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Natural remedies for bipolar disorder: Lifestyle and other remedies

Bipolar disorder involves extreme shifts in mood, energy, and levels of activity. Medications can help people manage symptoms, but these can have adverse effects. A number of natural remedies may also help.

The National Alliance on Mental Illness (NAMI) estimate that around 2.6 percent of people in the United States have bipolar disorder, and nearly 83 percent of cases are severe. On average, it starts when a person is 25 years old.

A person with bipolar disorder experiences times of severe depression and times of mania, or “high” mood. The risks during a low mood include an inability to function at work and in other areas of life.

During mania, the person may be at risk of making reckless decisions. If the mood becomes too high or low, psychosis can develop.

There is no cure for bipolar disorder, but treatment enables people to manage it. Some lifestyle adaptations can also help, alongside the medication.

Counseling, cognitive behavioral therapy (CBT), and a range of lifestyle changes can help people with bipolar disorder to manage their symptoms and improve their overall quality of life.


Bipolar disorder can disrupt a person’s sleep. During a manic phase, an individual may sleep very little, but during a low phase, they may sleep for a long time.

Missing sleep can trigger a mood change, and getting enough sleep is essential to managing mood.

Good sleep hygiene can encourage people with the condition to have regular sleep.

Tips include:

  • going to bed and getting up at regular hours
  • making sure the room is comfortable
  • avoiding screen time and potentially stressful situations before bed
  • not eating a large meal too soon to sleeping
  • avoiding or limiting alcohol intake

People with bipolar disorder who have difficulty sleeping should speak to their physician.


A healthful diet is an important lifestyle habit for a person with bipolar disorder.

A 2011 study found that up to 68 percent of people seeking treatment for bipolar disorder have excess weight or obesity. People with bipolar disorder also had a higher risk of various other conditions, including diabetes, low bone density, and cardiovascular disease.

A healthful diet can help to reduce the risk of these conditions.

In 2013, another study found that people with bipolar disorder are more likely to engage in binge eating than the general population.

This may be a side effect of medication or due to overeating during episodes of depression.

Being overweight can complicate recovery and increase the risk of diabetes, high blood pressure, and anxiety.

Share on PinterestRegular eating habits can help people with bipolar disorder to stay healthy and avoid gaining excess weight.

Doctors do not know what causes bipolar disorder, but it may be due to an imbalance of chemicals in the brain. These chemicals, also called neurotransmitters, are noradrenaline, dopamine, and serotonin.

Serotonin can also affect appetite. It may be that when serotonin levels are low, people experience cravings for carbohydrates and sweet foods.

Tips for maintaining a healthful diet include:

  • keeping to regular eating times
  • ensuring that the diet is varied, well-balanced, and has plenty of fresh fruits and vegetables
  • making a meal plan for the week, preparing a list before going to the grocery store, and sticking to it

Learning and practicing new recipes during times of positive mood may help a person to establish these habits.


Moderate and regular exercise can help to balance mood and prevent a number of health problems, such as obesity and cardiovascular disease.

There is a lack of evidence to show that physical activity can specifically help people with bipolar disorder, but some research suggests it may help to improve mood during a low phase.

A 2015 review of studies suggested that exercise “may be a viable and effective strategy to deal with the depressive phase of bipolar disorder.

Another review, published in 2016, concluded that “generally, exercise was associated with improved health measures, including depressive symptoms, functioning, and quality of life.”

More studies are needed to find out how much exercise an individual should have, how often, and how intense the activity should be, especially as bipolar disorder involves a number of physical and psychological factors.

Practicing moderation

People with bipolar disorder have a higher risk of engaging in addictive behaviors.

One study found that 56 percent of people with the condition had at some time experienced addiction involving either alcohol or drugs.

Certain circuits in the brain play a role in pursuing rewarding experiences. One study has suggested that people with bipolar disorder have stronger activation in these circuits.

This may be what drives the person towards risky behavior.

The positive side of this, say the authors of the study, is that it encourages people to work with energy toward their goals and ambitions.

On the other hand, it may mean that an individual focuses fully on the short-term rewards of a decision while disregarding the possible long-term risks.

Tips for avoiding these problems include:

  • becoming more aware of any tendency to engage in risky — for example, addictive — behaviors
  • seeking help if there is already a problem
  • asking friends and loved ones to support any decisions to avoid destructive or addictive behaviors

Friends who are aware of the risks might, for example, suggest going to see a movie instead of a bar on a night out.

Managing a manic episode

It is not always possible to prevent a manic episode, but as the condition progresses, the individual and their friends and family may start to notice the signs of a mood change.

Here are some tips when this happens:

  • See a doctor, if it is the first time, if you have discontinued treatment, or if treatment is not working.
  • Follow the treatment plan and keep all medical appointments, as medications may need adjusting.
  • Try to keep to a regular sleeping pattern and avoid unnecessary stress when possible.
  • Eat a healthful diet and get enough exercise.
  • Avoid alcohol and other substances.
  • Keep track of your moods and feelings.

If you have people around you, try to share with them what is happening so that they can support you.

Other remedies that do not involve the use of traditional drugs include supplements and counseling.

Herbs and supplements

Some people with bipolar disorder use herbs or supplements in an attempt to relieve their symptoms.


The fish oil extract omega-3 may help, according to some studies. Scientists have found that bipolar disorder is less common in countries where people consume a lot of fish. People with depression may also have lower levels of omega-3 in their blood.

Omega-3 fatty acids may have numerous health benefits, but it is best to eat them in their natural form. Cold-water fish, nuts, and plant oils are good sources.


Some scientists think magnesium has a role regulating mood and both manic and depressive episodes and work with the medications to make them work effectively.

As a result, some doctors may recommend magnesium supplements. Discuss magnesium supplements with your doctor. Taking a multivitamin will include the daily recommended dosage of magnesium.


Some people suggest that vitamins may help, specifically vitamin C and folic acid.

Researchers have found weak evidence that vitamin C may help, but none to support the use of folic acid specifically for bipolar disorder.

There is evidence that folic acid supports cognitive health, but it is not clear whether this or other vitamins can help with bipolar disorder.

Overall, it is not clear that dietary supplements can help people with bipolar disorder. More studies are needed to confirm the benefits of any supplement.

Nutrients in the diet

However, a diet that provides a variety of nutrients through fresh foods can help protect a person from a range of health problems. Green leafy vegetables are high in folic acid, and citrus fruits are a great source of vitamin C.

Anyone with bipolar disorder who decides to use complementary medicine should continue with their prescribed medication therapy sessions, and they should consult their physician before using supplements or an alternative therapy.

Choose “natural” products with care

People sometimes use St. John’s wort to treat depressive symptoms, but they may increase the risk of mania and interfere with antidepressants.

People with bipolar disorder should not use St. John’s wort.

Always speak to a doctor before trying any natural or alternative therapy. Some can interact with other drugs, and they may have adverse effects.

The FDA does not officially regulate supplements and herbal products, so people may not know exactly what they are buying.

Counseling and CBT

Share on PinterestResearch shows that CBT can help people to manage the challenges of bipolar disorder.

Counseling, for example, cognitive behavioral therapy (CBT) appears to be helpful in managing the symptoms of bipolar disorder.

A meta-analysis published in 2017 concluded that “CBT is effective in decreasing the relapse rate and improving depressive symptoms, mania severity, and psychosocial functioning.”

The studies reviewed showed that the effects of CBT were “mild to moderate,” and the improvements were most significant if a person attended sessions of 90 minutes or longer.

CBT can help people to identify negative and destructive habits and behaviors, and to change them to more positive ones.

A psychiatrist who specializes in bipolar disorder will normally guide a person’s treatment.

Sometimes there may be a wider team of professionals, including a social worker and a counselor.


A doctor may prescribe mood-stabilizing medications during a manic episode.

These include:

  • lithium
  • valproic acid
  • carbamazepine
  • lamotrigine

Regular monitoring may be necessary, as the dose sometimes needs adjusting.

If a person experiences psychosis, they may also need an antipsychotic drug, such as:

  • olanzapine
  • risperidone
  • quetiapine
  • aripiprazole
  • ziprasidone
  • lurasidone
  • asenapine

Doctors do not usually prescribe antidepressants alone for a person with bipolar disorder, even during a low mood, because they can trigger a manic episode.

For this reason, the person will normally use an antidepressant with a mood stabilizer or antipsychotic.

A doctor may recommend hospitalization if a patient is experiencing psychosis or if their symptoms may pose a danger to themselves or other people.

Bipolar disorder requires lifelong treatment, even when patients with the disorder are feeling better.

However, some lifestyle considerations can help to make the condition more manageable.

9 Natural Therapies for Bipolar Depression

2. SAMe

SAMe, or S-adenosylmethionine, is a coenzyme found naturally in the body that has been extensively researched and shown to reduce symptoms in people with major depressive disorder, according to a review of research published in 2015 in CNS & Neurological Disorders – Drug Targets. But SAMe should be used with caution in people with bipolar disorder who are suffering from depression because it can actually provoke mania, according to the National Center for Complementary and Integrative Health (NCCIH). It should be used only under the direct supervision of a physician.

RELATED: Are You Depressed, Bipolar, or Just Human?

“Anything that is a real antidepressant can cause mania in bipolar people,” Muskin says, “so there is some risk that a patient taking SAMe might become manic.” Several clinical trials are now underway to determine the best way to use SAMe in people with depression-related disorders as well as bipolar disorder.

3. St. John’s Wort

This herb, which is often used in Europe for mood management, is one of the better-known natural mood enhancers. Even so, evidence is mixed on whether St. John’s wort actually has a positive effect on major depression or bipolar disorder. The NCCIH states that St. John’s wort may help with depression but can also cause psychosis, and the agency warns that it could interact with many other medications people with bipolar disorder may be taking. St John’s wort has been shown to have similar side effects to some antidepressant medications because it appears to affect the body in a similar way, according to 2015 research published in the journal Clinical and Experimental Pharmacology and Physiology.

4. Meditation

People who meditate using a supervised mindfulness-based cognitive therapy approach may see a reduction in depression that directly correlates to how many days they meditate. The more they meditated, the fewer symptoms they had, according to a study published in 2013 in Behaviour Research and Therapy.

5. Omega-3 Fatty Acids

People with bipolar disorder may have extra motivation to start eating more fish that are heavy in omega-3s, such as salmon, mackerel, and sardines, or they may want to consider taking omega-3 supplements. That’s because the anti-inflammatory effects of omega-3 fatty acids could help regulate mood, according to research published in 2015 in the Journal of the American College of Nutrition. Adding about 300 milligrams of omega-3s each day to a depression treatment plan can enhance results, according to research published in 2012 in the journal Polish Psychiatry. “If you look at countries where they eat a lot of fish, they have a relatively low incidence of bipolar disorder,” Muskin says. “In the brain, we think omega-3s might help with moving neurotransmitters in and out, which may help stabilize moods.”

6. Light Therapy

People with bipolar disorder may have interrupted circadian rhythms, which means their daily biological clock isn’t working well. A number of strategies may help to reset this internal clock and improve bipolar management, according to a 2012 research review published in Dialogues in Clinical Neuroscience. These include timed exposure to periods of light and darkness and a forced change in sleep times. Be sure to discuss these or other similar strategies with your doctor before you try them on your own.

