Bipolar Disorder Redefined

What Is Bipolar Disorder?

Bipolar disorder is characterized by abnormal, uncontrolled mood swings or possible wild outbursts. Symptoms may be mild, moderate or even severe and could impact a person’s ability to live, their energy levels, their decision making, their job, their ability to care for themselves and their overall functionality. Without a doubt, loved ones are dramatically affected as family life, family dynamics and relationships are at best strained. The typical age of onset is in a person’s mid-20’s.

The life of a person with bipolar disorder is often very difficult, challenging, unstable, unpredictable, complicated and at times even scary. Many people have experienced the feeling of having to “walk on eggshells” or “not upset the apples” when in the company of a very moody or volatile person. These feelings are often associated with people who live with someone who suffers from bipolar disorder because they do not always act with consistency.

Although bipolar disorder is typically treated with medications such as mood stabilizers, antipsychotics and antidepressants as well as psychotherapy and lifestyle management, recent medical research has led to advances in understanding this disorder and how to redefine it. New technologies such as neuroimaging and more in-depth lab analysis have furthered the understanding of bipolar disorder. In addition, more practitioners are exploring new possibilities to understand how to help individuals with bipolar disorder cope and manage their life with new tools and a new understanding. There is no reason why a person with bipolar must forfeit their quality of life due to this mood disorder.

Symptoms of Bipolar Disorder

Bipolar disorder is a mental health mood disorder, and symptoms may vary between manic, depressive and mixed episodes:

Manic Episodes

Symptoms of manic episodes of bipolar disorder can be:

• Delusions of grandeur (feelings of being unusually powerful, important, brilliant and/or unstoppable)
• Loss of appetite
• Risky behaviors such as drug use, gambling, sex and spending an excessive amount of money
• Psychosis and loss of touch with reality
• Possible aggression, irritability and anger

Depressive Episodes

Symptoms of depressive episodes of bipolar disorder can be:

• Depression and withdrawal with possible mood swings
• Wishing life would be over
• Feeling hopeless or empty
• Changes in appetite, including overeating
• Loss of interest or pleasure in activities that used to be pleasurable, including relationships, work, hobbies and sex

Mixed Episodes

Symptoms of mixed episodes of bipolar disorder can be:

• High anxiety
• Suicidal

The History of Bipolar Disorder

Bipolar disorder is commonly regarded as a chronic mood disorder but was not formally recognized to be a psychiatric illness until the 20th century. Historically, in ancient Greece, modern day bipolar disorder was identified as depression and mania. Hippocrates, who is the father of modern medicine, was the first to describe these two extreme states of mood in the human condition: melancholia, which is the definition of depression and mania as in our modern day understanding of bipolar disorder. In the ancient world, melancholia and mania were perceived as having a cyclical relationship because both moods coexisted concurrently. For example, symptoms of sadness, hopelessness, loss of joy, loss of energy, and reduced cognition (depression) occurred at the same time as symptoms of elatedness, anxiety, agitation and hyper-irritability (mania).

Modern Day

In the 1970s, 1980s, and 1990s, mood stabilizers such as lithium carbonate, anti-convulsants, second-generation anti-psychotics and other pharmacotherapy were the treatments of choice at that time, but the side effects were always difficult to live with especially with long-term usage. Lithium carbonate is only available by prescription and has been known to cause debilitating effects to the kidneys and possible kidney failure after years and years of usage. By the 1970s, Hans Nieper MD, a German physician, formulated lithium with an orotate carrier which didn’t dissolve the lithium until it crossed the blood-brain barrier.

Lithium orotate became a much safer choice of lithium and could be purchased as a nutritional supplement rather than as a prescription. It is more potent, effective and less toxic than lithium carbonate and still available today as a much safer choice of lithium. James Greenblatt MD, a globally recognized leading functional psychiatrist, has 30 years of nutritional psychiatry in clinical practice under his belt, and his extensive research on low dose lithium treatment is internationally acclaimed. He redefined psychiatry with his groundbreaking book on Nutritional Lithium: A Cinderella Story the Untold Story of Mineral that Transforms Lives and Heals the Brain and changed its face by giving due diligence to one of the most misunderstood minerals in medical history. Low-dose lithium orotate continues today to be a dramatic mood stabilizer, and many lives with bipolar disorder continue to be transformed by this misjudged mineral.

