Bipolar Beat

Syndicated from the Bipolar Blog with a couple minor changes

The standard approach to treating bipolar disorder calls for a combination of medication and psychotherapy – a mood stabilizer for the mania, an anti-depressant to treat the depressive side, and psychotherapy to deal with the stressors and triggers that often push the disorder through the protective barrier of medications.

There are, however, some alternative and complementary treatments available that may help when the standard treatments are ineffective or cause intolerable side effects. When used in place of standard medications and therapies, these are known as “alternative.” When used along with standard medications and therapies, they are called “complementary” or “adjunctive.”

Caution: Consult your doctor before trying any alternative or complementary treatment, even if it is advertised as “natural.” Don’t assume that your doctor is ignorant or unwilling to consider the use of alternative treatments. Many doctors know something about them, are quite willing to discuss them with you, and can help guide you in making informed and safe decisions. As always, never make medication adjustments without your doctor’s approval.

Vitamins, minerals, and oils

Sometimes consuming a little more of what’s already a part of your diet may contribute to calming your mania or reducing your depression:

  • Omega-3 fatty acids: One relatively limited study has shown that high levels of Omega-3 (2 to 7 grams daily) can help prevent recurrence of mania and depression. Larger, more recent studies report that Omega-3 doesn’t reduce mania or mood cycling, but that in some cases, high doses of Omega-3 fatty acids can improve the effectiveness of antidepressants. Where do you get Omega-3? Cold water fish (salmon, mackerel, herring, tuna, anchovies, and sardines), wild animals (deer, buffalo, and free-range chickens), Omega-3 enhanced eggs, dark green, leafy vegetables (like purslane), flaxseed oil, walnuts, and Omega-3 supplements.
  • Choline and phosphatidyl choline: is an essential nutrient for healthy cell membranes. It is also the precursor to acetylcholine, one of the crucial brain chemicals involved in memory. A small study has shown choline to be effective in treating rapid cycling bipolar disorder when combined with lithium.
  • B complex vitamins: B-complex vitamins consist of B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B7 (biotin), B12 (cobalamin), and folic acid (folate or folacin), all of which your body uses to build cells, particularly nerve cells. Taking them together in the appropriate relative concentrations is important, because too much of one can cause a deficiency of another.
  • Folic acid: Folic acid is critical in the development of the human nervous system, so pregnant women must take folic acid supplements. People who abuse alcohol and people with certain illnesses who must take particular medications are at risk for folate deficiencies. Some research has connected low folate levels to depression, so checking levels and supplementing with folic acid may be part of treatment for depression, particularly in people in these high-risk categories.
  • Vitamin C: People with bipolar mania often have an elevated level of the trace mineral vanadium in their system. Vitamin C may help the body reduce the levels of vanadium. Whether this is effective in stabilizing moods, however, has yet to be determined.
  • Vitamin E: Some healers have touted vitamin E as a cure for everything from heart disease and cancer to depression, but large recent studies call these connections into question. True deficiencies are rare, and vitamin E may actually cause medical problems at high doses, so always consult your doctor.
  • Magnesium: A magnesium deficiency is rare, but high-risk groups include older adults, people who abuse alcohol, diabetics, and people with a number of other medical conditions that require a variety of medications. Low body stores of magnesium may be related to a number of health problems, including mood regulation.
  • Zinc: Some clinical studies suggest that low levels of zinc may contribute to depression, but a well-balanced diet typically provides enough zinc. People who abuse alcohol and patients with chronic stomach problems that include diarrhea are at risk of zinc deficiency.
  • EMPowerplus: EMPowerplus is an all-in-one pill or powder designed to treat multiple deficiencies in numerous areas of the body, including the central nervous system. This supposed wonder-brew is charlatanism at its worst. No reliable studies support its effectiveness, and its advocates recommend stopping all other medications before trying it. One of my patients followed their advice, and it was a disaster. The Canadian government shut down this company for awhile because it was so out of control. Consult your doctor before following any advice this company may offer.

