Bipolar disorder is probably one of the most difficult psychological disorders to treat.
The swings from depression to mania can occur rapidly and without notice. Every bipolar person’s symptoms are different, requiring individualized treatment protocols.
There are the two different sides (manic/depressive) and these can cycle slowly, rapidly or manifest together.
What makes treating bipolar syndrome so challenging is when you treat the mania with drugs or natural remedies, the bipolar brain can tend to overshoot and instead of coming back down to normal it may swing too far ending up in a low dopamine depression.
Similarly, antidepressants used to treat bipolar-depression can cause an overshoot in the opposite direction pushing dopamine levels up too high into bipolar-mania.
There is no one-size-fits-all treatment, but there are some basic foundations that can be helpful for everyone to treat bipolar-mania naturally.
Much of it revolves around Dopamine, the neurotransmitter that controls our pleasure/reward emotions, and Glutamate, an excitatory neurotransmitter that increases the level of activity in the brain and perpetuates signalling of thoughts circling around and around in the mind.
Note: If you are currently taking a pharmaceutical medication for bipolar disorder, do not stop your medication! Discuss any changes in medication and supplements with your doctor.
Dopamine gives us drive, energy, motivation, a switched on feeling and excitement about new ideas.
In the manic phase, dopamine and glutamate levels become excessively high and drive the reckless, risk-taking, hedonistic and destructive behaviors people engage in during phases of hyper-mania along with the speeded-up thinking and hyperactivity observed in both hyper and hypo-mania.
Conversely, during phases of bipolar-depression, dopamine activity appears to be inadequate and depleted.
The bipolar brain either speeds up and runs too fast or slows down and runs too slow.
Peter Smith, Naturopath, says:
“Caffeine, amphetamine and especially cocaine cause dopamine levels to surge in the brain. If you gave a cocktail of these drugs to a non-bipolar person and watched how they behaved over the next few hours they’d look remarkably similar to a person with bipolar mania.”
Dopamine levels naturally rise and fall a little, a healthy non-bipolar brain is able to efficiently self-regulate the levels adjusting them up or down to keep dopamine within the normal range.
In the bipolar brain, however, when dopamine levels start to rise they keep going and rise all the way up to the ceiling intoxicating the brain, hijacking the mind and causing manic behavior, then they crash down into bipolar depression.
Adjusting your dopamine levels by increasing or decreasing the natural remedies that affect dopamine is one of the best methods to treat bipolar syndrome.
The amino acids that boost Dopamine are Tyrosine and Phenylalanine.
To treat bipolar-mania, we need to reduce anything that enhances the absorption of Tyrosine and Phenylalanine. Be sure that any supplements you are taking do not include those amino acids while treating the manic side of bipolar disorder.
It is also advised to avoid SAMe (S-adenosyl-L-methionine) and Inositol (Vitamin B8) for bipolar-mania patients (while they can be helpful during a bipolar-depression episode).
Excess Glutamate intensifies anxiety in the bipolar brain. It speeds us up and intensifies anything else going on like imbalanced dopamine, driving us to pursue addictive and hedonistic pleasures.
Elevated Glutamate is the primary neurotransmitter speeding up the brain in bipolar-mania when you get those racing frenzied thoughts–that’s caused by too much Glutamate.
Avoid the amino acid L-glutamine, commonly used for digestive disorders like leaky gut. L-glutamine is a precursor to Glutamate.
To combat the tendency for glutamate to go too high, nutritional lithium can be effective. Lithium orotate (nutritional lithium), Zinc, NAC (N-acetyl-cysteine), Glycine and Taurine can be effective.
Dr. James Lake, MD, discusses many of these complementary and alternative treatments for bipolar disorder in Psychiatric Times.
If bipolar-mania symptoms include aggression, you may need to boost Serotonin.
Low Serotonin activity is associated with low impulse control and aggression, which are common behavioral problems for people with bipolar disorder in both the depressive and manic phases.
Boosting Serotonin with L-Tryptophan or 5-HTP can help tame impulse control and aggression. Be careful not to take these amino acids if you are taking an SSRI or SNRI anti-depressant.
You will also want to be sure to take a good B-Vitamin complex, Magnesium and Zinc to provide cofactors to direct Tryptophan/5-HTP towards Serotonin.
Acetylcholine is a major neurotransmitter that affects the memory circuits of the brain. It gives the brain quick and sharp thinking.
Acetylcholine appears to play a role in mood disorders as well.