7. Traditional Chinese Medicine

This approach relies on certain herbal combinations and comprehensive changes in diet and daily habits. There is not enough evidence yet to support or rule out Chinese herbal preparations, concludes a review published in 2013 in Evidence-Based Complementary and Alternative Medicine. But some combinations may benefit mood disorders. Work with a practitioner trained in the field in collaboration with your doctors.

8. Interpersonal and Social Rhythm Therapy

This technique teaches people with bipolar disorder to maintain a more regular schedule in all aspects of life, including sleeping, waking, eating, and exercise. It has been shown to improve daily functioning, according to a study published in 2015 in Bipolar Disorders.

9. Eye Movement Desensitization and Reprocessing Therapy

EMDR uses a supervised program of eye movements, combined with actively remembering traumatic experiences, to improve symptoms. This approach can be helpful to people who have bipolar disorder and a history of trauma, according to research published in 2014 in the journal Psychiatry Research.  

Complementary Bipolar Treatments: A Few Words of Caution

“The reality is that there is not a lot of data on complementary therapies for bipolar disorder,” Muskin says. “That doesn’t mean these products shouldn’t be used, but when patients try to find out about them, they shouldn’t expect to be able to go to [websites] like The New England Journal of Medicine and download a lot of articles.”

Muskin recommends ConsumerLab as a reputable site where people can go to research complementary therapies. “You can find out whether or not the product you’re buying really contains the product you think it does, as well as what it’s indicated for and whether it has contaminants,” he says. The National Institutes of Health Office of Dietary Supplements also provides an extensive online database of dietary supplements that includes detailed product and manufacturer information.

Most of these therapies are safe, and there is limited evidence of negative interactions with prescription medications. Regardless, patients and their family members should actively research these products and discuss options with a psychiatrist before taking them, especially because complementary therapies do not undergo the same strict review process as pharmaceutical medications.

Additional Reporting by Madeline Vann, MPH.

Using Nutritional Supplements to Treat Bipolar Disorder and Depression

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In the past two decades, researchers from all corners of the globe have come up with amazing medications to help relieve the symptoms of depression and bipolar disorder.

Healthcare professionals stay current on the research and prescribe those medications that have the best results. Often, however, they bypass nutritional supplements and herbal remedies. And who could blame them?

As yet, the efficacy and safety of nutritional supplements has not been proven by thorough studies and adequate clinical trials. Anecdotal evidence and limited studies don’t cut it when it comes to convincing doctors charged with ensuring their patients health and saftety.

But doctors are not the only ones who get to decide on what you’ll put in your body. Your value system and diet may lead you toward the use of supplements rather than or in addition to an FDA approved medication. If you choose this path, school yourself on the most important aspects of nutritional supplements.

“Drugs” v. “Nutritional Supplements”: Are Nutritional Supplements Actually Natural?

Nutritional supplements have benefitted from a rumor that isn’t quite true. While supplements can be less potent than FDA-approved drugs, they can still pose risks. First, both supplements and Merck-engineered, FDA-approved drugs are often derived from plants. Both substances are generally put through chemical processes that change their structures. If nutritional supplements are “natural,” technically we can say the same for many “drugs”, too. If drugs are “man-made,” so too are nutritional supplements.

Potential Risks

Supplements can and do interact with prescription medication and create serious problems. It’s important to research what medications your supplement of choice may either render ineffective or make toxic.

But even when used all on their own, supplements can and do have their very own side effects. For instance, St. John’s Wort has been known to cause high blood pressure, headaches, stiff neck, nausea, and vomiting. For fair-skinned people, it can aggravate sunburn and cause blistering after sun exposure.

Simply going to http://www.personalhealthzone.com/herbsafety.html will show you just how many side effects there are for each herbal remedy. Many of these side effects sound just like those one experiences when taking prescription medications. They include: dizziness, nausea, headaches, dry mouth and many, many more.

Is There Anything Else I Should Know About Supplements?

Less Rigorous Standards for Nutritional Supplements

Because the Food and Drug Administration evaluates nutritional supplements as a food rather than a drug, these supplements do not have to meet the rigorous standards prescription medications do. Through repeated clinical trials, medications must prove their efficacy and safety. They also have to go through strict tests to determine proper dosage. Doctors then keep to the dosage guidelines or risk having their licenses revoked. While dosage may be recommended on the supplement packaging, people seem to be less cautious about adding another pill or two of Echinacea or Colt’s Foot; they’re natural after all. This over-dosing can become a dangerous practice.

Active Ingredients Not Always Listed Accurately

Studies have shown that some supplements contain more active ingredients that stated on their labels. Further, some supplements have been found to contain harmful additives and even contaminants. In a few cases, unethical manufacturers have replaced what should be an herb or acid with a completely different—either impotent or dangerous—substance that costs less. The practice creates big profits for the manufacturer and a placebo effect at best for the patient.

Beware the terms: “standardized,” “certified” or “verified.”

These terms imply that some oversight committee measures quality and content. Too often, those applying the standards are simply the company producing the product rather than an objective third party. Consider these words bogus until the company can prove otherwise.

What Medical Conditions or Circumstances Preclude the Use of Supplements?

Take the above precautions seriously. Doctors and medical organizations are very concerned about many nutritional supplements, and not just because they’re short sited or greedy. Currently, doctors warn the following populations against taking supplements:

  • pregnant or nursing women

  • women currently taking birth control pills

  • people with HIV infection

  • those taking prescription or over-the-counter medication

  • children

  • those who’ve had organ transplants

Tools for Exploring the Safety and Efficacy of Nutritional Supplements.

If you feel convinced a supplement could help your case, look online for reputable services that, for a fee, provide reports on the efficacy and safety of thousands of supplements and herbal remedies.

One with their priorities in the right place is www.ConsumerLab.com, a privately owned testing company. Consumer Lab has found that, on average, about 25 percent of the nutritional supplements fail to meet their own claims of safety and ingredient integrity. Some don’t meet labeling requirements, some don’t contain what they claim to, some products are contaminated, while still others don’t dissolve properly. Consumer Lab also provides “one of the best science-based encyclopedias” of vitamins, minerals, supplements and herbs accompanied by drug interaction and side effect precautions. You can research Consumer Lab reports and the encyclopedia for the reasonable fee of $30 per year.

Nutritional Supplements are worth a look. If you find yourself intrigued by one, research the facts put out there by several sources. Do not depend on manufacturer’s explanations and studies. Go to the reliable websites like www.drweil.com, www.webmd.com and others before you shell out the big bucks for something the FDA has only evaluated as a food.

The Supplements Getting All the Attention Today

Omega-3 Fatty Acids

This “fatty acid”, actually an oil, occurs throughout the body. Due to some promising research, Omega-3s are being studied across the world today. Research subjects battling depression improved when their intake of Omega-3 fatty acid increased in some studies. In other studies, no improvement was made.

You may have heard of “docosahexaenoic acid (DHA), more prevalent in shelfish, sardines, tuna, salmon, canola oil, soy, flax, walnuts and wheat germ. Studies have concluded that ingestion of these foods in significant quantities improves heart health, immune function and other physical conditions. They can, however, cause mild nausea and indigestion.

St. John’s Wort

With such an awful name, it can be a surprise to find this herbal remedy is actually a flower (hypericum perforatum) filled with, some say, mood altering chemicals. Like studies on Omega-3s, the results are varied. Some studies have shown it to be effective in relieving mild to moderate depression. Others have shown no difference between St. John’s Wort and placebo. Where St. John’s Wort has been used on patients with severe depression, researchers find no improvement in symptoms.

Despite these disappointing findings, doctors in some European countries still prescribe St. John’s Wort for depression. For those studies which report positive results, researchers theorize that St. John’s wort may block nerve cells in the brain from reabsorbing the neurotransmitter serotonin, making it more available. Serotonin and other neurotransmitters affect and regulate mood.

With the jury out, go to the National Institute of Mental Health’s most recent analysis of St. John’s Wort so that you can decide for yourself. Visit: http://nccam.nih.gov/research/results/stjohnswort/


Like Omega-3 fatty acids, SAM-e (sort for S-Adenosyl-L-Methionine) occurs naturally in the body, appearing most abundantly in the liver and brain. Like St. John’s Wort, SAM-e impacts mood-regulating neurotransmitters like serotonin and dopamine. European doctors prescribe it for arthritis as well as depression.

Of the three supplements, SAM-e had returned the most encouraging results. Several studies concluded that SAM-e more effectively relieves symptoms of depression than placebo (impotent sugar pill). More impressive, however, severely depressed patients who took SAM-e in addition to their prescribed antidepressants had positive results. Half showed some improvement and the other half went into remission, showing no depression symptoms while taking the supplement and the medication together.

Side effects to look out for include nausea and constipation. These can lessen as the body adjusts to the supplement.

The Bottom Line on Supplements and Mood Disorder

Studies conflict, answers escape us and the jury is out when it comes to the great finds on nutritional supplements and mood disorders. The most important thing to remember is to talk to you doctor about studies you have read or supplements you’re considering using or adding to your treatment regimen. Your doctor should have the most up-to-date information on clinical studies and findings. Your doctor will also warn you about side- effects and potential interactions a supplement causes.

Like prescription medications, nutritional supplements can work wonders for one person and not even phase another. Our bodies are chemical storehouses, each one individual with differing levels of hormones, oils, proteins, acids and more! Taking one medication could do the trick for you. Taking two medications and one supplement may be just the cocktail your body needs to function optimally. With nutritional supplements—as with the right medication, the right therapist, and the right support group—success comes after persistent effort, trial and error.

That effort is the lot of the individual with the mood disorder, but if you consider Robin Nixon’s article “Why We Are All Insane,” you can recast it another way. In (www.livescience.com/health/o80826-insanity-evolved.html), Nixon explores ideas that “natural selection wants us to be crazy—at least a little bit” because with our increasing skills with tools, we achieved “a diversity of mental abilities, and disabilities.” She goes on explain the evolutionary genius in creating those with depression, ADD or bipolar disorder. If we are all a little crazy, those of us who treat it stand to gain the most.

For More Information:

National Institutes of Health, Offices of Dietary Supplements

(301) 435-2920 www.ods.od.nih.gov
National Center for Complimentary and Alternative Medicine


National Institute of Mental Health


National Library of Medicine


Alternative Medicine Foundation


HerbMed Database








That Is the Bipolar Depression Question

Along with my co-author, Boadie W. Dunlop, MD, I recently reviewed the efficacy data of nutritional supplements for the treatment of bipolar depression.3 From the PubMed and Ovid MEDLINE databases, I identified all randomized clinical trials of nutritional supplements in bipolar depressed patients that met the following inclusion criteria: the subject sample included adult bipolar (I, II, or NOS) depressed or euthymic patients; were randomized controlled trials; reported changes in depressive symptoms or depressive episode recurrences; and were written in English. Studies that enrolled both non-bipolar and bipolar patients were included only if they reported the results for the bipolar patients separately. Supplements were organized into 3 categories: essential nutrients/minerals, non-essential nutrients, and combinations of nutritional products. The study design, and efficacy and adverse event data for each study were evaluated.