Herbs and supplements

Nature provides a host of effective cures and treatments for common ailments, but do herbs and “natural” supplements hold out any promise for people with bipolar disorder? Some people seem to think so. The following list covers many of the herbs and supplements used in an attempt to treat depression and mania:

  • St. John’s wort: Limited studies suggest that St. John’s wort (a medicinal herb) is effective in treating mild to moderate unipolar depression. Be careful, though; like most antidepressants, St. John’s wort carries the risk of inducing mania. It can also interact with a number of drugs, so, as always, consult your doctor first.
  • Ginkgo biloba: Gingko biloba’s (a medicinal herb) use in treating mood disorders isn’t well established, but its effectiveness is being explored. At high doses, it can thin the blood too much and cause bleeding, so consult your doctor.
  • Black cohosh: Marketed primarily to help women with night sweats and hot flashes, black cohosh (a medicinal herb) hasn’t yet proven its effectiveness in formal research studies. Some studies have shown that it can trigger an autoimmune response in the body that attacks the liver, so consult your doctor before trying it.
  • SAMe: Short for S-Adenosylmethionine, SAMe (a natural substance found in your body) has been proved to function effectively as an antidepressant in some studies. However, SAMe can induce mania at rates similar to the SSRI antidepressants, making it extremely risky for treating bipolar depression.
  • GABA: GABA (gamma-aminobutyric acid, an inhibitory of the nervous system neurotransmitter) taken as an oral supplement doesn’t cross the blood-brain barrier, so any claims that it is a natural cure for bipolar disorder are baseless.
  • Taurine: An amino acid, taurine helps regulate the electrical activity in the brain and may counteract the effects of excitatory neurotransmitters, including dopamine and norepinephrine. Some studies show that taurine levels are depleted in the brains of people with bipolar disorder, but no studies currently show that taking supplements will improve depression.
  • Melatonin: Melatonin is a hormone that the brain uses in response to light and dark and is part of the body’s sleep/wake machinery. Supplements may reduce insomnia for sufferers of some types of sleep problems. It’s safe for short-term use, even in children. Check with your doctor before you use melatonin, however, because it can interact with some psychiatric medications.
  • 5-HTP: This supplement provides your body with the building blocks it needs to assemble serotonin, but no evidence proves that taking supplements of 5-HTP improves mood.
  • Valerian: Valerian is an herb commonly marketed for the treatment of insomnia. Although studies are currently deemed inconclusive, some have reported positive results. Valerian appears to be relatively safe, but be cautious, especially if you’re taking other medications or are pregnant or nursing.
  • Kava: This plant/herbal product purportedly reduces stress and anxiety, but some reports have linked it to liver damage, so practice extreme caution.

Caution: Before ingesting any substances (natural or otherwise), check with your doctor, and do additional research on your own. A reliable information source is the National Institute of Health’s National Center for Complementary and Alternative Medicine (NCCAM).

Lithium Orotate

If your doctor prescribed lithium as a mood stabilizer, you’re probably taking lithium carbonate (commonly sold as Carbolith, Cibalith-S, Duralith, Eskalith, Lithane, Lithizine, Lithobid, Lithonate, Lithotabs, and Priadel). You can also find a supposedly safer form of lithium at your local health food store – lithium orotate. The theory behind the claim is that lithium orotate delivers lithium to the brain more efficiently than lithium carbonate, so you need to take less of it to get the same effect. The question is: Does it work? I’ll be addressing this topic in a future post.

Warning: Because the recommended dosage of lithium orotate delivers less lithium to your system (than a dose of lithium carbonate), lithium orotate is considered “safer,” but if you take any form of lithium, inform your doctor, so he or she can have your blood levels tested. If blood levels are too high, the situation can become dangerous or even deadly. Under no circumstances should you take lithium orotate if you are already taking a prescribed dose of lithium carbonate.

Buyer beware

People often think that vitamins and herbs are “worth a try.” If you can get them at the store without a prescription, they must be safe, right? Well, not exactly. These so-called nutraceuticals carry their own potential risks and drawbacks. Unconventional treatments…

  • May cause you to forgo more effective treatments.
  • Can be costly.
  • May not be covered by your insurance.
  • May be very complex.
  • Can have negative or even dangerous side effects.
  • May cause dangerous interactions with your prescribed medications.
  • Are less strictly regulated.

