Complementary and Alternative Treatments for Bipolar Disorder

If you have bipolar disorder, you know how upsetting it can be when your treatment does not work. And you are not alone. Of the estimated 45 million people worldwide with bipolar, most have good and bad times. Sometimes you feel balanced and healthy (remission). Other times you feel unbalanced and manic or depressed (relapse).^1,2

Bipolar and integrative health practices

Side effects might also bother you. Or you may just not want to take strong medicines for the rest of your life. Maybe you feel that bipolar disorder drugs prevent you from living a meaningful life. You might have heard that complementary and integrative health (CIH) practices have advantages such as:^2-10

• Fewer side effects
• Thought to be "natural" approaches
• May cost less than drugs

Whatever your situation, be careful. While CIH options exist, studies have not proven the safety and effectiveness of all of them. If you decide to check out alternative substances and practices, talk first with your doctor:^1-3

• Tell them your concerns.
• Learn about the knowns and unknowns of your choices.
• Be safe: maintain your current treatment while you explore.

More "natural" mood stabilizers for bipolar?

Studies list different nondrug ways to help balance bipolar symptoms:^1-10

• Nutraceuticals
• Herbal medicines
• Spiritual exercises
• Physical exercise
• Lifestyle changes

Nutraceuticals

Nutraceuticals are high-grade nutrients that may help treat certain disorders or diseases. In people with bipolar disorder, several biochemical actions can go wrong. For example, the body may have trouble:²

• Forming nerve cells
• Stopping inflammation
• Balancing molecules
• Making energy in cells

One review examined 22 studies from 9 countries, researching 15 nutraceuticals. Four showed promise in treating bipolar:²

• Omega-3 fatty acids
• N-acetylcysteine
• Coenzyme Q-10
• Probiotics

Those that seemed to calm manic symptoms were:²

• Folic acid
• N-acetylcysteine
• An amino acid drink lacking tryptophan
• An amino acid drink lacking tyrosine

The review recommended that doctors closely monitor people who are using these agents. It also suggested that doctors use these agents in addition to – not instead of – conventional medicines. The reviewers stated that more studies are needed.²

Herbal medicines

Herbalists and alternative medicine doctors have long linked herbs with the successful treatment of mental disorders. One review of multiple studies considered the effects of 24 herbs. The author recommended using a mood stabilizer together with any herbal treatment.⁶

Although more study is needed, some herbs showed potential to help with mood disorders:⁶

• Two herbs helped specifically with bipolar symptoms: Korean ginseng and ashwagandha.
• Seven herbs reduced depression in major depressive disorder. But in people with bipolar disoder, some herbs that reduced depression prompted mania.
• Fifteen herbs showed promise in relieving anxiety in generalized anxiety disorder, which can be a part of bipolar disorder.

Spiritual exercises

Through prayer and meditation, you may learn to focus on calm, positive, hopeful thoughts and sensations. One study of 121 people with bipolar reported that 6 out of 10 participants used CIH practices. Five out of 10 said they turned to spirituality. A review of 14 studies concluded that while religion and spirituality seemed to have a positive effect on people with bipolar, more studies were needed.^3,4,7

Yoga is a physical and spiritual exercise. It includes movement, meditation, mindfulness, and controlled breathing. Scientists need to conduct larger studies specifically for yoga and people with bipolar disorder. But early evidence supports its use, as it may:4,7

• Decrease anxiety and depressive symptoms
• Stabilize moods
• Improve focus
• Allow changing of negative thoughts
• Physically improve circulation, heart rate, sleep, weight management, and energy.

Physical exercise

Physical exercise can improve depressed moods. One review examined 41 studies and confirmed that link. Another study also supported the link. Since exercise helps with depression, researchers are looking at exercise in treating bipolar as well. Some say it lessens symptoms.^5,8,9

Lifestyle changes

You can also help yourself cope with bipolar disorder with lifestyle strategies. For example, stop harmful activities and habits like:¹

• Drinking alcohol
• Smoking
• Taking recreational drugs

If you are not already, try the following:¹

• Have a stable daily routine.
• Get at least 8 hours of sound sleep at night.
• Walk for at least 30 minutes a day.
• Find a hobby you like.
• Follow a healthy eating plan.

What is the takeaway?

If you want to supplement your current bipolar disorder therapy, speak to your doctor.^1-3

Certain treatments, substances, and activities may claim to help manage bipolar symptoms. But there is a lack of large studies proving the safety and effectiveness of nutraceuticals or herbal remedies.^1-3,6

Other choices – such as spiritual or physical activity – may help indirectly by increasing your well-being. And positive lifestyle changes may offer you stability and structure in place of the frustrating chaos of bipolar.^1,4,5,8-10