Diet and Bipolar Disorder
The area of diet and mental illness is a contentious one. I suspect that’s for several reasons:
1. Many alternative practitioners make their living telling people what to eat and they want to believe this will help.
2. Individuals want to believe the treatment is simple, drug-free and something they can control.
3. The placebo effect leads to dramatic anecdotes.
Here's what we know about diet and bipolar disorder.
Bipolar and Quality of Diet
Quality of diet is measured in many ways but it can be thought of as a diet rich in varied, unprocessed food, lower in levels of refined sugars and with reasonable amounts of healthy fat; simply how an average person “should” be eating.
We know a less healthy diet with a higher hyperglycemic load is associated with bipolar disorder. This, however, does not indicate a cause and effect. (Does a bad diet lead to bipolar disorder or does bipolar disorder lead to a bad diet?)
In my opinion, people with bipolar and depression tend to have unhealthy diets due to their illness. We are constantly trying to make ourselves feel better, and food is one way to do that (see carbohydrates, below). Moreover, most of us have energy and motivational issues which result in behaviors such as less exercise and less cooking of fresh food. Bipolar patients who have never been on meds have also been found to be overweight.
Micronutrients and Bipolar Disorder
There are a couple of products on the market that claim to be “micronutrient” formulae and claim to treat a variety of psychiatric disorders in children and adults. From a research perspective, there is no scientific evidence this is the case. Several case studies have been written; however, as case studies are the experience of an individual, one cannot use it to generalize about the treatment as a whole. It’s just as easy to write up a case study where the product did nothing. There is also no evidence that we don’t get any micronutrients we need from a healthy diet.
One of these products, in particular, was banned for making false advertising claims. (It might now be available under a new name.) These products mostly rely on testimonies from others who believe these products have helped them but there is no solid evidence backing their claims.
Omega-3 and Bipolar Disorder
Omega-3 is an essential fatty acid needed by the brain to function. This important nutrient is often reduced in Western diets as it comes from “healthy” fats like those found in fatty fish (like salmon) and flax seed. Omega-3s have benefits outside your brain as well.
(FYI, essential fatty acids seem to be important in brain development too, which happens prenatal to age 5-6.)
However, while omega-3s have been shown to help for depression, evidence is inconclusive for bipolar disorder (omega-3s are not generally thought to have mood-stabilizing properties). Information about omega-3s and bipolar disorder.
Note the dosage of omega-3 in studies is far higher than in any over-the-counter supplement. You need to discuss with your doctor the right dose for you. And remember, supplements have side effects, especially in these doses, so never begin use without talking to your doctor.
(FYI, there is a refined omega-3 supplement available pharmaceutically as well. I’ve used it and it’s much better than the over-the-counter stuff. It’s regulated and you don’t taste fish all day.)
Bipolar and Sugar / Carbohydrates
Carbohydrates turn into sugar in your body and your brain needs this sugar to function. And, as most people have experienced, eating carbs makes a person feel good. This is because large amounts of carbs release serotonin in the brain. When depressed people eat carbohydrates or consume sugar they are attempting to medicate themselves. (As the food guide suggests, it’s a much better idea to eat complex carbohydrates, like brown rice, over simple carbs/sugars like white rice or soda pop.)
It may be the case that removing sugar/carbs (ketogenic diet, Atkins) may worsen depressive symptoms. Evidence for this is thin, but what I can say is the brain metabolizes sugar more quickly when depressed.
Diet and Psychotropic Medications
Keep in mind; none of these studies pertain to specific medications. Antipsychotics, for example, are widely known to have glycemic and weight control issues associated with them and this may impact dietary decisions.
Bottom Line on Diet and Bipolar Disorder
There is no diet or supplement that has been shown to help bipolar disorder, with the possible exception of omega-3s. The best advice is to eat a healthy diet. Sorry to be the bearer of bad news, but this disease just isn’t that simple.
Warning: Do Not Ever Change Your Diet without Talking to Your Doctor
Any changes need to be discussed with your doctors, see:
(And, in case you were wondering, I haven't turned into a doctor or a dietitian.)
Tracy, N. (2011, March 31). Diet and Bipolar Disorder, HealthyPlace. Retrieved on 2020, March 29 from https://www.healthyplace.com/blogs/breakingbipolar/2011/03/diet-and-bipolar-disorder
Author: Natasha Tracy
When I'm depressed my energy level is low and mental clarity is limited. Over the years my unhealthy mind has been conditioned through bad eating habits to reach for sugary foods or caffeine to compensate for this. Since there isn't as many effective bipolar meds for depression as there is for mania I still find myself instinctively reaching for the unhealthy stuff. It's a hard habit to break.