Remember: Always consult your doctor before you try an alternative treatment.

Share your experience

If you have tried any of the treatments discussed in this article or other alternative treatments I haven’t mentioned, I encourage you to share your experience with other visitors to this site. Keep in mind, however, that anecdotal evidence from others is no substitute for data collected from controlled studies. In other words, just because something worked for someone else doesn’t mean it will work for you. Talk to your doctor before trying anything someone else recommends.


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16 Comments to
“Alternative and Complementary Treatments for Bipolar Disorder”

Information about history of the Empowerplus scam is available in our book.

It is still being marketed from Canada, and is manufactured in the U.S. The FDA has done nothing.

There have been reports of serious side effects and at least one death (suicide) as a direct result of a patient being told to go off his medication and start Empowerplus.

Terry

The book Terry mentions is called Pig Pills: The unlikely story of the “Pig Pill Cure” for psychiatric illness - and their struggle against the government. You can find out more about the book by visiting pigpills.com.

Terry Polevoy’s book, PigPills is probably one of the most inaccurate, if not defamatory accounts of TrueHope and EmpowrePlus. Polevoy’s responsibility as a current licenced member of the CPSO is to provide free and clear, and unbiased access to medicine. Polevoy lies and deception are designed to interfere with consumers freedom of choice by creating doubt and suspicion where there are grounds for none. The CPSO should be ashamed of Polevoy’s disgraceful and unprofessional behavior.

If you are going to post an attack against Polevoy and his book, I would hope you would identify yourself, so we know who you are and whether you’re speaking as a representative of TrueHope, a colleague of Polevoy’s, a licensed member of the CPSO, or from some other position. Who are you? What are your credentials? What interest do you have, if any, in this debate?

Terry had the courtesy of posting under his name, which does lend more credence to what he says.

I’m not picking sides. I’d just like to see a fair fight that fulfills this blog’s goal of transparency.

My name is Jason Gorman and I am 45 years old. My wife was taking 1200mg of Lithium Carbonate daily prescribed by the doctor for over two years. During this time no lab work was ever ordered. It built up in her system over a period of time. She was taken to the ER where she almost died. Her pulse was down to 31 and her blood pressure as low as 43 over 17. She under went kidney dialysis continuously for over 30 hours in ICU. She spent a total of 5 days in the hospital. I strongly recommend against taking Lithium. At least have periodic Lab Work done. Also if you do take this medication look up the side effects on the internet.

My wife has experienced some of these side effects-
Dizziness, Vomiting, Diarrhea, Confusion, Tremors, Muscle Weakness, Loss of Bladder Control, Inability to talk

I hope this information will be useful to others,
Jason Gorman

I’d publish my name but then Polevoy would start defaming and libeling me to my employer…In fact, he’d probably start stalking me….

Polevoy is a faruncle on the ass of the CPSO.
The CPSO likes to have pustules like Polevoy on its ass. It deflects attention away from the hole (CPSO)…By the way Joe, you’re an asshole to believe or support anything that comes out of the mouth of Dr. “I’m restricted from seeing children in my practice” Polevoy….

Anonymous–

First, your own profanity-laced expressions undermine your credibility. Second, I never said I believe or support Polevoy or anything Polevoy said or wrote. You need to read more carefully before you go on the attack.

Wish I’d known decades ago what I know now about brain function & nutritional supplements.

Regarding the “Buyer Beware” section above: Shame on you for using such specious arguments against Nutraceuticals. Psych meds are quite ‘costly’, ‘may not be covered by your insurance’, are certainly chemically ‘very complex’, have published negative or even dangerous side effects’, ‘may cause dangerous interactions with other prescribed medications’, and ‘are less strictly regulated’ than they should be if people are still suffering the harsh and life-threatening side effects the FDA doesn’t consider sufficiently significant statistically to keep a multi-billion dollar international conglomerate from making huge profits.