What the evidence showed

Among essential nutrients/minerals, omega-3-fatty acids had the strongest evidence of efficacy for bipolar depression, although some studies failed to find positive effects from this supplement. The interpretation of results from omega-3-fatty acid trials is complicated by the varying doses and ratios of eicosapentaenoic acid and docosahexaenoic acid-the 2 forms of omega-3-fatty acids used in trials of this supplement.

Weak evidence supported the efficacy of vitamin C, whereas no data supported the usefulness of folic acid and choline. However, folic acid’s role in prevention of birth defects, particularly among bipolar patients, is of great importance-regardless of its usefulness for bipolar disorder symptoms.4

Among the non-essential nutrients, the 2 studies of N-acetylcysteine produced unclear efficacy for treating acute depressive episodes relative to placebo. One study demonstrated its potential to improve depressive symptoms over time. The other, although nonsignificant, suggested it had a prophylactic effect against future depressive episodes.

Inositol is another nonessential nutrient for which the data were unclear. Although all but one of the studies of inositol failed to demonstrate efficacy, the negative studies were underpowered and indicated numerically positive effects. Cytidine was the least supported nonessential nutrient.

Combination supplements (ie, 2 or more supplements taken as a single pill) come in a variety of OTC products, but very few have been the focus of controlled, clinical evaluations. We found no evidence of efficacy for citicoline in uncomplicated bipolar depression, although it may have value for comorbid substance abuse among bipolar patients. Finally, the combination of omega-3-fatty acids and cytidine demonstrated no evidence of efficacy.

Our review did not support routine use of nutritional supplements in the treatment or prophylaxis of bipolar depression. However, study design limitations for both the positive and negative studies reduced the confidence with which our conclusions could be drawn. For example, many of the acute treatment studies had a long duration that may have allowed patients to experience a natural recovery from their episode, unrelated to the study treatment. This would diminish any drug-placebo difference and lead to false-negative outcomes. Sample sizes were often small, which could lead to both false-positive and false-negative efficacy assessments. Baseline mood symptom severity and/or episode were often not reported, thus introducing a potentially significant uncontrolled confounder of outcomes. Some studies included patients in any mood pole of bipolar disorder, making it unclear which phase of the illness was most affected by the study compound.

For some supplements, particularly the omega-3-fatty acids, the unique taste may have unblinded the participants or raters, leading to symptom reporting or scoring based on the expectation of improvements, rather than actual improvements. Changes to adjunctive psychotropic medication doses were permitted in some studies, which made it unclear whether a reported benefit or lack of benefit for a supplement was influenced by such medication changes. Finally, some studies included patients with very low symptom severity, which made it difficult to demonstrate the supplement’s potential benefit because of a floor effect on potential improvement.

Patients with bipolar disorder who seek alternative treatments in the form of nutritional supplements will likely be disappointed by these findings. However, supplements can be expensive, and they are usually not covered by health care insurance policies. In addition, these products may present unknown physical harms, because the FDA holds them to a different standard of safety than psychotropic medications.5 Finally, those who stop psychotropics, believing that supplements are superior and safer, can experience a worsening symptom course.

Given these risks, better-designed studies must be conducted to determine whether nutritional supplements will help bipolar depression before we encourage widespread use of individual supplements. Despite these inconclusive findings, psychiatrists must remain open to the possibility that with further studies, we may eventually identify minerals and supplements that will benefit bipolar patients. Remember, lithium-the cornerstone of bipolar treatment for several decades-is also a mineral.


Dr Rakofsky is Assistant Professor in the Mood and Anxiety Disorders Program at Emory University School of Medicine in Atlanta. He is also the Director of Medical Student Education in the Department of Psychiatry and Behavioral Sciences and trains psychiatry residents in outpatient psychopharmacology practice. His research interests include the treatment and neurobiology of bipolar depression.


1. Benkert O, Graf-Morgenstern M, Hillert A, et al. Public opinion on psychotropic drugs: an analysis of the factors influencing acceptance or rejection. J Nerv Ment Dis. 1997;185:151-158.

2. Astin JA. Why patients use alternative medicine: results of a national study. JAMA. 1998;279:1548-1553.

3. Rakofsky JJ, Dunlop BW. Review of nutritional supplements for the treatment of bipolar depression [published online ahead of print December 18, 2013]. Depress Anxiety. doi: 10.1002/da.22220.

4. Green NS. Folic acid supplementation and prevention of birth defects. J Nutr. 2002;132(suppl 8):2356S-2360S.

5. US Food and Drug Administration. Q&A on dietary supplements. http://www.fda.gov/Food/Dietarysupplements/default.htm. Accessed February 24, 2014.

Amino Acid Supplements for Bipolar Disorder

An amino acid is an organic compound containing an amino group (-Nh3) and a carboxyl group (-COOH). They are the building blocks for all life, in that they are the chemical basis for all proteins.

Protein is one of the biggest components of our bodies. Our bodies use amino acids to form the proteins which build everything from muscles and bones, skin and hair, to internal organs and fluids. In addition, amino acids play an active role in our nervous system, where they function as ​neurotransmitters in the brain.

Amino acids can be divided into two basic groups: essential and nonessential. The essential amino acids are those which your body cannot synthesize. Your body only gets these through your diet. The nonessential amino acids are just as important, but your liver can manufacture them.

The Amino Acids That May Be Important in Bipolar Disorder

The specific amino acids that have been linked with bipolar disorder are tyrosine, tryptophan, and taurine. Tyrosine is essential to several key brain chemicals including mood-boosting dopamine and norepinephrine. Tryptophan is an essential amino acid obtained through the diet that produces the so-called happiness hormone serotonin. A deficiency in one or both of these amino acids is associated with low mood and aggression.

Bipolar disorder has also been specifically linked to a taurine deficiency. Taurine is an amino acid made in the liver and creates a calming effect in the brain. A taurine deficiency may lead to more manic episodes in a person with bipolar disorder.

One supplement called N-acetylcysteine, or NAC, consists of the amino acid cysteine, which is converted into taurine in the liver. Unfortunately, scientific studies examining this supplement have not shown a benefit in people with bipolar disorder.


According to a 2014 review study in Depression and Anxiety, which examined a number of different nutritional supplements in bipolar disorder including NAC, there was no benefit in using nutritional supplements to either prevent or treat bipolar disorder. That being said, it’s important to note that this review study did not specifically examine tryptophan or tyrosine.

Regardless, it’s extremely important to first speak with your doctor before taking any supplements. Taking too much of an amino acid supplement may be harmful. Also, supplements should not be used to replace prescription medications for your bipolar disorder.

Popular Vitamins to Supplement Bipolar Disorder Treatment

Some people look to help lighten the load of bipolar disorder symptoms with vitamins and supplements. Here’s a look at what trends.

Prescribed medication for bipolar disorder is a cornerstone of treatment. But as more and more folks are learning to advocate for their own wellness, many are finding the addition of other resources may help alleviate symptoms.

Bipolar disorder is characterized by mood changes that can last from a few months to a few years. People often seek additional help managing the two main mood alterations:

  • Mania. An ever-elevating or irritable mood that may start euphoric but ends with exhaustion or impulsivity. It may lead to interpersonal, social, sexual, financial, work, or legal consequences.
  • Depression. A period hallmarked by feelings of hopelessness, despair, brain fog, slowed concentration, and possibly suicidal thoughts.

Much research has been done studying fish oil and its addition to our diet. We already know that cod, salmon, and other fish can help treat heart disease and arthritis.

For folks with bipolar disorder, we also have reports that fish oil may:

However, it’s important to note that the benefits of fish oil supplementation are really only effective in people who are deficient in these fatty acids, and specifically during depressive episodes, according to a 2015 research review.

Vitamin B1 (thiamine)

Anxiety disorder often accompanies bipolar disorder. Vitamin B1 can help ease anxiety and irritability for some adults, according to a 2021 study.

Vitamin B12

Though some folks low in B12 report mood changes, depression, and mania, to date there’s no direct correlation between its deficiency and bipolar disorder symptoms.

However, the vitamin — known for its energy-boosting benefits to those deficient in it — might be helpful if bipolar disorder depression has you feeling fatigued.

It’s water soluble, which means when your body has had enough of it for the day, you’ll see that tell-tale neon yellow when you pee.

If you eat a balanced diet, you’re likely getting enough B12 and don’t need a supplement. But poor diets might make you low in B12.


Magnesium may help ease manic episode symptoms of irritability, anxiety, and insomnia for people already deficient in it.

It relaxes the nerves — both the neurotransmitters that communicate stress and distress to the brain, among other messages, when taken orally, and nerve endings within the sinews of your muscles, when taken orally or used topically.

Vitamin C

An older study found that people with bipolar disorder have too much of the mineral vanadium, which factors into mania and depression.

Vitamin C, also called ascorbic acid, has been observed to protect the body from damage fueled by too much vanadium.

Oranges, kiwis, and red peppers all pack a vitamin C punch.

Vitamin D

There is a link between low vitamin D levels and bipolar disorder.

Simply and safely getting some sunshine can restore vitamin D in your system. If that’s not practical in your climate, you can ask your healthcare team about vitamin D supplements, or even invest in a light box.

Folic acid

So many studies suggest a relationship between low levels of dietary folic acid and subsequent depressive or manic episodes.

Researchers haven’t yet pinpointed the chicken-egg relationship — if a folate deficiency causes bipolar symptoms, or a folate boost alleviates symptoms — but if you can naturally add more of the nutrient to your diet, it may help enhance cognition.


Bipolar disorder is a long-term condition that’s best managed by a consistent collaboration of therapies including:

Vitamins may help provide some symptom relief, but none of these strategies can manage bipolar disorder alone.

Have any other candid questions about bipolar disorder? You can get answers from our tell-all FAQ.

Vitamins consumed in your diet and boosted by supplementation might help prevent bipolar disorder episodes or reduce their severity in some cases, but we need more research.

Folks with bipolar disorder should seriously avoid some supplements, like SAM-e or gingko biloba, since they can worsen mania or interfere with bipolar disorder medications like antidepressants.

If you’re still interested in keeping up your wellness with the help of vitamins and supplements, the smartest thing to do is take your wish list to your healthcare team. Ask them whether any potential vitamins or supplements on your list will counteract with your existing management plan and general condition.

The fact that you’re reading this means you’re doing a diligent job of looking to manage your condition well. Bravo. Keep at it and read on for more helpful intel.

Alternative and Complementary Treatments for Bipolar Disorder

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. However, no studies show that lithium orotate is effective in treating mania or depression.

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.

90,000 Natural supplements for depression

Depression is a mental illness that is widespread among the world’s population. Treatment strategies for depression include omega-3s, St. John’s wort, rhodiola, curcumin, probiotics. In combination with drug treatment, they have a positive effect.

Major depressive disorder (MDD), or clinical depression, is a common condition that negatively affects performance, thoughts, and mood.

Supplements for the treatment of depression

Symptoms of MDD

In MDD, some of the symptoms should appear almost daily for two weeks:

  • sadness, anxiety,
  • a sense of hopelessness, guilt,
  • mood swings, irritability,

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  • Loss of interest in past activities that were enjoyable,
  • loss of appetite, weight fluctuations,
  • permanent fatigue,
  • Sleep Disorders,
  • difficulties with concentration, memorization,
  • headaches, cramps, digestive problems.

