Bipolar disorder, also known as manic-depressive disorder, is characterized by mood swings ranging between depression and energetic mania. In most cases, bipolar disorder can be managed with medication and counseling. One of the mood stabilizing drugs used to treat bipolar disorder is sodium valproate, a salt of valproic acid. Adding a healthy diet and exercise routine to your treatment plan may alleviate some side effects and help balance your life.
Overview of Bipolar Disorder
Bipolar disorder is characterized by mood swings between a low, depressed mood and a high, manic mood. These mood periods can last from several months to only a few hours. Bipolar disorder has several subtypes based on the severity of the mood swings or the level of disruption of your life.
Symptoms during a depressed period may include: sadness, fatigue, guilt, anxiety or loss of interest. Symptoms during a period of mania may include: euphoria, increased energy, increased risk taking, increased aggression, and rapid speech, thoughts and behavior. Symptoms that may be present throughout mood swings may include irritability, problems concentrating, anxiety and disruption of sleep, appetite and work or school performance.
It is important to note that bipolar disorder is characterized by the disruption of your life, and treatment should focus on that specific disruption and not just on regulating your mood.
How Sodium Valproate is Thought to Work
Unfortunately, the brain is exceptionally complex, especially when it comes to controlling behavior. The cause of bipolar disorder is not understood, although there is significant evidence that imbalances in neurotransmitter levels and the signaling of another messenger molecule, arachidonic acid, are involved.
Sodium valproate regulates the main inhibitory transmitter GABA, preventing over-inhibition, thereby moderating the decreased brain activity that may cause depressive episodes. Sodium valproate is also used to prevent seizures and acts to block certain types of ion channels responsible for propagating brain activity. Over-activity is thought to underly manic episodes.
In addition to neurotransmitter activity, the level of arachidonic acid, a phospholipid found in large amounts in the brain, has been shown to correlate with manic-depressive episodes and is also affected by sodium valproate administration. Too little arachidonic acid has been correlated with depression and too much has been correlated with manic episodes.
Side Effects
Sodium valproate is a fatty acid that gets distributes throughout your body and has a broad range of effects outside of therapeutic targets. Although most of these are mild or occur in only a small percentage of people, a few of the common ones can be mitigated through better diet and exercise. These include high blood pressure, weight gain, liver stress, gastrointestinal distress, increased cholesterol, sleep disturbances and hypoproteinemia (or low levels of available protein).
Diet and Exercise Recommendations
A poor diet and lack of exercise can worsen the side effects of sodium valproate. You should follow a diet high in fiber and protein and avoid foods with large amounts of sodium and processed carbs. Although it may be harder to get motivated to exercise while on sodium valproate, exercise should be a routine part of your day.
The best way to approach a high-fiber and high-protein diet is to plan to have lean protein with fruits and vegetables at each meal. Good sources of protein are beans and other legumes, omega-3 eggs, chicken breasts, lean beef or pork and soy-based proteins. All fruits and vegetables are good for your in moderation. Several that are particularly high in fiber are beans and other legumes, blackberries, pears and raisins. Drink plenty of water throughout the day when consuming a high amount of dietary fiber.
Your body is continually balancing pro-inflammatory and anti-inflammatory signals. Sodium valproate affects levels of arachidonic acid, which may bias your body toward inflammation. Certain diets can produce low levels of chronic inflammation that could worsen the side effects of sodium valproate. Diets high in omega-6 fatty acids and low in omega-3 fatty acids promote inflammation. Take an omega-3 supplement with each meal and eat foods rich in omega-3 fatty acids such as flaxseeds, chia seeds and cold-water fish such as salmon. According to Dr. John Berardi, matching your intake of protein and carbs with vegetables can help prevent the buildup of acids in your bloodstream that can cause inflammation and metabolic dysregulation.
Caution
Bipolar disorder is a serious, long-term medical disorder. Any changes to your treatment should be performed with the knowledge and supervision of your doctor. If your current medication is having disruptive side effects or is not effective, do not discontinue it. Instead describe your complaints in detail to your doctor and decide together on an alternative course of treatment.
References
- MayoClinic.com: Bipolar Disorder
- Drugs.com: Valproic Acid and Derivatives
- "Biochemical Society Transaction"; Is the Brain Arachidonic Acid Cascade a Common Target of Drugs Used to Manage Bipolar Disorder?; Bazinet, RP; 2009
- "Cellular Molecular Life Sciences"; The Mechanisms of Action of Valproate in Neuropsychiatric Disorders: Can We See the Forest for the Trees?; Rosenberg, G; 2007
- Colorado State University Extension: Dietary Fiber
- Precision Nutrition: Covering Your Nutritional Bases: The Importance of Acid-Base Balance