As with any therapy, supplements must be taken advisedly. No responsible person would suggest anyone go off a prescription to use something to *replace* their psych meds, but there are a number of supplements that not only compliment the meds, but actually support the brain in its natural functions, thereby improving the effectiveness of the meds and one’s day-to-day functionality. These include high quality brands of Fish Oil (Omega 3 only; stay away from -6 & -9, which are found in abundance in processed foods, and cause inflammation), B-Complex vitamin, C-Complex vitamin, and Lecithin (which contains Choline and Phosphatidyl Choline), and Zinc (which should always be taken in combination with Copper, because Zinc depletes Copper in the body).

None of these products are expensive. They’re not covered by insurance because they’re not drugs, which by definition must be chemically altered or lab-created in order to be patentable. And thank your lucky stars that the FDA *doesn’t* regulate nutritional supplements!

The problem with consulting your health care professional is that few know anything about nutritional supplements, and of those who do, many don’t believe they have any positive effects for anyone. Remember: Doctors go to *Medical* School, where they study disease states and the use of Rx. Has anyone ever heard of a Rx that actually *cures* anything? Instead, Rx address symptoms, without addressing the source of the imbalance that caused the symptoms to occur, and often cause side effects worse than the original problem!

The many medical professionals I’ve consulted over the years have been far from being helpful in my search for optimal health with minimal side effects. They simply don’t study shining health or how to achieve and maintain it. I actually learned about B-Complex deficiencies causing mental problems on an episode of “House”! I began using it myself, in addition to fish oil, and now experience tons of focussed energy during the day, clearer thinking, and increased memory. It seems to also have resolved a degree of the vertigo and light-headedness caused by the psych meds.

Sorry to get so wordy here, but I’ve seen marvelous results (my own and others) with the addition of nutritional supplements taken to support people’s bodily functions. Changes of diet (eliminating gluten- and casein-containing foods, and processed foods, especially) have effected immediate results in autistic and ADHD individuals, as well as completely resolved the symptoms of people who had been diagnosed with Crohn’s Disease, IBS, diverticulitis/osis, leaky gut, colitis, etc.

Conventional medicine is scary as hell. The cure is in the cupboard, people.

I am really surprised that this site would speak so bad of Empower Plus. Actually if you go to their website http://www.truehope.com you can read the ingredients. They are many of the same ingredients listed in this article that work. So how could they be charlatans? Also you can watch a 4 part documentry on youtube about how this discovery was made. I have been taking empower plus for 2 months now and am doing so much better. Depression is gone. Many are getting off psych meds and switching to empower plus. I do not work for this company nor do I have any vested interest. I am a producer/songwriter. http://www.myspace.com/roblovegreen

I have a son who has suffered with bi-polar depression for 19 years. I believe it is the worst possible disease that anyone can contract. It has been stated that it is caused by an imbalance of chemicals in the body and, in particular, the brain. This is probably a logical conclusion, but imbalance can be too little or too much of a substance. Too little seems to be more likely as the natural foods we eat which should contain minerals, etc., don’t. Soils everywhere have been depleted of nutrients by over-farming and dumping other poisonous chemicals in an attempt to increase production. The list of vitamins and minerals on the TrueHope website seems fair. None of these in controlled amounts could kill anybody. Stopping prescribed meds can. I don’t see anywhere that TrueHope is advocating quitting all meds. In fact, they state the opposite. We have not tried the product, but we, like everyone else, are looking for an answer that the medical profession has not, as yet, supplied, mainly because we are all different. Fixing high blood pressure or diabetes is a fairly standard procedure. Not so with depression. I certainly would give TrueHope the benefit of a trial without slagging them out of hand. It was stated that Canada pulled the pills off the market, but it also stated they had been reinstated. As far as I am concerned, the Canadian government is superior to the farcical American FDA, which openly appears to be in control of the Big Pharma.