MDD Therapy: Natural Ingredients

Depression is treated with a combination of antidepressants and psychotherapy. But patients with MDD experience side effects from taking antidepressants. There are scientifically proven dietary supplements with antidepressant effects.

St. John’s wort

St. John’s wort is effective in the treatment of mild to moderate depression. The plant shows antidepressant properties, but produces fewer side effects.

Omega-3 fatty acids

Omega-3 polyunsaturated fatty acids (PUFAs) are found in fatty fish and can reduce the risk of depression. Supplemental omega-3 supplementation has been shown to improve the relief of depression associated with bipolar disorder. The fact is that omega-3s have the ability to directly affect the properties of membranes and reduce inflammation.

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This is an adaptogen plant with anti-stress and antidepressant properties. The therapeutic effect of rhodiola is associated with its ability to interact with the neuroendocrine-immune system and neurotransmitter receptors that work in depression .Rhodiola improves symptoms such as insomnia, emotional instability, somatization.


Curcumin’s antidepressant properties are attributed to its ability to influence neuroprogression and pathways of immune, inflammatory, oxidative and nitrosative stress . Curcumin is a safe and effective treatment for MDD sufferers who are not possessed by suicidal thoughts and other psychotic disorders.


Stigma and saffron petal have antidepressant properties.Saffron patients perform better on the Hamilton Depression Characteristic Scale.

S-adenosylmethionine (SAMe)

SAMe is a substance found in the human body. SAMe plays a role in cell metabolism. This compound is used in the treatment of MDD in people who do not respond to antidepressant medication . SAMe is also used as a concomitant therapy for depression associated with Parkinson’s disease.


An imbalance of the intestinal microflora (dysbiosis) is associated with some diseases (and depression as well). Parallel administration of certain strains of probiotics and antidepressants has a positive effect. Among these strains: Lactobacillus helveticus, Bifidobacterium longum, Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium bifidum. Published econet.ru

P.S. And remember, just by changing your consumption – together we are changing the world! © econet

* Articles of Econet.ru are intended for informational and educational purposes only and do not replace professional medical advice, diagnosis or treatment.Always consult your doctor for any questions you may have about your health condition.

Improve Your Mood, Ease Your Pain, Clear Your Mind – With Natural Remedy S – Blog

Patricia L. Herbarg M.D. and Richard P. Brown M.D.

In this Article:

In our opinion, SAMe (SAMe, SAM-e, S-adenosylmethionine, S-adenosyl-L-methionine, adomethionine) is the most natural antidepressant, since it participates in at least 100 biological processes in cells of our body.SAMe is a source of methyl groups (3 hydrogen atoms bonded to one carbon atom) and other molecules that are involved in the synthesis of proteins, phospholipids for cell membranes, antioxidants, mood-regulating neurotransmitters, and other important cell components. Methyl groups transferred from SAMe to DNA bases can turn on or off the expression of certain genes. Abnormal methylation may be associated with depression and dementia (Bottiglieri, 2017). That is why, as well as for other reasons, it is important to maintain the required level of SAMe in the body.SAMe is naturally synthesized in our bodies, but many people need to get additional SAMe from food and supplements, especially if they have depression, certain medical conditions, or when severe stress is present. Since SAMe is found naturally throughout the body, it can help heal many organs and tissues, including the brain, liver, and joints.

SAMe is as effective in treating depression as prescription antidepressants, according to the AHRQ’s SAMe Clinical Trials Review.The AHRQ also believes it is beneficial in osteoarthritis and liver disease (2002), noting that this finding needs to be confirmed by additional research. Stronger positive effects were observed in severe depressive disorders than in moderate forms of depression.

More than 40 clinical studies show that the use of SAM-e for the treatment of severe depressive disorders is safe and effective. A recent review of SAMe by the American Psychiatric Association Research Council (Sharma et al., 2017) confirmed that SAMe causes far fewer side effects compared to prescription antidepressants and does not enter into adverse reactions with other drugs. In fact, SAM-e is able to protect the liver from the toxic effects of other drugs, as well as the effects of infections such as hepatitis. In addition, studies have shown that SAM-e can accelerate and enhance the onset of therapeutic effect when taken in combination with standard antidepressants (including MAO inhibitors) (Alpert et al., 2004; Berlanga, et al. 1992; Torta et. al., 1988).

A recent multicenter, randomized, controlled trial of depression treatment found no significant differences between SAMe, escitalopram and placebo (Mischoulon et al., 2014), possibly due to the high incidence of treatment response to placebo, or due to the fact that the majority of participants there were milder (rather than severe) depressive disorders, or due to the use of a less potent form of SAMe.A reanalysis of data from one of two studies showed that the improvement in depression with SAMe was equivalent to the improvement with escitalopram, with both drugs being significantly more beneficial than placebo (Sarris et al., 2014). Differences in results can also be attributed to different proportions of men and women among participants, different principles for selecting participants, or for other reasons.

Not all SAMe forms are the same

When SAMe first appeared in the United States, higher quality products contained SAMe 1,4-butanedisulfonate.However, most companies then switched to less expensive toluenate or tosylate forms. If a depressed patient does not improve sufficiently with SAMe toluenate or SAMe tosylate, then SAMe 1,4-butanedisulfonate should be offered. In clinical practice, SAMe 1,4-butanedisulfonate is considered more effective (sometimes a lower dose is sufficient), and also more effective, in particular, for improving cognitive functions.

It is very important to use the best quality SAMe products.Because SAMe reacts quickly with oxygen, tablets should be sold in blisters, not vials. Without protection, the tablets will lose their potency during storage. For the same reason, the manufacturing process for SAMe tablets has been carefully thought out to ensure that they are effective over the long term.

Side Effects SAMe

SAMe is usually taken at least 30 minutes before breakfast and lunch to ensure good absorption.However, if mild nausea occurs, it can be relieved by taking SAM-e after a small snack or by using ginger capsules. Abdominal pain, indigestion, loose stools, and headaches may also occur. SAMe is stimulant, so in some cases it can cause anxiety, panic, or agitation like any other antidepressant. Like other antidepressants, SAMe can cause hypomania or mania in patients with bipolar disorder (manic-depressive).On rare occasions, SAMe can aggravate symptoms in patients with cardiac arrhythmias. Unlike many other prescription antidepressants, SAMe has no side effects such as altered sex drive, weight gain, or cognitive impairment. SAMe is effective in the elderly and is better tolerated than prescription drugs.

SAMe Misconceptions

If you search for information about SAMe on the Internet, you will find a lot of information, some of which will be true and some will not.One myth is related to a study in which a SAMe solution was injected directly into the brains of rats without comparison to a control group. Unsurprisingly, the injected solution damaged the brain, causing tumors. As a result, it was incorrectly concluded that oral SAMe may worsen Parkinson’s disease. It has also led to the incorrect conclusion that SAMe may attenuate the therapeutic effect of L-dopa. But in fact, SAMe is not only safe, but also beneficial for people with Parkinson’s disease.below). To date, there is no evidence that SAMe affects the therapeutic effect of L-dopa. In fact, chronic L-dopa supplementation can lead to a decrease in SAMe stores, which in this case must be replenished through supplementation.

Another common myth is that SAMe increases homocysteine ​​levels (this increases the risk of heart disease). But a randomized controlled trial at the Mayo Clinic demonstrated that SAMe does not alter plasma homocysteine ​​levels (Thompson, et al.2009).

Dosage SAM-e

Older adults or those with significant levels of anxiety, gastrointestinal problems, or serious medical conditions may start with a low SAMe dosage of 200 mg / day. Comparatively healthy people can start at 400 mg / day. If there are no problems after 3-7 days, you can increase the dosage by 400 mg per week to 800 mg before breakfast and lunch. Typical dosage for mild depression is 400-600 mg / day; with moderate depression – 600-1200 mg / day; with severe depression – 1200-1600 mg / day; for very severe resistant depression – 1600-2400 mg / day.Before starting a dosage above 1600 mg / day, you should consult a physician and a specialist with experience in treatment with SAMe.

Getting the most out of SAMe with B vitamins

SAMe methylation reactions (methyl group transfer) may require the following cofactors: B12 (methylcobalamin) and folate. A deficiency in these vitamins can reduce the effectiveness of SAMe, but it can be replenished with 1000 mcg / day of B12, 800-1,000 mcg / day of folate and 50-100 mg / day of vitamin B6.

Depression, arthritis and fibromyalgia

People with arthritis and fibromyalgia also often suffer from depression. SAMe has been shown to relieve pain and inflammation in numerous studies for the treatment of osteoarthritis (1200 mg / day SAMe) and fibromyalgia (800-1200 mg / day) (Brown, Gerbarg & Muskin 2009). In Germany, a randomized controlled trial (involving over 20,000 patients) showed SAMe to relieve osteoarthritis pain as effectively as NSAIDs (Bradley et al.1994)

Depression and liver disease

SAM-e improves liver function in individuals with liver cirrhosis or hepatitis caused by alcohol, drugs, toxic substances, infections or stones (including during pregnancy) (Lieber 1999, 2005; Mato et al. 1999). Prescription antidepressants such as SSRIs can cause liver problems. Statins (used to lower cholesterol) when taken in combination with prescription antidepressants can increase the risk of liver damage.Moderate to severe liver dysfunction can be alleviated by taking 1200-1600 mg SAM-e per day in combination with polyenylphosphatidylcholine and, if necessary, with betaine (trimethylglycine), B vitamins and alpha-lipoic acid (Lieber 2005; Efrati et al. 2003; Kharbanda et al. 2005). Additional benefits have been found in the treatment of depression in HIV / AIDS patients (Shippy et al. 2004).

Depression and Parkinson’s disease

Certain drugs, such as carbidopa, used to treat Parkinson’s disease, decrease SAM-e stores in the brain, leading to resistant depression (Carrieri, Indaco, & Gentile, 1990).Such depression may respond well to SAMe treatment. Preliminary research also suggests that symptoms of Parkinson’s disease can be improved with very high doses of SAM-e, 1600-4000 mg / day (Di Rocco et al., 2000).

Depression in children

Although there are no published studies to support the safety and efficacy of SAM-e in children, some reports on the use of SAM-e suggest that it has been used successfully to treat depression in children and adolescents (Schaller, Thomas, & Bazzan , 2004).

Attention deficit disorder

SAMe may be helpful for those seeking to minimize stimulant use in Attention Deficit Disorder. One small study found significant improvements in attention deficit disorder in men when SAMe was tried. These improvements can be enhanced with some herbal remedies, in particular Rhodiola rosea (Brown, Gerbarg, & Muskin 2009).

Cognitive functions, age-related weakening of cognitive functions, dementia

Small studies suggest SAMe may improve brain function.Several more recent randomized controlled trials have shown that a formula containing SAMe, vitamins and nutrients can improve cognitive function in patients with early, moderate and severe symptoms of Alzheimer’s disease (Chan et al. 2008; Remington et al. 2009; Remington et al. 2015).