It has been observed that administration of drugs that increase the release of Acetylcholine can decrease manic symptoms during manic phases but may worsen depression during depression phases or even precipitate depression.
Choline is a necessary precursor for the synthesis of Acetylcholine. Abnormally low Acetylcholine levels may underlie some cases of mania, reports Dr. James Lake.
Findings of a small controlled trial suggest that Phosphatidylcholine (15 to 30 gm/day) may reduce the severity of mania and depressed mood in bipolar patients.
During manic phases it has been observed that supplements that increase Acetylcholine activity in the brain have useful anti-mania affects.
Lecithin is just such a supplement. Lecithin’s primary ingredient is Phosphatidylcholine. Be aware that most Lecithin is from soy if you are avoiding soy.
One of the side effects of taking high doses of Lecithin is that it makes you sleepy. This is exactly what you want to introduce during periods of bipolar-mania.
The combination of high Phosphatidylcholine and low Phosphatidylinositol in Lecithin can be useful to induce sleep, bring down a manic state and yet give you a soft landing so you don’t drop out of mania straight into depression.
Natural Treatment Protocol for Bipolar Mania
One of the greatest challenges with bipolar-mania is that the bipolar person typically LIKES having the increased energy that comes with mania. They may be more creative, even more productive yet in a frenzied and distracted way during manic periods.
Along with this creative energy comes recklessness, risk-taking, impulsiveness and destructive behaviors.
Physiologically, a continued manic state can be damaging to the brain because of the high levels of Glutamate and Dopamine.
Note that you should work with a qualified healthcare practitioner whenever you are starting, stopping or changing a supplement or medication.
Even natural supplements can have side effects. Their combination with prescribed medications must be monitored by a doctor.
Also, be sure to check for toxic heavy metals as part of your protocol as they can also affect neurotransmitter synthesis as well.
The number one issue to address in bipolar mania is SLEEP.
Whatever you have to do to get adequate amounts of sleep, do it. Sleep is critical.
Changes to your sleep-wake cycle should be a warning that you may be heading towards or are already in a manic episode.
Sleep changes everything and the manic person typically cannot sleep. During times of bipolar mania the amount of time one spends in REM (rapid eye movement) sleep is diminished.
Below are recommended methods to return to normal sleep patterns:
- Total Darkness Therapy is a concept that Peter Smith discusses as essential to sleep for the manic person.
When you’re manic, the last thing you need is more stimulation so you should avoid bright light, especially in the evening prior to bedtime.
Darkness therapy is much more than just avoiding stimulation in the evening. It somehow seems to actively treat mania and rapid cycling.
Be sure to dim the lights in the evenings after dinner to signal your body that it’s time to prepare for sleep.
As well, use blue-blocking glasses in the evenings to avoid the blue light coming from the TV, computer screens, etc.
The goal is to get 12 hours of Total Darkness Therapy per day. This can be very difficult for a person in mania.
Seven hours of sleep plus five hours with the blue blocker glasses can be a good starting point.
- Melatonin on the other hand does not interfere with any normal sleep phases and promotes non-REM deep sleep and REM dreaming sleep.
Buy a very low dose Melatonin to start with so that you have the flexibility to experiment from very low to very high doses and see what works for you.
Anywhere from 0.5 mg to 3 mg is typically available.
For a hyper-manic crisis or any time you feel you are beginning to lose control, begin the crisis management treatment with a single dose of the amino acid Glycine.
Glycine comes in a powder form, capsules or in sticks. Whatever works best for you.
I find the capsules are easy to open, control the dose and mix with water or juice. The sticks are great for panic attacks to hold under the tongue for faster absorption into the brain. Most amino acids are sweet tasting.
At the onset of symptoms, Peter Smith recommends 15-30 gm (15,000-30,000 mg) in water/juice on an empty stomach at least two and half hours after eating a protein.
Adjust the dosage according to your body weight. Take 30 gm if you’re a big person and 15 gm if you’re petite.
You should feel calmer, even sleepy, fairly quickly.
On subsequent days, lower the dose to 2-4 gm (2000-4000 mg) on an empty stomach once or twice per day as needed.
The amino acid, Taurine, is best used on an ongoing basis. It is anti-inflammatory and works with GABA to prevent overactivity of the neurotransmitters.
Like all amino acids, it should be taken away from meals.
Take 1000 mg at least 30-40 minutes before each meal and optionally another dose before bed until things begin to calm down. Thereafter 500 mg on the same schedule.