@Jason Gorman:

I sorry to hear that about your wife. But, I should point out that there is a *very* large difference between a drug being overall bad for you, and the misuse thereof. In other words, your wife’s doctor didn’t manage the drug properly and bad things happened. That is very different from starting from a small(er) dosage, doing a level, and going from there. The latter is what responsible docs do. Quite frankly, if her doc prescribed that high a dose and never did a level, then (s)he’d be liable.

@Jain Makepeace:

I admire your enthusiasm regarding supplements. But, the problem with what you’re saying is pretty much summed up when you said, “The cure is in the cupboard, people.” This is just plain wrong. At least when it comes to mental illness.

You see, *very* mild disturbances can be brought about by not eating right. But, the *clinical* problems, i.e. actual mental illness, can only be controlled through prescription meds. That is _not_ to say that supplements don’t have there place. But, one must recognise that supplements just don’t have enough “oomph” to really do much. At best, they can allow people to take less prescription meds. Which is of course a very good thing as these meds tend to be quite harsh.

I’ll also call you on, “Remember: Doctors go to *Medical* School, where they study disease states and the use of Rx. Has anyone ever heard of a Rx that actually *cures* anything?”

First, to answer your question: Yes, I’ve heard of *lots* of prescriptions that cure things. Vaccines anyone?

To address your criticism regarding there training, you’re way off base. Docs don’t shun natural things because they aren’t prescriptions. They shun them because there’s no actual evidence that they work. There’s actually a running joke in the medical field, “You better use it before it stops working.” Of course referring to the drugs.

Why is this so? Because, before randomised placebo controlled trials were required, there was all kinds of false positives with regards to any drugs effectiveness. Now, if the FDA or any countries equivalent approves a drug for a certain use, we know that there is a *very* good chance that it’ll work as advertised (though some people just won’t respond, it happens).

@Rob:

You should really read up on the history of those people. They actually originally marketed it as a *replacement* for meds. They got in *a lot* of trouble for that and now no longer do it. There so called research has been of questionable quality to the point where there are serious ethical concerns about it. Again, that is well documented.

In short, instead of watching and listening to propaganda generated by the company itself, you should really look into matters to see what’s really going on.

@Derek Pepper:

They have in the past recommended people going off it. They got in *a lot* of trouble for it. It’s all well documented.

I’ll also point out that because the supplement industry is *NOT* regulated, the Canadian government would have little recourse if TrueHope changed its advertising. Which it did. Which is why they were allowed to put it on the market again.

In all seriousness, there is a *very* shady history from these people. If that isn’t enough to keep people from buying there products, then I don’t know what is.

Oh, and I should also point out that mental illnesses are not caused by problems with nutrition. But, problems with nutrition can cause SYMPTOMS that can be misdiagnosed as mental illness. There is a difference. We need to acknowledge that if a meaningful discussion is going to happen.

However, when it comes to someone who actually has a mental illness, will a better diet, exercise, supplements, etc help? Of course, one of many of them will help. But, helping, and getting the symptoms under control are two *very* different things. The latter not being possible if one actually has a mental illness with supplements alone.

So, if you’ve been diagnosed with a mental illness and supplements “cured” you. Then it isn’t “big pharma” that’s the problem. You really should be going back to the original diagnosis and questioning that.

My husband took Truehope’s Empowerplus two years ago. They kept urging he step down from the lithium he was on, so we faithfully followed their instructions. As a result my husband had several very severe manic episodes, one which resulted in a car crash. He suffered a concussion, back, and shoulder injury.

We’re college educated with years of life experience and cannot believe we fell for their hype. TRUE - we have seen nutrients do wonders - but complimentary to the lithium.

PLEASE don’t follow Truehope’s drug withdraw regime!!! Your loved one - and everyone they love - will suffer the horrible consequences.