A significant body of research confirms the safety and efficacy of SAMe in depression, osteoarthritis and liver disease.Several studies suggest that SAMe may have a therapeutic effect in Parkinson’s disease, attention deficit disorder, neurocognitive impairment, Alzheimer’s disease, AIDS / HIV, and drug abuse.

Consumers should be educated on how to find the best quality SAMe, and be wary of false information that often appears on the Internet (Brown, Gerbarg & Muskin, 2009; Sharma et al.2017).


  1. Alpert, J. E., Papakostas, G., Mischoulon, D., et al. (2004). S-adenosyl-L-methionine (SAMe) as an adjunct for resistant major depressive disorder: an open trial following partial or nonresponse to selective serotonin reuptake inhibitors or venlafaxine. J Clin Psychopharmacol, 24 (6), 661-4.
  2. Barak, A. J., Beckenhauer, H. C., & Tuma, D. J. (1996). Betaine, ethanol, and the liver: a review. Alcohol, 13 (4), 395-8.
  3. Berger R, Nowak H. A new medical approach to the treatment of osteoarthritis: Report of an open phase IV study with ademetionine (gumbaral). Am J Med 1987; 83: 84-8.
  4. Berlanga, C., Ortega-Soto, H. A., Ontiveros, M., & Senties, H. (1992). Efficacy of S-adenosyl-L-methionine in speeding the onset of action of imipramine. Psychiatry Res, 44 (3), 257-62.
  5. Bottiglieri T. In Complementary and Integrative Therapies for Psychiatric Disorders, Edited by Phillip R.Muskin, Patricia L. Gerbarg, and Richard P. Brown. Psychiatric Clinics of North America. March 2013, 36 (1): 121-140. doi: 10.1016 / j.psc.2013.01.001.22.
  6. Bottiglieri T, Gerbarg PL, Brown RP. S-Adenosylmethionine, Adometionine, SAMe. In Complementary and Integrative Treatments in Psychiatric Practice, edited by Gerbarg PL, Brown RP and Muskin PR. Washington D.C., American Psychiatric Association Publishing, 2017, pp 41-52.
  7. Bradley JD, Flusser D, Katz BP, et al.A randomized, double blind, placebo controlled trial of intravenous loading with s-adenosylmethionine (SAM) followed by oral SAM therapy in patients with knee osteoarthritis. The Journal of Rheumatology 1994; 21: 905-11.
  8. Brown RP and Gerbarg PL. Non-drug Treatments for ADHD: Options for Kids, Adults, and Clinicians. W.W. Norton & Company, New York, 2012.
  9. Brown RP, Gerbarg PL, Muskin PR. How to Use Herbs, Nutrients, and Yoga in Mental Health Care. W.W. Norton & Company, New York. 2009.
  10. Carrieri, P. B., Indaco, A., & Gentile, S. (1990). S-Adenosylmethionine treatment of depression in patients with Parkinson’s disease: a double-blind crossover study versus placebo. Curr Ther Res. 48,154-160.
  11. Chan A, Paskavitz J, Remington R, et al. Efficacy of a vitamin / nutriceutical formulation for early-stage Alzheimer’s disease: A 1-year, open-label pilot study with a 16-month caregiver extension. Am J Alzheimers Dis Other Demen 2008; 23: 571-85.
  12. Di Rocco A, Rogers JD, Brown R, et al. S-Adenosyl-Methionine improves depression in patients with parkinson’s disease in an open-label clinical trial. Mov Disord 2000; 15: 1225-9.
  13. Efrati, O., Barak, A., Modan-Moses, D., et al. (2003). Liver cirrhosis and portal hypertension in cystic fibrosis. Eur J Gastroenterol Hepatol, 15 (10), 1073-8.
  14. Kharbanda, K. K., Rogers, D. D. 2nd, Mailliard, M. E., et al. (2005). A comparison of the effects of betaine and S-adenosylmethionine on ethanol-induced changes in methionine metabolism and steatosis in rat hepatocytes.J Nutr, 135 (3), 519-24.
  15. Lieber, C. S. (1999). Role of S-adenosyl-L-methionine in the treatment of liver diseases. J Hepatol, 30 (6), 1155-9.
  16. Lieber, C. S. (2005). Pathogenesis and treatment of alcoholic liver disease: progress over the last 50 years. Rocz Akad Med Bialymst, 50, 7-20.
  17. Mato, J. M., Camara, J., Fernandez de Paz, J., et al. (1999). S-adenosylmethionine in alcoholic liver cirrhosis: a randomized, placebo-controlled, double-blind, multicenter clinical trial.J Hepatol, 30 (6), 1081-9.
  18. Mischoulon D, Price LH, Carpenter LL, et al. A double-blind, randomized, placebo-controlled clinical trial of s-adenosyl-l-methionine (SAMe) versus escitalopram in major depressive disorder. J Clin Psychiatry 2014; 75: 370-6.
  19. Remington R, Chan A, Paskavitz J, Shea TB. Efficacy of a vitamin / nutriceutical formulation for moderate-stage to later-stage Alzheimer’s disease: A placebo-controlled pilot study. Am J Alzheimers Dis Other Demen 2009; 24: 27-33.
  20. Remington R, Bechtel C, Larsen D, et al. A phase II randomized clinical trial of a nutritional formulation for cognition and mood in Alzheimer’s disease. J Alzheimers Dis 2015; 45: 395-405.
  21. Sarris J, Papakostas GI, Vitolo O, Fava M, Mischoulon D. S-adenosyl methionine (SAMe) versus escitalopram and placebo in major depression RCT: Efficacy and effects of histamine and carnitine as moderators of response. J Affect Disord 2014; 164: 76-81.
  22. Schaller, J.L., Thomas, J., & Bazzan, A. J. (2004). SAMe use in children and adolescents. Eur Child Adolesc Psychiatry, 13 (5), 332-4.
  23. Sharma A, Gerbarg PL, Bottiglieri T, Massoumi L, Carpenter LL, Lavretsky H, Muskin PR, Brown RP, Mischoulon D. S-Adenosylmethionine (SAMe) for Neuropsychiatric Disorders: A Clinician-Oriented Review of Research. J Clin Psych. 78 (6): e656 – e667, 2017.
  24. US FDA Agency for Healthcare Research and Quality (AHRQ) reviewed, S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease (2002).
  25. Thompson MA, et al. 2009. Dietary supplement S-adenosyl-L-methionine (AdoMet) effects on plasma homocysteine ​​levels in healthy subjects: a double-blind, placebo-controlled, randomized clinical trial. JACM 15 (5): 523-9
  26. Torta, R., Zanalda, F., Rocca, P. et al. (1988). Inhibitory activity of S-adenosyl-L-methionine on serum gamma-glutamyl-transpeptidase increase induced by psychodrugs and anticonvulsants. Curr Ther Res, 44, 144-159.
  27. Varanese S, Birnbaum Z, Rossi R, Di Rocco A.Treatment of advanced Parkinson’s disease. Parkinsons Dis 2011.

This article was written by integrative psychiatrists Dr. Patricia Gerbarg and Dr. Richard P. Brown. Dr. Gerbarg, assistant professor of psychiatry at New York Medical College, graduated from Harvard Medical School and has been practicing psychiatry for 39 years. Her research and publications focus on psychotherapy practices for stress, anxiety, PTSD, depression and mass disaster.Dr. Brown, Associate Professor in the Department of Clinical Psychiatry at Columbia University, lectures internationally and has co-authored over 100 scientific articles, chapters and books. Dr. Brown and Dr. Herbarg developed a neurophysiological theory investigating the effects of yoga breathing on the treatment of stress, anxiety, depression, PTSD, and stress-related medical conditions, which has been validated in clinical trials and in disaster survivors. www.Breath-Body-Mind.com.

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90,000 Fish Oil and Depression – Blog

What if, in treating depression, doctors stop manipulating brain chemistry with drugs and focus on maintaining that chemistry? A new study on fish oil supplements from the University of Pittsburgh suggests that fewer college students may be depressed or need to take antidepressants

Depression is a big problem for college students.According to recent studies, 30% of students experienced depression, making it difficult for them to live, and 6% seriously considered suicide in the previous 12 months. Given the relative ineffectiveness of prescription antidepressants and the potential adverse reactions to their use, it is important to help these young people with proper nutrition and supplementation. After all, you don’t get depressed because you lack Prozac or another antidepressant. But the fact that you are missing an important element, such as long-chain fatty acids from fish oil, can be one of the main causes of depression.


Fish oil supplements, mainly long-chain omega-3 fatty acids, EPA and DHA, which are free of lipoperoxides, heavy metals, environmental pollutants, and other harmful compounds, revolutionized nutrition … A huge body of scientific evidence now shows that fish oil can prevent or help treat over 60 different diseases, including depression and other brain disorders.

Studies have also shown that countries with a high consumption of fish oil have low rates of depressive disorders.

The importance of omega-3 fatty acids for brain function is related to their role in the phospholipid composition of nerve cell membranes. Studies have shown that EPA and DHA affect:

  • The flexibility of the cell membranes in the brain.
  • Synthesis of neurotransmitters.
  • Binding of neurotransmitters.
  • Activity of key enzymes that break down neurotransmitters such as serotonin, adrenaline, dopamine and norepinephrine.

Fish oil rich in EPA and DHA has been shown to have beneficial effects in patients with depression and bipolar disorder (manic depression) when taken in recommended doses (eg 1000-3000 mg EPA + DHA). But these studies have mostly been done in older people and tend to take antidepressants.

New data:

To evaluate the effects of fish oil supplementation on young people with depression, a double-blind study was conducted in 23 patients (78% of women) with an average age of 20 years.These patients suffered from severe depression as evidenced by the fact that they scored more than 10 points on the standard diagnostic questionnaire (Beck Depression Inventory [BDI]). They did NOT take antidepressants. Subjects were randomly assigned to receive placebo (corn oil) and fish oil (1.4 g EPA + DHA [eicosapentaenoic and docosahexaenoic acids]). The BDI was completed prior to receipt of the supplement and on day 21 of receipt.

The results showed a significant difference between the groups regarding depression.Among the fish oil patients, 67% no longer met the criteria for depression, while in the placebo group, only 20% no longer met the disease.


These results are significant and show that a low dose of fish oil can lead to very rapid results in improving mood. Despite the impressive results, my recommended dosage for therapeutic fish oil is 3000 mg EPA + DHA.This dosage level could provide even better results based on previous studies in older patients.

In addition, over the past few years, I have presented several newsletters highlighting nutrition research that improves mood, brain health, memory, and / or prevents age-related mental decline. Key research areas are: reducing inflammation, controlling blood sugar levels, providing essential nutrients through high-quality nutrition, and protecting the brain from damage through the consumption of antioxidants, both with diet and through supplementation.

When it comes to diet, the Mediterranean or New Nordic diets seem to be very beneficial. When it comes to supplements, in addition to fish oil, there are three other basic guidelines:

# 1. Take in a high quality complex and minerals that provides at least the RDA for all vitamins and minerals.

# 2. Take a sufficient amount of the vitamin (typically 2,000-5,000 IU daily) to raise blood counts to the optimal range (50-80 ng / ml).

