Conditions > Bipolar Disorder

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Definition

Bipolar disorder is a mental health condition in which periods of mania alternate with periods of depression. Mild cases of bipolar disorder can often go undiagnosed, with symptoms being mistaken for normal mood swings. Bipolar Disorder was formerly know as Manic Depression.

The are three main classifications of bipolar disorder:


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Issues

Omega-3 fatty acids and Bipolar Disorder

Andrew Stoll M.D. is director of the Psychopharmacology research lab at Boston's McLean Hospital and assistant professor of Harvard Medical School Department of Psychiatry. He has published research on the relationship between omega-3 fatty acids and bipolar disorder. His research found that high-dose, concentrated omega-3 fatty acids (EPA & DHA) have effective mood stabilizing and antidepressant effects for many people with bipolar disorder. Omega-3 fatty acids are essential components of brain cell membranes, including those of neurotransmitter receptors. Omega-3 fatty acids also alter signal transduction and electrical activity in brain cells and control the synthesis of chemicals such as eicosanoids and cytokines, which may have a direct effect on mood. The following is an overview of a lecture by Dr. Stoll:

The Omega-3 Connection: The Groundbreaking Anti-depression Diet and Brain

The Omega-3 Connection: The Groundbreaking Anti-depression Diet and Brain Program
by Andrew Stoll, 2001.

In this book Stoll outlines the evidence for omega-3 fatty acids in treating illnesses such as bipolar disorder and depression.

Research relating to bipolar disorder by Dr. Stoll:

Psychiatrist Jerry Cott, PhD has a graph available on his site comparing the lifetime prevalence of bipolar disorder against seafood consumption. (It should be noted that association does not necessarily mean causation.) This corresponds to Dr. Stoll’s findings concerning omega-3 fatty acids, which are concentrated in fish:

Pfeiffer Treatment Center protocol

The Pfeiffer Treatment Center (PTC) possesses an extensive database of biochemical data from more than 1500 patients they have treated for bipolar disorder. The PTC express their concern that many nutritional treatments offered are highly generalized and can produce unpleasant effects. Their research has found that a subgroup of bipolar disorder patients are deficient in arachidonic acid, an omega-6 fatty acid. They have developed three primary biochemical classifications of bipolar disorder as follows (written by and printed with permission of co-founder and chief-scientist of the PTC, William Walsh, PhD):

  1. Undermethylation: This condition is innate & is characterized by low levels of serotonin, dopamine, and norepinephrine, high whole blood histamine and elevated absolute basophils. This population has a high incidence of seasonal allergies, OCD tendencies, perfectionism, high libido, sparse body hair, and several other characteristics. They usually respond well to methionine, SAMe, calcium, magnesium, omega-3 essential oils (DHA & EPA), B-6, inositol, and vitamins A, C, and E. They should avoid supplements containing folic acid. In severe cases involving psychosis, the dominant symptom is usually delusional thinking rather than hallucinations. They tend to speak very little & may sit motionless for extended periods. They may appear outwardly calm, but suffer from extreme internal anxiety.

  2. Overmethylation: This condition is the biochemical opposite of undermethylation. It is characterized by elevated levels of serotonin, dopamine, and norepinephrine, low whole blood histamine, and low absolute basophils. This population is characterized by the following typical symptoms: Absence of seasonal, inhalent allergies, but a multitude of chemical or food sensitivities, high anxiety which is evident to all, low libido, obsessions but not compulsions, tendency for paranoia and auditory hallucinations, underachievement as a child, heavy body hair, hyperactivity, "nervous" legs, and grandiosity. They usually respond well to folic acid, B-12, niacinamide, DMAE, choline, manganese, zinc, omega-3 essential oils (DHA and EPA) and vitamins C and E, but should avoid supplements of methionine, SAMe, inositol, TMG and DMG.

  3. Pyrrole Disorder: This condition, also called pyroluria, is a genetic stress disorder associated with severe mood swings, high anxiety, and depression. The biochemical signature of this disorder includes elevated urine kryptopyrroles, a double deficiency of zinc and B-6, and low levels of arachidonic acid. Pyrolurics are devastated by stresses including physical injury, emotional trauma, illness, sleep deprivation, etc. Symptoms include sensitivity to light and loud noises, tendency to skip breakfast, dry skin, abnormal fat distribution, rage episodes, little or no dream recall, reading disorders, underachievement, histrionic behaviors, and severe anxiety. They usually respond quickly to supplements of zinc, B-6, Primrose Oil, and augmenting nutrients.

Table 1. Bipolar disorder subtypes

Under-methylated
(high histamine)		 Over-methylated
(low histamine)		 Pyroluria
Subtype patient distribution 35% 25% ~18%
Potentially harmful supplements Folate, choline, DMAE,
copper and histidine		 Methionine, SAMe,
inositol, tryptophan,
phenylalanine, St. John’s wort, tyrosine, copper, TMG and DMG		 Histidine, copper and
omega-3 fatty acids

The following on site link is a tabulated catalog of typical characteristics of these subtypes, which may be used to determine an individuals subtype in many cases, although laboratory tests are required to be certain:

The Pfeiffer Treatment Center claims that due to the diverse chemical nature of these different biochemical subgroups, a number of nutritional supplements for each group can exacerbate biochemical imbalances and be harmful for the individual. Biochemical sub-groupings must be determined with the help of a health professional before taking any of the supplements listed in the potentially harmful row above.