I was diagnosed with bipolar disorder over 20 years ago. The med walk began and continued for nearly 19 years before all gave up, even Ect’s prooved ill effective. Needless to say, my health failed, gallbladder, appendix, cancer, and then my career and marriage. My health insurance was lost and so too my counseling and medication. Every 6 month’s or so I check with a psychiatrist to see if there is anything new on the market that may help me. Thus far, nothing helps. How have I made it for nearly 9 years? I pray a whole lot and live a very simple and secluded life,, avoiding stressors the best that I can, adhere to a healthy diet and exercise daily. I also take fish oil which helps for the most part. I wish that I could find something to relieve the constant stress of this disorder,, try doing it aunaturale and keeping a normal healthy life, it is hell.. yes, I have tried all the natural remedies. i worry that untreated it could worsen,but thus far nothing helps…any suggestions here??

@Katherina– I so feel for you. I hope you can find something that helps.

@Nutriceuticals–

I pay close attention to supplement studies. I use the most sensible, relevant and highest quality ones I can afford.

I grow home mulched organic leafy greens in my yard. I prepare most of my family’s food from scratch. I have eliminated plastic dishes, chemical cleaners, and am careful about EMF fields.

I loathe exercise, yet have become a decent age group bike racer.

I’ve had 20 years of good CBT. Marriage classes. Parenting classes. Hobbies I love. Lots of fresh air, natural light, and faithful friends. I am a pastor’s wife, with an authentic spiritual life of my own.

I am committed to making peace with life’s vissicitudes, boredoms, joys and discomforts.

And yet. Crippling depression. Crazy plans, racing thoughts, unmanageable anger, irritibility, confusion.

My paternal grandmother committed suicide at 40. My mother died of cancer at 41, but not before two significant suicide attempts. And last month, 35 yo brother shot himself in the head. After going on antidepressants for the first time.

Four months ago I started Wellbutrin for chronic fatigue. Then bought my husband an expensive bicycle on credit, etc. By last week, I couldn’t get out of bed. Sunday was spent curled in a ball weeping for six straight hours.

Monday I started Lamictal. I was returned to a normal baseline within 24 hours. Because it worked so well, I looked it up, and learned about the expanded categories of BP from 1994. BP II, anyone, and the crazy mood swings of my family, their propensity to take their own life?

After my mother died, I spent the summer locked in a dark room, eating Oreos, and memorizing Dickinson and Blake.

Complementary or alternative therapies have not TOUCHED my internal turmoil, anxiety, and madness flavored darkness.

This is MY journey, and I am responsible for the cost/benefit analysis of my treatment choices. I’m going to take my fish oil, now, and think positive thoughts in the general direction of my psychiatrist.

And keep looking for ANY better way to manage this. To hell with bootstraps. I have three young children and the stakes are too high.

PRISTIQ® (desvenlafaxine) is approved for the treatment of major depressive disorder in adults.

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, teens, and young adults.

Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior.

All patients taking antidepressants should be observed closely for signs that their condition is getting worse or that they are becoming suicidal. This is very important when an antidepressant is started or when the dose is changed.

Patients should be watched for becoming agitated, irritable, hostile, aggressive, impulsive, or restless.

PRISTIQ may cause or make some conditions worse,
Discontinuation symptoms may occur when stopping PRISTIQ, especially when therapy is stopped suddenly.

Until you see how PRISTIQ affects you, be careful driving a car or operating machinery. Avoid drinking alcohol while taking PRISTIQ.

Side effects when taking PRISTIQ 50 mg may include nausea, dizziness, sweating, constipation, and decreased appetite.

I have had several people visit our health food stores and mention that they had been diagnosed with either bipolar disorder or some sort of depression. After reading the comments here I have been able to get a closer look of how this disease affects our diagnosed customers.

We never, nor would we ever, recommend that someone stops taking their medication without doctor and/or pharmacist recommendation. However, we do customers who cannot afford prescriptions and/or want something that helps without side effects.

In the past customers have purchased many of the nutraceuticals mentioned above. Unfortunately, even though we ask, few people ever let us know how they work.

You may want to research the herbs Jiao Gu Lan (Gynostemma pentaphyllum) and Korean Ginseng for their adaptogenic properties. I am willing to share any research/knowledge I have concerning this.

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Candida Fink, M.D. and Joe Kraynak are authors of Bipolar Disorder for Dummies. Pick up the book today!
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