# 3. Take additional plant-based antioxidants such as flavonoid-rich extracts such as grape seed or pine bark, curcumin (Theracurmin), green cocktail or resver.


Ginty AT, Conklin SM. Short-term supplementation of acute long-chain omega-3 polyunsaturated fatty acids may alter depression status and decrease symptomology among young adults with depression: A preliminary randomized and placebo controlled trial.Psychiatry Res. 2015 Sep 30; 229 (1-2): 485-9.

The author of this article is Dr. Michael Murray, Chief Scientific Advisor of iHerb. For more than three decades, Dr. Murray has been a respected expert and author of publications in the fields of nutrition, nutritional supplements and natural products. He has written over 30 books, including the best-selling Encyclopedia of Natural Medicine, which has gone through five editions and is used by more than 100,000 medical professionals around the world.Learn more about Dr. Murray at DoctorMurray.com or on his page on iHerb.

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90,000 Bipolar Disorder Treatment | | Bipolar.su

With the right treatment, most people with bipolar disorder – even in its most severe forms – can stabilize mood swings and other symptoms of the disease. Because bipolar disorder is recurrent, preventive treatment is not only indicated but strongly recommended. Treatment that combines medication and psychotherapy is optimal to keep the disease under control.

In most cases, bipolar disorder is controlled much more effectively if the patient does not interrupt the course of treatment, but constantly follows it.But even in these cases, episodes of mood swings are quite likely. In such cases, it is imperative to notify the attending physician. Timely changes in the course of treatment by the doctor can prevent a full-blown episode.
Treatment will be more effective if doubts and proposed treatment options are discussed openly with your doctor.
In addition, if the patient himself and his loved ones fill in the graph of mood symptoms, medication, sleep patterns, daily events on a daily basis, then they begin to better understand the disease.Schedules like these also help the treating doctor more effectively monitor the progress of illness and treatment.


Medication for bipolar disorder is prescribed by board certified doctors of medicine (MD) psychiatrists who specialize in the diagnosis and treatment of mental illness. Although a physician can also prescribe medication, it is strongly recommended that people with bipolar disorder be seen and treated by a psychiatrist.
For bipolar disorder, so-called mood stabilizers are usually prescribed.There are several types of them. Typically, people with bipolar disorder continue to take mood stabilizers for an extended period of time (years). Other drugs are given as needed, usually for a shorter period of time, to relieve episodes of mania or depression that may occur intermittently, even with mood stabilizers.

Lithium is the first mood-stabilizing drug approved by the US Food and Drug Administration (FDA) for the treatment of mania.This medication is effective in controlling mania or preventing relapses of both manic and depressive episodes.

Anticonvulsants such as valproate (Depakote®) or carbamazepine (Tegretol®) also have mood-stabilizing effects and can be used in particularly difficult-to-treat cases of bipolar disorder. FDA approved valproate for the treatment of mania in 1995

New anticonvulsants such as lamotrigine (Lamictal®), gabapentin (Neurontin®), and topiramate (Topamax®) are under study to determine how well they work. to stabilize mood cycles
For maximum effect, several anticonvulsants may be prescribed at once, or they may be used in combination with lithium.

Children and adolescents with bipolar disorder are usually treated with lithium, but valproate and carbamazepine are also used. Scientists are investigating the safety and effectiveness of these and other psychotropic drugs for children and adolescents. Studies have shown that valproate can lead to hormonal changes in adolescent girls and polycystic ovarian syndrome in young women who start taking this drug before the age of 20.13 Therefore, young patients taking valproate should definitely be closely monitored by a doctor. …

Patients with bipolar disorder who are wishing to become pregnant or are already pregnant face difficult choices as mood stabilizers can have negative effects on the fetus or breastfeeding infant.14 Thus, before making a responsible decision, it is necessary to discuss everything with a specialist “ pros and cons of all kinds of treatment. New drugs are currently being tested to significantly reduce risk during pregnancy or breastfeeding.

Treatment for bipolar disorder

Studies have shown that patients with bipolar disorder treated with antidepressants are at risk of developing mania, hypomania, or rapidly circulating disease.

To protect people with bipolar disorder from these effects, mood stabilizing drugs are usually required, either in combination with antidepressants or on their own. Lithium and valproate are currently the most commonly used mood-stabilizing drugs.However, trials are ongoing to evaluate the effectiveness of new drugs for mood stabilization.
Atypical antipsychotics, including clozapine (Clozaril®), olanzapine (Zyprexa®), risperidone (Rispendal®), quetipine (Seroquel®), and ziprasidone (Geodon®), are being investigated for use in the treatment of bipolar disorder. There is evidence that clozapine may help patients who do not respond to lithium or anticonvulsant treatment.
Other studies have confirmed that olanzapine is effective in acute mania, and has recently been approved by the FDA for this use.17 Olanzapine has also been shown to help treat psychotic depression.18
Aripiprazole (Abilify®) is another atypical antipsychotic drug used to treat symptoms schizophrenia and manic or mixed (manic and depressive) episodes of bipolar I disorder. It comes in both tablets and liquid form. Injections are used to treat the symptoms of agitation in schizophrenia and manic or mixed episodes of bipolar I disorder.
If insomnia is a problem, highly effective benzodiazipine drugs such as clonazepam (Klonopin®) or lorazepam (Ativan®) may help. However, because these drugs are addictive, they are only prescribed for a short time. In some cases, sedatives such as zolpidem (Ambien®) are prescribed instead.
During the course of treatment for bipolar disorder, medications must be changed more than once in order to achieve the most effective treatment. All drug changes and dose changes should be made as directed by the attending psychiatrist.
Be sure to tell your psychiatrist about all medications you are taking, including over-the-counter medicines, homeopathic remedies, vitamins, and other supplements. This is very important as some medications and supplements are incompatible and may cause adverse reactions.
To avoid relapse or a new episode, you must strictly adhere to the treatment plan. Talk to your doctor about any medication questions.

Thyroid function

Thyroid dysfunction is common in patients with bipolar disorder.Elevated or lowered thyroid hormone levels by themselves can have an impact on mood and energy changes. Therefore, it is very important that the thyroid gland parameters are under constant control of the attending physician.
The rapidly circulating bipolar disorder is often associated with thyroid disease. In such cases, thyroid medications must be taken along with medications for bipolar disorder.It should also be borne in mind that in some patients, lithium can cause a decrease in the activity of the thyroid gland. At the same time, medications must be introduced into the course of treatment to regulate the function of the thyroid gland.

Drug side effects

Before starting new drugs, be sure to consult with your doctor and / or pharmacist about possible side effects. Depending on the drug, side effects may include weight gain, nausea, tremors, decreased sexual activity or ability, anxiety, hair loss, difficulty moving, and dry mouth.Be sure to tell your doctor about any side effects that appear while taking this or that medication. To remove or reduce side effects, the doctor may change the dosage of the drug or change it to another. Do not change medications or stop taking them without consulting a psychiatrist.

Psychosocial Methods

Psychosocial therapies are recommended along with medication, including some form of psychotherapy (or “talking” therapy).These methods help patients with bipolar disorder and their families understand the specifics of the disease and obtain the information they need. Research results have shown that psychosocial therapy helps to stabilize mood, reduce hospitalizations and improve performance in various areas of human activity.

Typically, licensed psychologists and social service providers perform this therapy in coordination with the treating psychiatrist and jointly monitoring the patient’s health progress.The number of sessions, their frequency and duration depend on the individual needs of each patient.
Psychosocial treatments for bipolar disorder include cognitive behavioral therapy, psychological education, family therapy, and a new technique called interpersonal and social rhythmic therapy. Researchers at the National Institute of Mental Health (NIMH) are studying and comparing the effectiveness of these therapies when used in combination with various drugs to treat bipolar disorder:
Cognitive behavioral therapy helps patients with bipolar disorder understand and change negative or distorted thinking and behavior patterns associated with disease.
Psychological education provides patients with information about the disease and how to treat it, and helps them learn to recognize the signs of relapse so that they can seek early help and prevent a full-blown episode from occurring. Mental education is also useful for the family members of the patient.

Family therapy uses a strategy to reduce the level of tension in the family, which can aggravate the symptoms of illness or provoked by them.
Interpersonal and social rhythm therapy helps patients with bipolar disorder improve interpersonal relationships and organize their daily routine.A regular schedule and regular sleep patterns can help prevent manic episodes.
As with medication, the prescribed course of treatment must be strictly adhered to in order to achieve successful psychosocial therapy results.

Other therapies

Electroconvulsive therapy (ECT) is used when drug therapy, psychosocial therapy, or a combination of both does not work, or is too slow to treat severe symptoms such as psychosis or suicidal symptoms.The use of ECT can also help during acute episodes when the patient’s physical condition (including pregnancy) does not allow the use of drugs. ECT is highly effective in the treatment of severe depression, manic and / or mixed episodes. The potential for long-term memory problems from ECT, which until recently was a major cause for concern, is now significantly reduced by the latest ECT techniques.
However, the pros and cons of ECT and other alternative therapies should be discussed in advance with the patient and, if necessary, with family or friends.
Herbs and natural supplements, such as St. John’s wort (Hypericum perforatum), are not well understood and there is little information available about their effects on bipolar disorder. Since FDA regulations do not apply to these products, different manufacturers of these supplements use different amounts of active ingredients. Before taking medicinal herbs or natural supplements, you should consult with your healthcare professional. There is evidence that St. John’s wort can reduce the effectiveness of certain drugs (see.: www.nimh.nih.gov/events/stjohnwort.cfm) leaving the OMH site. 20 In addition, like prescription antidepressants, St. John’s wort can provoke mania in some people with bipolar disorder, especially when the patient is not taking mood stabilizers.
Studies are being conducted on the efficacy of omega-3s (fatty acids found in fish oil) in the treatment of bipolar disorder, in combination with conventional medications or alone.

A chronic illness that can be treated very effectively

Although episodes of mania and depression tend to come and go, it must always be remembered that bipolar disorder is a chronic condition that currently has no cure.The only way to keep this disease under control is to constantly take medication, even during periods when you feel good. Only in this case can the chance of relapses and worsening of the condition be reduced.


Alcoholism and drug addiction are very common among patients with bipolar disorder. Studies have shown that there are a number of reasons for this, including self-medication, mood swings from alcohol or drug abuse, and risk factors that affect both the development of bipolar disorder and drug dependence.

Treatment for alcohol or drug addiction is an important part of the overall course of treatment.
Anxiety disorders such as post-traumatic stress disorder or obsessive-compulsive disorder (obsessive-compulsive disorder) are also common in bipolar disorder.

Comorbid anxiety disorders can sometimes be controlled by the same means as bipolar disorder, but in some cases special treatment is required.

Care for people with bipolar disorder and their families

People with bipolar disorder should be guided by an experienced psychiatrist who specializes in the diagnosis and treatment of the condition.Psychologists, social mental health workers, and mental health nurses help provide various aspects of treatment and care for patients and their families.