Overall, these symptoms of depression and mania have had dramatic effects on individuals throughout the ages with very limited hopeful solutions. The question is how may bipolar be redefined today to offer a new beginning to those who struggle with such extensive debilitating symptoms of this disorder.

What Factors Could Contribute to Bipolar Disorder?

Gut Dysbiosis and Leaky Gut

The human gut ecosystem is highly implicated in contributing to bipolar disorder. Gut dysbiosis, an overbalance of pathogenic microbes in the gastrointestinal tract, can lead to increased intestinal permeability known as a “leaky gut”, which allows biological waste and toxins to enter the blood stream. This process can trigger systemic inflammation, including neuroinflammation.

Gut dysbiosis is typically caused by a reduced diversity of the microbiome due to not enough beneficial, fermented or butyrate-producing healthy microbes. Butyrate is a short-chain fatty acid that produces healthy beneficial gut flora that is critical for brain health, ensuring a well-functioning vagus nerve and strong gut/brain connection. Researchers have found that people with depression and mania have a higher abundance of proinflammatory bacteria and reduced short-chain fatty acids such as butyrate, which exerts neuroprotective effects by reducing neuroinflammation, enhancing blood-brain barrier integrity, and promoting brain plasticity and neurogenesis.

Immune Dysregulation and Neuroinflammation

There are immune imbalances which can account for the various irregularities involved in immune dysregulation in bipolar disorder.  These irregularities can affect mood stability because they elevate proinflammatory cytokines (small proteins that acts as cell messengers and help regulate immune responses, inflammation and stimulate blood cell production) and reduce anti-inflammatory ones, which can set the environment for neuroinflammation to occur especially during depressive and manic episodes.These articles by medical researcher Joshua Rosenblat (here and here) show that “innate immune system dysfunction may play a role in the pathophysiology” and that “elevated proinflammatory cytokine levels have been identified.”

Autoimmunity

Neuroinflammation can occur for a variety of reasons, but it is associated with autoimmune diseases because it initiates a cascade of immune reactions that can ultimately lead to an autoimmune disease. Some of the triggering factors are:

• Fluctuating mood
• Impacted sleep
• Changing appetite
• Thyroid dysregulation
• Hormone imbalances
• Gut dysbiosis

Neuroinflammation can also lead to the oxidation of fats in the cell membrane making the cell membrane permeable so that nutrients escape or even cause cell death (apoptosis). Therefore, a neuroinflammatory condition may be the direct result of the immune dysregulation in bipolar disorder which, therefore, may lead to a higher propensity to autoimmunity.

Lyme Disease

Immune dysregulation from Lyme disease is poorly understood by mainstream medicine. Borrelia burgdorferi is one of the bacterial species implicated in Lyme disease although most people with Lyme disease also have co-infections such as bartonella, rickettsia, babesia and erlichiosis. At least 42% of people diagnosed with Lyme disease present with psychiatric manifestations such as those associated with bipolar disorder. However, those with repeated infections were at an even higher risk.

Lyme disease affects the central nervous system, increases neuroinflammation and results in abnormal brain functioning. Some common symptoms of Lyme disease are obsessive thoughts, compulsive behaviors, mood swings, depression, anxiety and possibly even psychosis, all of which can be associated with bipolar disorder. Therefore, treating Lyme disease could potentially reduce symptoms of bipolar disorder.

Cell Danger Response

The cell danger response is a theory and the work of Robert Naviaux MD PhD. This theory offers a whole new perspective on understanding medical diseases and illnesses. It also sheds new light on mental health conditions such as autism, depression and anxiety. This response is triggered by stressors that cause the nervous system to get stuck in fight-or-flight mode due to the prolonged signalling of ATP in mitochondria. The body remains in defense mode and is unable to recover fully from chronic disease. Naviaux postulates that understanding the cell danger response’s connection to chronic diseases will ultimately change how diagnoses are made and give hope for healing.

