Bipolar disorder (BP), once known as manic depression, is defined by and diagnosed according to cycling between two disruptive mood extremes. On the one end of the spectrum is profoundly low energy, despondency or despair (the depressive element). On the other end is high energy, atypical elation, and reckless over-confidence (the manic aspect).
These mood swings can be short- or long-lived and often negatively impact thought patterns and behavior, relationships, learning, working, and overall quality of life. While the condition is chronic with no known cure, those affected can manage it with proper treatment once diagnosed.
According to the World Health Organization (WHO), bipolar disorder is the sixth leading cause of disability worldwide, affecting 6.3 million US adults (2.6%). The mental health condition is usually diagnosed in the late teens or early adulthood (average age 25). However, it can also be picked up in childhood or later, even among adults in their 40s and 50s. The condition is experienced equally among males and females and occurs across all ethnicities, races, and social classes.
Due to the disruptive nature of this illness, many with bipolar disorder experience symptoms for up to ten years before an accurate diagnosis. Only a quarter receive appropriate diagnoses within three years of symptom onset. In addition, females are more likely to be misdiagnosed with unipolar depression (major depressive disorder) and males with schizophrenia.
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More About Bipolar Disorder
There are two types of bipolar: bipolar I and bipolar II. The latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5, published May 2013) defines bipolar I as involving episodes of depression and severe mania. In Bipolar I, manic episodes continue almost every day, for most of the day, for at least seven days.
Depressive or mixed feature episodes usually last for at least two weeks, with severe manic symptoms often warranting urgent medical attention. Tragically, bipolar can result in a nine-year life span reduction, with an up to 20% suicide rate.
What distinguishes bipolar II is a milder form of mania called hypomania. Symptoms can otherwise overlap.
Symptoms of bipolar depressive episodes can include severe fatigue, loss of interest in favorite activities, unexplained crying, and sleep disturbances such as insomnia or hypersomnia. There may also be ongoing thoughts of suicide.
A bipolar II diagnosis requires one or more major depressive episodes, while bipolar I does not (although one or more may have been experienced). In both diagnoses, periods of emotional stability (euthymia) may occur.
A combination of manifestations can identify manic episodes. These symptoms include a noticeable increase in energy, less need for sleep, heightened libido, feelings of euphoria or irritation, delusions of grandeur, and, potentially, hallucinations. These periods of hyperactivity can incorporate impulsive decision-making and reckless behavior, such as excessive spending or high-risk sexual behavior. This extreme of the cycle usually lasts at least seven days.
While experiencing a manic episode does not necessarily suggest violent or aggressive behavior, more severe symptoms could include the potential for self-harm, requiring hospitalization.
Hypomania shares symptoms with mania but with more limited impairment. These milder episodes seldom require hospitalization, with those experiencing the episode even enjoying the benefits of more energy and less sleep.
A cyclothymic disorder presents as recurring hypomanic and depressive symptoms. These symptoms are not sufficiently intense or enduring to qualify as bipolar episodes.
Experiencing four or more manic or depressive episodes within 12 months is called “rapid” cycling. “Unspecified” bipolar is diagnosed when symptoms are intense but don’t align with bipolar I or II requirements.
Many with bipolar also experience other mental issues concurrently, such as eating disorders, substance abuse, anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and dermatillomania (skin picking). However, what causes this frequently debilitating disorder?
What Causes Bipolar Disorder?
No one knows precisely what causes bipolar. However, the following factors seem to contribute:
- Genetics: Over two-thirds of those with bipolar have at least one near relative with bipolar or depression. Studies of bipolar I indicate shared occurrence among 40% of identical twins compared to only one in every ten fraternal twins. Additionally, the condition is more likely to affect children of parents with bipolar. The risk ranges from 15% with a single parent to 75% with both parents living with the mental illness.
- Brain structure and functioning: Bipolar may be caused by changes in brain circuitry, neurotransmitter irregularities, or executive functioning deficits.
- Environmental factors: External triggers can include childhood abuse or trauma.
Possible causes are diverse, with factors such as disability, poverty, and individual psychology possibly increasing predisposition. In addition, while the condition occurs equally across genders, the disorder can present differently among biological females. Biological females (and those diagnosed with bipolar II) are more likely to experience “rapid” cycling and a more significant number of depressive episodes than biological males with bipolar.
How Is Bipolar Disorder Treated?
Therapy aims to alleviate the distressing symptoms of mania and depression in the short term while also focusing on stabilizing mood in the long term. Approaches vary depending on diagnosis and mood.
Treatments usually combine psychoeducation (helping the patient understand and monitor symptoms), lifestyle adjustments, individual, family-focused, and group psychotherapy and counseling, and medication. The most prevalent bipolar psychotherapy modalities are cognitive behavioral therapy (CBT) and patient-to-patient support groups.
Pharmaceutically managing mood and symptomology is a delicate art. Antidepressants during the depressive phase can tip the patient into mania or psychosis. In contrast, antipsychotics during the manic phase can drop the individual into depression. As a result, while these approaches are warranted in mood extremes, stabilizers such as lithium are also recommended.