Help is available at the following locations:

  • Treatment programs at universities or medical schools
  • In psychiatric wards in hospitals
  • In private psychiatric offices and clinics
  • In health care organizations (HMOs)
  • In district offices or pediatricians
  • Community mental health centers
  • People with bipolar disorder may need help to get help

People with bipolar disorder often don’t realize how sick they are, or they do not see the cause of their illness in the mental disorder, but in what Something else.
People with bipolar disorder may need encouragement and support from family and friends to seek help from a doctor. The therapist can play an important role in insisting on consultation with a psychiatrist.
Occasionally, a family member or friend may need to accompany a person with bipolar disorder to see a doctor and receive treatment.
Occasionally, a patient with an acute attack may need to be hospitalized for his / her own safety and treatment.In some cases, the patient has to be hospitalized against his / her will and without consent.
It is necessary to constantly support and encourage the patient after the start of treatment, because in some cases it may take quite a long time to find the right course of treatment.
In some cases, people with bipolar disorder who are in remission may negotiate a specific course of action in the event of a future manic or depressive relapse.

Like other serious illnesses, bipolar disorder affects spouses, family members, friends, and employers.

Family members of a person with bipolar disorder often have to deal with serious behavioral problems, such as spending money rampant during episodes of mania or withdrawing from depression, and the long-term consequences of such behavior.

Many people with bipolar disorder are supported by support groups supported by various organizations such as the National Depression and Manic Depression Disorders Association (NDMDA), the National Mental Assistance Alliance (NAMI), and the National Mental Health Association (NMHA).These support groups also help families and friends of people with bipolar disorder. The coordinates of these organizations can be found in the Useful Information section of our brochure.

Source: http://www.omh.ny.gov/omhweb/russian/booklets/bipolar.html

Fast Cycles for Bipolar Disorder

mood swings, when a person experiences at least four (or more) manic, hypomanic or depressive episodes during the year.Why is this happening and why is it dangerous?

In a person with bipolar disorder with fast cycles, the mood rises and falls, sometimes for the better, then for the worse, and vice versa, and such fluctuations can occur over several days or even hours. The person feels like they are on a roller coaster, with powerful shifts in mood and activity that cannot be controlled. For some, rapid cyclicality is manifested by severe irritability, anger, impulsivity, and sudden outbursts of aggression.In fast-cycling bipolar disorder, episodes come in a random sequence.

Some patients may experience true mania, hypomania, or depression in just one day. The fast-cycling course of BAR has several subspecies. If there are 4 mood swings in a month, it is called “ultra-fast cycling”, if several alternations of episodes occur in one day or over several days during one week – this is “ultra-ultra-fast cycling”, or “ultra-range cycling”.

Typically, those with bipolar disorder with low amplitude fluctuations in mood experience longer episodes. In some “bipolar” patients, BC (fast cycles) are observed from the beginning of the course of the disease, but in many the disease takes on this form over time.

Most people with bipolar disorder will, in fact, experience shorter and more frequent episodes as the illness progresses if not properly treated. For some people, the appearance of BC is temporary.It is possible to experience a rapid alternation of episodes for a while, and then return to more prolonged conditions and less frequent swings, and at best, to a stabilized mood with treatment. Few have long-term persistence of bipolar disorder with a fast-cycling form.

It is important to see a doctor immediately in order to find the most appropriate and effective treatment for this form of bipolar disorder, because the longer a person goes without treatment, the more drug-resistant the disease becomes.

Who gets RBC?

Almost half of people with bipolar disorder may develop BC at some point. There is no definite answer as to who is more likely to have them, but women are more prone to fast cycles than men, although the disease is equally common among both sexes. An increase in the frequency of episodes can be triggered by the use of certain antidepressants. Often, when you stop taking them, fast cycles go away, but you should be aware of the possibility of recurrence of depressive episodes, so you need to work with your doctor to find a more effective combination of drugs, and never stop taking drugs or change the dosage without first discussing with a specialist.

There is undoubtedly an undeniable relationship between the emergence of BC and the use of drugs or alcohol. Substance abuse makes a person more prone to bipolar disorder. According to the research results, it was revealed that alcohol and drug addiction is most common in families of patients with bipolar disorder with a fast-cycle form than in families of patients with bipolar disorder without fast cycles. Whether this is the result of a genetic link between substance abuse or self-medication is unknown.

Causes of Fast Cycle Bipolar Disorder

The underlying cause of fast cycles remains unknown, but there are three theories.


Sensitization is an increase in the sensitivity of nerve centers under the influence of a stimulus. In theory, early episodes arise from various triggers. These can be different events: from the death of a loved one to an upcoming interview.Over time, the person with bipolar disorder becomes more sensitive to small triggers or stressors and is more likely to experience episodes in response to stressful situations. After all, the person begins to cycle rapidly without any “triggers”. Episodes become more frequent, and the end result, provided the disease is not properly treated, can be rapid, ultra-rapid, or ultra-range cycling.

Disorders of biorhythms

This theory states that in patients with BC, daily biorhythms are not synchronized with such phenomena as dawn and dusk.Disruption of biorhythms leads to sleep disturbances, characteristic of mania and depression, and also causes other symptoms. There may also be an association between BC and seasonal affective disorder. Abnormal diurnal biological rhythms do not cause illness, but contribute to the duration and severity of a manic or depressive episode. Therefore, it is better to treat insomnia in a timely manner.


Rapid alternation of episodes of mania, hypomania and depression may be caused by a lack of thyroid hormone in the brain.Most people with a fast cycle have normal thyroid hormone levels but may still respond well to thyroid hormone treatment regardless of the level.
Are there effective treatments for the rapid cycle of bipolar disorder?
Yes, although it is difficult to find the right treatment. People with bipolar disorder should not despair if the first few medications or prescribed combinations of drugs fail. There are many different treatment options.Observe what works for you, what does not work for you or is ineffective to help your doctor understand the choice of future medications. Be sure to talk with your doctor about adding any medications to your treatment, including natural herbal supplements.

Psychotherapy should be an important part of your treatment plan. In addition to the fact that people with bipolar disorder are at risk for another manic or depressive episode, they may also have difficulty coping with past episodes.Feelings such as irritability, tearfulness, jumping thoughts, or impulsivity lead to social problems. Because people with bipolar disorder are often unfairly judged, they may lose opportunities to develop friendships or romantic involvement, or find it difficult to achieve their career goals. These factors contribute to self-esteem problems. This is why people with bipolar disorder should work with psychotherapists, in person with a doctor, or with family members.It is important to make and stick to a treatment plan that is effective, and work to prevent suicidal thoughts, as this is vital.

Diagnosing your condition can help you and your doctor determine what is causing stress, keep track of which medications are working for you, and prevent new episodes. You can try keeping a personal mood calendar, keeping track of the medications you take, tracking mood changes, and noting stressful situations, side effects, and other symptoms.


Research shows that the fast-cycle course of bipolar disorder is different from other forms of bipolar disorder. People with fast cycles may respond differently to standard and experimental treatments than people with bipolar disorder in its standard form. With sudden and unpredictable mood changes, episodes are harder to tolerate. It is highly recommended that you interact with your doctor, adhere to an appropriate treatment plan, and not give up hope.

Translation: Nadya Abramova
Source: http://www.dbsalliance.org/site/PageServer?pagename=education_brochures_bipolar_disorder_rapid_cycling

Depression, its types and treatment

Everyone at least once, but experienced a state of deep sadness or grief. In the normal state of the body, these feelings usually go away within a few weeks, depending on the circumstances. If this condition lasts longer, then it not only affects the body’s ability to function, but is a sign of depression.

Common symptoms of depression:

  • Deep Sense of Sadness
  • Bad mood
  • Feeling worthless and hopeless
  • Changes in appetite and sleep
  • Loss of strength and energy
  • Inability to concentrate
  • Difficulties in daily activities
  • Apathy and loss of ability to communicate
  • Death anxiety, suicidal tendencies

Depression can affect everyone in different ways, but over time, it becomes a part of life.Next, we’ll break down the main types of disorder to understand how to deal with it.

Types of depression

Major depressive disorder

This is a classic (unipolar) depression, a fairly common disease that affects more than 264 million people worldwide. Symptoms usually appear every day and, for the most part, do not depend on what is happening around. A person can lead an absolutely normal life, but at the same time, feel despondency or sadness.Diagnostic markers of depression are all of the above symptoms, as well as unexplained pain, memory problems, anxiety, and self-harm. They can last for months, years, or even a lifetime.

Persistent depressive disorder

It is a form of chronic depression and contains two diagnoses: dysthymia and major depressive disorder. Symptoms are similar to the previous case and last at least 2 years. They very often appear during childhood or adolescence.Children may have problems with school performance, avoid social activity, and have difficulty communicating with peers.

Manic depression or bipolar disorder

The disorder consists of constantly changing phases of mania or hypomania (a state in which a person feels very happy) to depression. Depressive episodes include symptoms of classic depression, but the manic phase is characterized by a state of high energy, increased self-esteem, self-destructive behavior and, at the same time, high spirits.In addition, accelerated speech, “grandiose” thinking and irritability are characteristic. Severe forms can include hallucinations and delusions. There are several types of bipolar disorder: Type I, Type II, Cyclothymia, Fast Cycle Bipolar Disorder, and a special category that includes symptoms other than the previous four.

Depressive psychosis

A condition characterized by a loss of connection with reality and may include psychotic disorders: hallucinations and delusions.For example, a person can hear voices, see people who are not there. He is in a state of delusion, that is, he is pursuing a deeply rooted belief that is clearly false or meaningless. There is a slowdown in physical movement and problems with sitting.

Perinatal (postpartum) depression

Occurs during pregnancy or within four weeks after delivery. The hormonal swing causes changes in the brain that lead to mood swings.The symptoms of the disorder are similar, but they are just as severe and can lead to negative consequences. A woman may experience difficulties in caring for herself and the child, thinking about harming the child.

Premenstrual dysphoric disorder

This is a severe form of premenstrual syndrome and includes both physical and psychological changes. Bloating, breast tenderness, mood swings are observed. But symptoms often worsen immediately after ovulation and subside after menstruation begins.

Seasonal Depression

The so-called seasonal affective disorder is associated with the change of seasons and usually appears in the fall. Social isolation and the need for sleep increase, and weight increases. This type of depression can worsen over time and even lead to suicide.

Situational depression

This condition is clinically known as adjustment disorder with depressed mood. It is similar to classic depression, but triggered by specific events.For example, the death of a loved one, illness, social problems.

Atypical depression

This is a depression that occurs in response to any events, even positive ones. It is not something rare, and can manifest itself during the course of other types of disorders as an episodic phenomenon. If it seems to you that your body is ugly, and at the same time you eat erratically, and your weight is constantly increasing, then these are the first bells. Symptoms of the disorder are also: insomnia, heaviness in the limbs, sensitivity to criticism and apathy.

If you think someone is at risk of self-harm or harm to another person, call 103.

If someone you know is thinking about suicide, seek help from the suicide prevention line:

Ukraine: 73-33

Belarus: (8-017) 290-44-44

Russia: +7 (499) 791-20-50

Other countries

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Don’t be indifferent. Save another person’s life.