Mitochondrial Dysfunction

Mitochondrial dysfunction is strongly implicated in the pathophysiology of bipolar disorder. This type of dysfunction contributes to oxidative stress through the generation of reactive oxygen species, which are strong contributors to bipolar disorder. In fact, mitochondrial dysfunction there is such a strong association with bipolar disorder that researchers have considered it as a biomarker of illness state in bipolar disorder. 

Blood-Sugar Dysregulation

Blood-sugar dysregulation can lead to mood and behavioral symptoms because the brain needs stable glucose. Otherwise, brain function is disrupted. Medical researchers such as Dorota Łojko and others have confirmed that impaired glucose metabolism is common in those with bipolar disorder. In fact, 9% of those with bipolar disorder also have type 2 diabetes, while 48% have insulin resistance. Find out how to optimize blood sugar for blood-sugar stabilization in our article here.

Nutritional Deficiencies

People with bipolar disorder typically have deficiencies in important micronutrients, and this may affect mood and triggering episodes. See discussion below in “Nutritional Supplementation” about how supplementation with particular nutrients can potentially improve symptoms of bipolar disorder. Nutrient levels can be confirmed by testing by a functional-medicine doctor and/or an integrative psychiatrist. Those with bipolar disorder should always consult with a healthcare provider before incorporating supplements.

Non-Celiac Gluten Sensitivity

Patients with bipolar disorder were found to have elevated levels of IgG antibodies to gliadin, a marker of gluten sensitivity in this small study. This type of immune reaction is known as non-celiac gluten sensitivity, and it is documented (see Sources & References, below) as a common root cause in many types of mood disorders, including bipolar disorder.

Calcium- and Potassium-Channel Imbalances

Researchers have discovered that intercellular calcium is elevated in the cells of individuals with bipolar disorder and can be present in both manic and depressive states. Potassium channels, on the other hand, are vital to the regulation of the firing of neurons and the release of dopamine in the brain. If either intercellular calcium and/or potassium levels are altered, then the combined dysfunction of these two imbalances can lead to an extreme hyper excitable state of the brain neurons due to the release of dopamine during mania and diminished cellular functioning during depression.

Neurotransmitter Imbalances

Neurotransmitters are vitally important to brain functioning and emotional regulation due to their complex job as signaling messengers and their integral involvement with the whole network of neurotransmission. The key neurotransmitters are dopamine, norepinephrine and serotonin and they can be over functioning or under functioning.

• Dopamine increases energy and impulsivity in mania while low levels cause lack of motivation during depression.
• Norepinephrine increases hyperactivity, agitation and alertness during manic episodes while low levels result in apathy and depression.
• Serotonin is necessary for mood stabilization while low levels are often connected with depressive episodes, mood instability and insomnia.

Addressing neurotransmitter imbalances is important in regulating and stabilizing mood and controlling episodes.

Cortisol

Cortisol abnormalities are common in bipolar. People with bipolar disorder can experience changes in the Hypothalamic Pituitary Adrenal (HPA) axis which produces more cortisol as a response to constant stress causing the nervous system to be on sympathetic overdrive (“fight or flight”) continually.

This can affect one’s adrenal functioning and ability to cope with day to day living challenges. High cortisol levels can also lead to oxidative stress and mitochondria changes that impact the energy production of the cells. An increase in cortisol can impact and aggravate bipolar symptoms.

EMFs

Chronic exposures to EMFs (electromagnetic fields) such as cellphones, WiFi and powerlines may negatively affect people with bipolar disorder. For instance, EMF exposure has been shown to alter the balance of dopamine, serotonin and norepinephrine, the three main neurotransmitters implicated in mood modulation. Because calcium-channel activation is one of the identifying issues in bipolar disorder as discussed above, Voltage-Gated Calcium Channels (VGCCs) may trigger increased susceptibility to bipolar disorder. Some studies (see Sources & References, below) suggest that exposure to EMFs from wireless devices might cause VGCCs to open, allowing an abnormal influx of calcium into cells.

