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.)