The Delicate Art of Medically Managing Bipolar
Unfortunately, according to the Surgeon General Report for Mental Health, lithium success rates during acute manic episodes can reach 85%. However, recently, it’s common to see response rates of 50% or less. Additionally, while mania can be more successfully controlled, antidepressants may be less effective in managing depression.
At the same time, the potential side effects of multi-medication bipolar regimes can be unpleasant and frustrating. The challenges of the program and unwanted consequences can leave people feeling overwhelmed, leading to treatment non-compliance or cessation, both adding unnecessary, potentially dangerous complications.
Among the most common side effects are depression – the most patient-dreaded of the extremes, weight gain, and feeling zombie-like instead of fully “alive.” Some medications can also predispose users to other conditions, such as thyroid and kidney diseases, or be contraindicated in pregnancy.
People facing these challenges increasingly turn to dietary supplements and other lifestyle changes or additions to help manage side effects or symptoms. What are these supplements, and how can they help?
Supplements for Bipolar Disorder
A holistic wellness approach, including a healthy diet, adequate hydration, rest, exercise, and social support, is foundational to ensuring nutrition to support your body and brain when diagnosed with bipolar. At the same time, appropriate supplementation can help replace any nutrients reduced or lost due to medication and boost those that can help you cope, especially with bipolar lows.
Among the vitamins, minerals, and other supplements experts recommend for complementary use are folate (folic acid), omega-3 fatty acids, NAC, vitamin D, and co-enzyme Q10 (CoQ10). Other promising inclusions are magnesium and melatonin.
Folate (Vitamin B9, Folic Acid)
This vitamin and its synthetic form, folic acid, is essential for helping maintain cell health and growth. According to research, there may be an association between low folate levels and bipolar disorder. Instead, a dose of 3mg was found to be safe and effective in combination with medications in treating bipolar I mania. Vitamin B-9 supplements are also more successful than placebos in treating depression.
Omega-3 Fatty Acids
These healthy fats are obligatory for optimal functioning, especially for the brain and heart. Plant-oil-based alpha-linolenic acid (ALA), marine-based eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) have been well-researched for possible neuroprotective benefits. Findings suggest that supplementing with omega-3 fatty acids can improve bipolar depressive symptoms, especially DHA and EPA.
N-Acetyl Cysteine (NAC)
NAC is an antioxidant that may help prevent cancer and, potentially, bipolar. Clinical trials have suggested that supplementing with NAC combined with medication may be better than a placebo for managing bipolar depression, skin picking, and OCD.
The “sunshine” vitamin helps maintain healthy calcium levels for bone health. According to the Journal of Clinical Psychopharmacy, it is five times more deficient among those with bipolar than average. Supplementing with Vitamin D, regularly eating vitamin D-rich foods such as eggs, mushrooms, and oily fish, and spending a few minutes in the sun may help.
Coenzyme Q10 (CoQ10)
In combination with antidepressants and mood stabilizers, CoQ10 proved better than a placebo in reducing bipolar depression. This result may be thanks to its antioxidant and anti-inflammatory functions.
Melatonin is a brain hormone generated by darkness to promote sleep, potentially helping those with bipolar manage insomnia during manic or hypomanic episodes.
Cognitive-enhancing nootropics work deep within cell mitochondria to boost oxygenation, increasing energy, focus, clear thinking, and elevated mood. While these natural and synthetic supplements offer milder side-effect profiles than conventional bipolar pharmaceuticals, they should never be considered a substitute.
If you’ve been diagnosed with bipolar disorder, selective supplementation can help support your system and mood when using a range of medical bipolar treatments. However, while vitamins, minerals, and herbs may seem benign, many have potent effects, particularly when controlling such a complex condition.
So, always consult your doctor or other medical professional – even a pharmacist – before taking any supplements to avoid unwelcome drug interactions. Contraindicated combinations could reduce the effectiveness of your medication or cause rapid heart rate, blood pressure changes, or liver damage.
What to Know Before Supplementing for Bipolar
It’s essential to use high-quality supplements from reputable brands. Unfortunately, the US Food and Drug Administration (FDA) is not authorized to regulate supplement and vitamin efficacy or safety, making sourcing appropriate products challenging. At the same time, credible manufacturers tend to state warnings and contraindications clearly on their labels, so always review these carefully.
Among definite options to avoid are weight-loss supplements containing ephedra, SAMe (s-adenosylmethionine), the herbs Rhodiola rosea and St. John’s Wort, and the hormone DHEA (dehydroepiandrosterone), as these may exacerbate specific mania symptoms.
Supplements for Bipolar Disorder: Promising Support for BP Depression?
Safely exploring the promising and natural support offered by selected omega fatty acids, vitamins, minerals, and nootropic supplements is a potential adjunct solution to difficult-to-manage bipolar depression. The goal is to manage your condition within an overall pattern of self-care. This approach means taking prescribed medications diligently and under a doctor’s supervision, potentially combining them with quality-of-life enhancing therapies, support, and supplements.
Disclaimer: Last update on 2024-02-24 / Affiliate links / Images from Amazon Product Advertising API.
This content is provided solely for educational reasons and should not be seen as medical guidance. It’s important to consult with a healthcare expert prior to making any changes to your health regimen, including dietary adjustments or the use of supplements.
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