Taurine is a useful remedy to use as soon as you see the early warning signs that have previously told you that a mania is ahead.
Lithium can effectively stabilize both the wild euphoria and the crushing melancholy that are the hallmarks of manic depression or bipolar disorder.
Lithium exerts a push/pull effect on the neurotransmitter Glutamate, eventually causing it to level off in a stable zone where it can control both extremes.
Our levels of the mineral Lithium go down when we are manic.
I’ve discussed low-dose nutritional Lithium before.
We are not talking about the pharmaceutical type of lithium, Lithium Carbonate.
Lithium Orotate, on the other hand, can be very effective in controlling both the manic and depressive sides of bipolar disorder in low doses .
Lithium is necessary for the regulation of our sleep cycles as well.
It takes a few weeks before Lithium begins to relieve depression and mania in bipolar patients.
Peter Smith recommends 5 to 10 mg of Lithium orotate in combination with other remedies as a standard dose and up to 20 mg as needed during manic phases.
Dr. James Greenblatt, psychiatrist, recommends a dosage of 2 to 5 mg of lithium orotate for a healthy adult simply seeking optimal health. For people with clinical symptoms, he recommends a dose of 5 to 40 mg.
Note: Be sure to purchase Lithium orotate brands that label the product with the amount of Elemental Lithium that is in each capsule so that you know what you are getting. There should be 3.83 mg of Elemental Lithium in 100 mg of Lithium orotate.
Branched Chain Amino Acids
Branched Chain Amino Acids, BCAA, reduce the availability of the building blocks of dopamine within the brain. They are very effective for reducing Dopamine levels.
The BCAAs are Leucine, Isoleucine and Valine. These can be purchased as a combined amino acid supplement.
This PubMed study supports the BCAA method of reducing dopamine.
Omega-3 Fish Oil
Omega-3 fatty acids are anti-inflammatory, but they compete with Omega-6 fatty acids.
We typically get plenty of Omega-6 fatty acids in a Standard American Diet (SAD), but not enough Omega-3s. Omega-3s are found in fish, fish oils and foods like hemp seed, flax seed, walnut and wheat germ.
Two types of Omega-3s that are essential for cognition and brain function are EPA (Eicosapentaenoic) and DHA (Docosahexaenoic). Both are obtained from fish oil.
DHA is most important for cognitive function because the brain is made up mostly from this fat.
Peter Smith recommends 1500 mg EPA upon the onset of symptoms. This helps bring down the inflammation and helps with sleep.
When the mineral Vanadium builds up in people with bipolar disorder, they are more likely to become manic.
Administering 2000 to 4000 mg of vitamin C per day detoxifies the excess Vanadium and speeds up the recovery from mania, according to Peter Smith and others.
It is believed that this is because Vanadium and Lithium are antagonistic minerals meaning that as vanadium levels go up it suppresses lithium levels, the very thing we need to control bipolar mania.
Vitamin C is a well-known detoxifier.
Taking 2000 to 4000 mg of vitamin C a day prevents Vanadium build up and protects Lithium from being suppressed.
Abnormally low levels of Folate, Vitamin B9, are also associated with mania.
Methylated Folate, preferred over Folic Acid due to the high numbers of people who have the MTHFR gene mutation, increases the effectiveness of lithium.
Magnesium is a calming mineral. It relaxes the muscles and body.
Dr James Lake reports that:
‘Preliminary findings suggest that oral or intravenous magnesium may be an effective adjuvant to mood stabilizers in patients with acute mania or rapid cycling bipolar disorder.’
It’s a Lot to Swallow
The recommended supplements may seem like a lot to swallow every day, but if you have ever had a loved one struggle through resolving their bipolar disorder using pharmaceutical remedies, you will appreciate the lack of extreme side effects.
These supplements allow the flexibility to treat each person’s symptoms accordingly. This protocol may be helpful for one person but not for another. Tweaking dosages is important, which is another reason why a healthcare practitioner should be involved.
Bipolar-Depression and Bipolar-Mania require different treatment protocols.
My article “Treating Bipolar-Depression Naturally” addresses the factors to consider for the depression phases of Bipolar disorder.
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Joli Tripp and Mind Blowing Wellness are not medical doctors nor licensed medical professionals. No comment or recommendation should be construed as being a medical diagnosis. If you suffer from a medical or pathological condition, you should consult an appropriate healthcare provider.
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