It can be doubly frustrating when some of the meds contribute to metabolic syndrome and weight gain. The heavier I got the less energy I'd have. Initially I got panicky and succumbed to some of the purging behaviours from my youth. It's was a vicious cycle. Some bipolar meds have also been known to contribute to diabetes and being pre-diabetic already increases my chances of getting it. Diabetes is also linked to depression
It just goes to show how very important diet is, especially for those of us with bipolar disorder. I'm lucky, I love fish
You are welcome. I hope it helps.
My husband is bipolar and I am hoping to better understand him by reading your posts. Thank you so much.
Allow me to respond to some of your comments.
"There’s loads out there on weight gain and specific 2nd gen anti-psychotics, yet you say, “none of these studies pertain to specific medications.”"
You are absolutely correct. Which I specifically stated. When I stated no cited study pertained to specific medications, that is what I meant. The dietary recommendations were not regarding a medication, and medications may change the type of diet a person may choose.
"We don’t know (rather, you didn’t cite) any info on O3’s effectiveness on BPD w/o pharmaceuticals."
You are correct. I did not cite references for that assertion. You may certainly do so if you wish.
If you review the link I provided, you'll see many studies on bipolar disorder and omega-3 and depression and omega-3: http://psycheducation.org/depression/meds/Omega-3.htm
The reason I mentioned that bipolar people who have never been on medication have been found to be overweight was I was simply making the connection between quality of diet and the disorder. I never said people on medication were or were not anything.
There's loads out there on weight gain and specific 2nd gen anti-psychotics, yet you say, "none of these studies pertain to specific medications." You surely can't mean there are no studies on weight gain and Zyprexa or Seroquel???? Or metabolic syndrome (related, relevant, unmentioned) and those drugs?
Also, your link re: Omega 3s as a "help" for BPD leads to a story on those who take O3s "when added to an existing psychopharmacological maintenance treatment for bipolar disorder." Therefore, what we know is that O3s do little to reduce BPD when taken WITH psych drugs. We don't know (rather, you didn't cite) any info on O3's effectiveness on BPD w/o pharmaceuticals.
At the top of the story you say, "Bipolar patients who have never been on meds have also been found to be overweight," and link to a summary of a Jour of Affective Disorder article that says--in the 1st paragraph--that this is also true for persons w/BP who take "medications used to treat the disorder." So why did you single out only those who have never been on meds (and carry excess weight) and not also those--as the researchers found--who took BP meds and carried excess weight?
angela (tweets as @HerHealthySelf
Yes, Twitter is quite a bandwagon.
You're welcome. I think everyone appreciates the connectedness. No one is alone and it's helpful to be reminded of that.
Thanks, Natasha. I just subscribed to your personal blog. When I join the Twitter bandwagon, I'll check you out there as well.
Thanks for doing this--the informational writing as well as the deeply personal writing. I think it makes those of us who struggle with this illness to feel more connected.
As for the mantra that "natural" is healthier--apple pits are pretty darn natural. And they contain cyanide.
"I’m tired of people suggesting supplements and “natural” remedies."
That's a peccadillo of mine. Drives me batty. I think because I've seen so much of it over the last decade. I try not to be too biased on the issue, but it's challenging.
Thank-you, I'm glad you like the writing. I love a picky reader (I'm one too).
I'm not aware of any way to subscribe to the Breaking Bipolar blog, sorry about that, but I'm sure HealthyPlace is happy to hear of your interest in that.
For my blog at http://natashatracy.com (in no way affiliated with HealthyPlace) there are rss subscription buttons on the blog pages. (I'm adding subscription by email, I just haven't quite gotten it up yet.)
I do send out Tweets and Facebook updates for each article I write, for all the different places I write. (Twitter and Facebook links are at the bottom of this post.)
Thanks for your interest.
Well put, Martha. I'm tired of people suggesting supplements and "natural" remedies. (I had to remind someone the other day that lithium is in fact quite natural.)
Natasha, I just stumbled across your Caught in My Bipolar Burble blog, which led me to your ECT blog, and eventually to here. I love your writing style. (And I'm rather picky.) So how can I subscribe to this blog? I couldn't find any buttons for doing so.
Thanks so much. I like to think so.
Natasha, another great blog. What can I say? You're a voice of reason in a wilderness of misinformation and disinformation.