Factors contributing to the development of depression

The main cause of depression is a complex interplay of social, psychological and biological factors and includes:

  • Genetic predisposition : People with a history of the disease in their family are at high risk of developing depression.
  • Childhood Injury : The disorder is the body’s defensive response to stress.
  • Features of the brain : When the frontal lobe is less active, the risk of depression increases.
  • Medical Conditions : Chronic illness, insomnia, attention deficit hyperactivity disorder, and other conditions can trigger depression.
  • Drug and alcohol use : About 21% of people who use psychoactive substances experience depression.
  • Hormonal Disruptions : Any changes in hormonal status, including menopause, childbirth, thyroid problems, can cause depression.
  • Situational and Seasonal Changes : Changes in daylight hours, difficulties in life, or major changes can cause depression.

Depression is diagnosed in the same way as other diseases, namely, after a complete examination of the patient, studying the medical history and understanding the causes.For a more thorough examination, a psychiatric examination may take place, during which a diagnosis will be made.

The effect of depression on your body

Depression is technically a mental disorder, but it also affects physical fitness. Changes in your body can affect your quality of life. We propose to consider them in more detail.

Central nervous system

The symptoms we have discussed above are changes in the central nervous system.A person with this disorder may not only experience anger, sadness, but also lose interest in things that used to be enjoyable, such as sex or food. Soon, headaches begin to appear that do not respond to treatment. They trigger neurological diseases such as Alzheimer’s disease, epilepsy, and multiple sclerosis.

Digestive system

Very often people with such disorders suffer from malnutrition or, conversely, overeating.This increases the risk of obesity, type II diabetes. Cramps, constipation, abdominal pain – then we will talk about how to get rid of unpleasant symptoms and, finally, heal.

Cardiovascular and immune systems

Stress hormones accelerate heart rate and constrict blood vessels. As a result, the body lives in a state of anticipation of the next stress, and this leads to heart disease. The disorder also affects the immune system, making the person more vulnerable to infection and disease.

Seeking a cure

The first step in treating depression is making an appointment with a therapist who will examine you and recommend a doctor. The American Suicidology Association reports that treatment for depression is 60-80% effective. Although the risk of suicide is 25 times higher, even during the healing process. There are several practices that are used to treat depression.

Conversation therapy

Includes a discussion of problems and feelings with a qualified therapist.This type of treatment is effective in reducing stress and anxiety; helps to understand the strategies for preventing the influence of triggers on the course of depression.


Medication for depression is a traditional approach and can be used for a long time. Drugs used to treat depression include:

  • selective serotonin reuptake inhibitors (fewer side effects than other antidepressants): fluoxetine (Prozac), sertraline (Zoloft) and escitalopram (Lexapro).
  • serotonin and norepinephrine reuptake inhibitors : duloxetine (cymbalta) and desvenlafaxine (pristik).
  • Tricyclic antidepressants (can be very effective, but have very serious side effects): imipramine (tofranil) and nortriptyline (pamelor).

Mood stabilizers or anxiety medications are sometimes combined with antidepressants.

Alternative solutions to combat depression

These methods should not be used without medical advice, especially if you are taking prescription drugs.

Some alternative remedies for depression include supplements:

  • St. John’s wort : Studies show that a number of active ingredients such as hypericin, hyperforin and adhyperforin increase the levels of serotonin, dopamine and norepinephrine, which can improve mood [1].At the very least, St. John’s wort is able to reduce symptoms to the same extent as antidepressants, while having fewer side effects [2]. In one study, 251 people who took 900-1800 mg of St. John’s wort for 6 weeks experienced a 55.6% improvement in depression and 55.6%, compared with 44.8% of those taking antidepressants [3].
  • omega-3 fatty acids: There are three main types of omega-3 in the diet. Of these, DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) are found in fish oil.You can get them in the form of nutritional supplements. In 2009, a study was conducted, which confirmed the positive effect of EPA on the reduction of symptoms of depression, as well as bipolar disorder [4]. Also, there is low levels of EPA and DHA in people with classic and postpartum depression, suicidal ideation. The combination of EPA and DHA found in fish oil improved depression symptoms in the majority of participants in testing [5].
  • Niacin or Vitamin B3 : Helps convert nutrients into energy.At the same time, it acts as a powerful antioxidant, helps in the production of sex and stress hormones, and also improves blood circulation and breaks down fatty acids. Niacin deficiency causes depression because it regulates the synthesis of dopamine and serotonin. It can be taken in pill form. The dosage is often 14-18 mg.
  • Vitamin D : A 2013 metanalysis described the fact that people with depression have low levels of vitamin D. Earlier, in 2005, vitamin D receptors were identified in the same areas of the brain that are associated with depression [6 ].Exposure to the sun, as well as supplementation of vitamin D in the diet, will significantly improve psychological well-being.

In addition, acupuncture, massage therapy, relaxation techniques, and meditation significantly alleviate the symptoms of depression.

Let’s summarize

Depression is a psychological disorder that can become chronic and last for many years, or even a lifetime.Depression has many symptoms that are similar to its types. At the same time, the types of depression themselves differ in causes, triggers, chronology, psychiatric characteristics, as well as treatment. However, supplements such as St. John’s wort, vitamin D, niacin, omega-3s can be used for alternative solutions. Do not ignore them, since you have decided on treatment. According to the studies in this article, they manage symptoms as well as antidepressants. But unlike the latter, they act without causing side effects.


  1. Butterweck V. Mechanism of action of St John’s wort in depression: what is known? // CNS Drugs, 2003, Vol. 17 (8), 539-62.
  2. Apaydin E.A., Maher A. R., Shanman R., Booth M. S., Miles J. N. V., Sorbero M. E., Hempel S. A systematic review of St. John’s wort for major depressive disorder // Syst. Rev., 2016, Vol. 5 (1), 148.
  3. Szegedi A., Kohnen R., Dienel A., Kieser M.Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St John’s wort): randomized controlled double blind non-inferiority trial versus paroxetine // BMJ, 2005 Mar 5, Vol. 330 (7490), 503.
  4. Osher Y., Belmaker R. H. Omega-3 fatty acids in depression: a review of three studies // CNS Neurosci. Ther., 2009, Vol. 15 (2), 128-33.
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90,000 DMAE – Is It Worth Taking This Supplement

DMAE is a special compound that, according to most people, can improve mood, have a positive effect on the brain, and also prevent premature aging of the skin.This substance is often called deanol. Moreover, in online stores, this compound is found under a variety of names, ranging from 2-dimethylaminoethanol to hemi-succinate de decanol.

Unfortunately, there are not very many studies conducted to study the benefits of DMAE. However, proponents of this supplement believe the compound could be used to treat Alzheimer’s disease, depression, dementia, and attention deficit disorder.

A compound called DMAE is naturally generated in the human body.But despite this, it can enter the body along with certain foods such as salmon, sardines, anchovies and other types of oily fish.

Presumably, the effect of DMAE on the body is provided by increasing the generation of acetylcholine (Ach), a neurotransmitter that ensures the transmission of nerve impulses to cells. Ach is involved in many functions that are controlled by the brain, namely sleep, muscle contraction, pain responses.

One of the features of deanol is to prevent the accumulation in the human brain of a substance called amyloid beta.An increase in the volume of this substance is one of the most common causes of memory loss and impaired brain function. Therefore, regular consumption of DMAE can improve brain function, which is especially important for the elderly.

How DMAE is used

During a certain period, dimethylaminoethanol was sold exclusively as a drug for children with behavioral and learning problems.Then it could only be purchased with a doctor’s prescription. But in 1983, Deanol was discontinued.

It appeared on the market relatively recently, but not as a prescription drug, but as a food supplement, which comes in two forms – powder and capsule. At the same time, recommendations for their use directly depend on the brand. Therefore, when including DMAE in the diet, the recommendations from the instructions should be strictly followed.

In addition, DMAE is now sold as a serum that is recommended for use on the skin.Also, this substance is often found in the composition of anti-aging cosmetic products.

Today there is no specific data on the content of deanol in oily fish. However, scientists have proven that frequent consumption of anchovies, sardines and salmon is one of the most effective ways to obtain this substance.

Useful properties of DMAE

The number of ongoing studies aimed at studying the beneficial properties of dimethylaminoethanol is relatively small and most of them were carried out even before 1980.But among them there are several unofficial reports confirming that DMAE has a number of beneficial properties. However, due to the fact that they have not been published for a long time, the buyer should be as careful as possible when including deanol in the diet.

The most significant beneficial properties of DMAE include:

  • Eliminate wrinkles and increase skin elasticity – a face gel containing 3% DMAE, when applied to the skin for 16 weeks, smoothes wrinkles, increases the size of the lips, and also improves skin elasticity;
  • memory improvement – deanol supplements can improve brain function in dementia, Alzheimer’s disease and other diseases associated with impaired mental abilities;
  • Improvement in physical performance – unofficially, DMAE in combination with other supplements can increase endurance and strength performance;
  • 90,015 hyperactivity reduction – studies conducted from 1950 to 1980 show that deanol supplements increase children’s concentration on the educational process and reduce their level of physical activity;

  • Mood Improvement – DMAE supplements are able to alleviate symptoms of depression, anxiety and increased irritability while increasing motivation.

It should be noted that most of the properties described above have not been confirmed by research, as well as refuted. Therefore, by including supplements in your diet, you should not expect impressive results.

Potential risks associated with taking DMAE

Doctors strongly discourage DMAE supplements for people with bipolar disorder, epilepsy, or schizophrenia.Also, they should not be taken during pregnancy, as deanol can cause a neural tube defect in children. In addition, dimethylaminoethanol should not be consumed during breastfeeding.

According to information provided by the US National Institutes of Health, consumption, application to the skin and inhalation of DMAE may cause the following side effects:

  • skin redness and swelling;
  • convulsive muscle contraction;
  • insomnia;
  • shortness of breath, cough and runny nose;
  • severe eye irritation.

It is also important to know that DMAE can react with certain medications, thereby having negative effects on the body. Let’s consider them in more detail.

Acetylcholinesterase Inhibitors

Cholinesterase inhibitors are used to reduce the rate of dementia in people with Alzheimer’s disease. These drugs interfere with the production of Ach.Therefore, their use in combination with DMAE can further aggravate a person’s condition and lead to a deterioration in cognitive functions. It is strongly discouraged to use deanol with drugs such as Arisept, Reminil and Cognex.


Anticholinergics are prescribed by doctors to treat a variety of conditions, including OAB, Parkinson’s disease, and COPD. Their principle of action is to block nerve impulses entering the cells.At the same time, DMAE amplifies signals with the opposite effect.

Cholinergic drugs

Cholinergic agents are able to mimic the work of inhibitors and increase the supply of nerve impulses. These drugs are most commonly used to treat Alzheimer’s disease. However, the inclusion of DMAE in the diet can interfere with their effects on the body.


The use of DMAE in combination with warfarin or other blood thinners is strictly prohibited.


The beneficial properties of DMAE are to improve the quality of the skin, reduce hyperactivity, improve mood and brain function. However, all of them have not been confirmed by scientists. Therefore, before including deanol in your diet, you should consult with your doctor, especially if you are taking other medications.

To avoid side effects and to prevent birth defects in your baby, do not take DMAE while pregnant or breastfeeding.


  • Blin O, et al. (2009). Effects of dimethylaminoethanol pyroglutamate (DMAE p-Glu) against memory deficits induced by scopolamine: Evidence from preclinical and clinical studies.