of Mental Health, or NIMH, notes that mood stabilizing and antidepressant medications are the most common forms of medical therapy. Psychotherapy is also important; the NIMH says alternative supplements such as St. John's Wort and omega-3s have also been investigated. All supplements should be discussed with your physician before use.
Natural Antidepressants
St. John's wort is a well-known natural antidepressant. Its effects help to maintain healthy levels of important brain chemicals by limiting how the body disposes of them. Low levels of these chemicals are indicated in depression. SAMe, otherwise known by its chemical name S-adenosyl-L-methionine, affects depression through its involvement in the production of various neurotransmitters, according to a 2002 article in the American Journal of Clinical Nutrition, or AJCN. Omega-3 fatty acids are reported by a Prevention magazine article to be lower in the blood of depressed patients. According to Prevention, supplementing the diet with 1.5g to 2g omega-3s per day with conventional medications offered significant benefit to bipolar patients.
Consult a doctor before using alternative supplements for the alternative treatment of bipolar disorder. The NIMH says taking St. John's wort may cause a switch from depression to mania in some people. The ACJN article concurs that the antidepressant action of SAMe may also result in manic swings and suggests its combined use with either mood stabilizing or antipsychotic medications. However, the omega-3 fatty acids were found in a 2008 Cochrane Database of Systematic Reviews article to benefit depression without affecting the manic aspect of the disease.
Manic Mood and Behavior
The manic aspect of the disease is characterized by the National Institute of Mental Health as affecting both mood and behavior. Mood changes include long periods of feeling overly happy or outgoing with possible interspersed period of extreme irritability, agitation or a "wired" feeling. The behaviors that result may include fast talking, racing and unfinished thoughts, ease of distraction, restlessness, unrealistic beliefs in one's abilities, impulsive and high-risk behaviors as well as excessively acquiring new projects and goal-directed activities. Alternative supplements for managing the manic aspect of the disease are discussed by the Prevention article but are less well studied.
Managing the Mania, Naturally
The Prevention article suggests the use of choline in two divided doses of 2g to 4g per day as being helpful in boosting the levels of the nervous system chemical acetylcholine. Low levels of acetylcholine are believed to potentially induce manic behavior, and supplemental choline can increase these levels. Restricting supplemental calcium or supplementing only under medical supervision was suggested by Prevention, as high levels of calcium slightly increased mania and restriction alleviated some mania symptoms. A moderate potency multivitamin-mineral-amino acid supplement was found to lower mania symptoms by 60 percent, while also decreasing depression by 71 percent in a small six-month trial. Discuss all supplements with your doctor.
Cellular Free Radical Damage
The origin of bipolar disease has long been thought to be related to imbalances in important neurotransmitters such as serotonin, norepinephrine and acetylcholine. However, emerging research is pointing to the molecular pathway of the disease to dysfunction in the crucial energy producing powerhouse of the cell--the mitochondria. The dysfunction of the mitochondria is believed to be caused by free-radical damage. Mitochondrial dysfunction has been implicated in many other conditions, mostly degenerative and age-related diseases such as dementia and Alzheimer's but also including chronic conditions such as heart disease and chronic fatigue syndrome. This pathway was outlined by a 2007 Experimental and Molecular Pathology journal article.
Antioxidant Therapy
Free radical damage is considered reversible, or at least manageable by the use of antioxidants. Antioxidants such as alpha-lipoic acid, l-carnitine and CoQ10 have been studied for their effects as mitochondrial cofactors by a 2008 Expert Opinion on Investigational Drugs. The study concluded that the supplements are capable of protecting the nervous system and possibly enhancing cognition.
References
- National Institutes of Mental Health (NIMH): Bipolar Disorder
- American Journal of Clinical Nutrition: "Role of S-adenosyl-L-methionine in treatment of depression: A Review of the Evidence"
- Cochrane Database of Systematic Reviews: "Omega-3 fatty acids for bipolar disorder"
- Prevention: "Natural Remedies -- Bipolar Disorder"
- Experimental and Molecular Pathology: "Mitochondrial dysfunction and molecular pathways of disease"