Related links:

The True Hope Institute is an organization dedicated to helping the mentally ill through nutritional supplementation. They place a major focus on bipolar disorder. True Hope has designed a nutritional supplement called Empowerplus, containing a range of vitamins, minerals, amino acids and other components. The following three studies have been published concerning the Empowerplus nutritional supplement:

"RESULTS: For those who completed the minimum 6-month open trial, symptom reduction ranged from 55% to 66% on the outcome measures; need for psychotropic medications decreased by more than 50%."
"It [was] clear that the effectiveness and safety of EMP remain to be established in controlled trials, but this approach does appear to represent an exciting potential direction for new research in bipolar disorder."
“These cases suggest that mood lability and explosive rage can, in some cases, be managed with a mixture of biologically active minerals and vitamins, without using lithium or other traditional psychopharmacologic agents.”

Unfortunately, these studies have limited value as they were not placebo-controlled. A more individualized approach, as performed by the Pfeiffer Treatment Center, balances biochemistry with more precision.

Hypoglycemia and bipolar disorder

Hypoglycemia is characterized by abnormally low blood sugar. Hypoglycemia can reduce the glucose supply to the brain, contributing to mood swings and depression.

Sensitivities and bipolar disorder

Food and chemical sensitivities can contribute to bipolar disorder. Some people find hidden food sensitivities are a major contributing factor. Common sensitivities include:

Related book:


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Publications

Natural Healing for Schizophrenia & Other Common Mental Disorders
by Eva Edelman, 1998 (highly recommended book)

While this book was written predominantly in reference to schizophrenia, the principles described apply to mental illnesses generally. The book embraces the ideas concerning individuality and nutritional therapy currently used at the Pfeiffer Treatment Center. A quote from William Walsh PhD, (co-founder and chief-scientist at the Pfeiffer Treatment Center), on the back cover states:

“This is the most useful volume on nutritional methods for mental illness written in the past 20 years. I believe that it will be a valuable resource for researchers, clinicians, and families alike. It is required reading for our research and medical staff.”

The book also contains a detailed description of medical conditions known to contribute to mental illness. For anyone looking for alternatives for mental conditions, this book is a must read! Eva is presently compiling a book specifically on Bipolar disorder

A Dose of Sanity: Mind, Medicine, and Misdiagnosis
by Sydney Walker, MD (psychiatrist and neurologist), 1997

This brilliant book discusses in detail why underlying medical conditions which contribute to mental symptoms must be carefully identified rather than simply treating the symptoms with medication, psychotherapy or even nutritional therapies. Case studies illustrate how brain tumors, hypothyroidism, heart conditions and sleep deprivation often produce symptoms mistaken for conditions such as depression, AD(H)D and schizophrenia. Every psychiatrist and psychologist should read this ground-breaking book! The following article discusses Sydney Walker's treatment protocol - Finding the Medical Causes of Severe Mental Symptoms: The Extraordinary Walker Exam

Too good to be True? Nutrients Quiet an Unquiet Mind: A Four Generation Bipolar Odyssey
by David Moyer, 2003

This book, by licensed clinical social worker and board certified diplomate David Moyer, describes the author’s experience with True Hope products for his son. He also discusses generally his findings while searching for answers for bipolar disorder.

Nutritional Influences on Mental Illness: A Sourcebook of Clinical Research (second edition)
by Melvyn Werbach, MD, 1999

Melvyn Werbach, MD is a psychiatrist and nutritional medicine researcher. This excellent book contains a section on bipolar disorder, which reviews a huge amount of clinical research on its nutritional treatment. A considerably more detailed version of this document is available on the following CD-ROM:

Prescription for Nutritional Healing (2000 edition)
by James Balch, M.D. and Phyllis Balch, C.N.C.

This book has an interesting section on Bipolar Disorder [page 502].

The Natural Medicine Guide to Bipolar Disorder
by Stephanie Marohn, 2003

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Recommendations


  • Find and work with a supportive and knowledgeable health professional who practices nutritional and environmental medicine and can perform/take a thorough individualised assessment. If you live in Perth, Western Australia you may book an appointment for a consultation with Integrative Nutritionist Blake Graham by phoning (08) 9487 7409 or emailing Blake via the Contact page. Non-Perth residents may enquire about phone consultations. If you are in need of a practitioner in your area, see the Referrals page.
  • Have a range of nutritional tests (including for zinc, iron, magnesium, folate, B12)
  • Test for hypoglycemia, anaemia, thyroid imbalances (including free T4, free T3 & reverse T3), pyroluria, steroid hormone imbalances via salivary hormone assessment (including progesterone, estrogen, testosterone, cortisol & DHEA), dysbiosis (imbalance of micro-flora in gastrointestinal tract), malabsorption (malabsorption may contribute to symptoms in up to 4% of bipolar disorder cases) & parasites
  • Get the Organic Acid Test (OAT) done via Great Plains Laboratory (which tests for yeast, bacteria, nutrient abnormalities, inborn errors of metabolism, toxin exposure, etc.)
  • Ensure an optimum intake and balance of omega-3 and omega-6 fatty acids
  • Have a hair mineral analysis +/- a Toxic Element Clearance Profile which tests for toxic elements
  • Identify any food or chemical sensitivities (such as aspartame and gluten)
  • Question whether any other medical causes could be contributing to symptoms (see Health Questionnaire)
  • If you feel that one or more of the following issues [stress, depression, unresolved trauma, cravings/addictions, fears, phobias, anger, pain, insomnia, etc.] is contributing to your health problem in some way, consider Emotional Freedom Techniques (EFT). See www.integrative-clearing.com.au for quality EFT consultations and workshops in Perth, Western Australia or visit the official EFT website for a worldwide listing of EFT practitioners.
  • Minimise exposure to environmental pollutants.

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