EMFs are also well known to disrupt melatonin production and therefore affect the circadian rhythm of individuals. Because sleep disruption is a primary trigger for manic and depressive episodes, it is advisable for people with bipolar disorder to reduce their exposure to EMFs such as turning the WI-FI off at night.

In addition, prolonged exposure to EMFs may increase oxidative stress, which could negatively affect the functioning of mitochondria. 

Epigenetics

Everyone is born with genetic mutations or SNPs (Singular Nucleotide Polymorphisms) that affect how our brain and body function. Epigenetics refers to the changes in gene expression that can happen due to certain influencing factors in one’s life such as environmental factors, childhood trauma, nutritional status and the impact of stress.

What’s important to understand about these SNPs is that even if a person has them, their expression can be changed significantly by diet and lifestyle factors. Knowing this can prevent a person from having a fatalistic view of their genes and thinking that “because I have these SNPs, this will happen to me”.

MTHFR

The MTHFR SNP, known as the MethyleneTetraHydroFolate Reductase SNP, relates to a type of folate that crosses the blood-brain barrier to assist in methylation, the production and distribution of methyl groups (CH3) that is a necessary part of the majority of biochemical reactions in the body. The reduced enzyme activity caused by the MTHFR mutation can potentially alter the expression of genes involved in mood regulation and brain functioning. Therefore, people with an MTHFR mutation have a significantly increased risk of developing psychiatric disorders such as bipolar disorder.

KCNQ2 and KCNQ3

The KCN2Q and KCNQ3 SNPs encode a potassium voltage-gated channel subunit involved in regulating neuronal excitability. As discussed above, this excitability can be a feature of bipolar disorder. While KCNQ3 shows stronger and more consistent epigenetic and expression links to bipolar disorder, KCNQ2 is part of a larger group of ion channel genes that contribute to the neurobiological pathways underlying bipolar disorder.

ANK3

The ANK3 (Ankyrin 3) gene is a well-established genetic risk factor for bipolar disorder. This gene helps to regulate mood, stress response, and neural circuit function.

CACNA1C

The CACNA1C gene is also strongly associated with bipolar disorder. It encodes a particular type of voltage-gated calcium channels, affecting brain circuitries involved in mood regulation and cognition. 

Traumatic Brain Injury

Traumatic brain injury (TBI) is associated with an increased risk of developing bipolar disorder. The risk of developing bipolar disorder after TBI increases with injury severity, older age at injury and for females.

Can Functional Medicine Make a Difference?

The symptoms of depression and mania have had dramatic effects on individuals throughout the ages with very limited hopeful solutions. By the year 2000, Jeffrey Bland PhD founded the Institute for Functional Medicine (IFM), which focused on paving the way forward with creative solutions. The IFM promotes identifying and treating root causes through a systems-biology-based approach to chronic diseases rather than just treating obvious symptoms.

This functional-medicine approach leaves no stone unturned through the personal individual approach of addressing root causes whether they be genetic predispositions, hormonal imbalances, or environmental factors by examining all possible contributors. This approach has been found to be one of the most effective approaches for bipolar disorder. Even though the medical field does not have an exact cause for bipolar disorder, identifying root causes through the IFM functional-medicine approach aids in understanding all the contributing factors that produced the perfect storm to create this disorder.

There is typically never just one causation factor when identifying underlying components in a diagnosis. It is usually the combination of numerous agents coming together that tips a person’s total load of stressors into a diagnosable condition. Using these concepts, functional psychiatry today has redefined the historical understanding of manic-depressive illness that we call bipolar disorder. Functional-medicine psychiatrists believe it is important to look at the whole picture of a person’s health to have a more comprehensive, accurate understanding and overall assessment of an individual’s medical condition.

What Are Potential Supports for Bipolar Disorder?

The question is how to treat this disorder the most effective way possible. Just treating symptoms with a pharmaceutical approach may result in years and years of a vicious cycle of temporary relief and potentially no visible possibility of anything beyond managing symptoms. Is there another more comprehensive approach to this disorder that offers real change? Are there underlying factors contributing to bipolar that once addressed can redefine this disorder?

Changing one’s diet and lifestyle and including nutritional supplementation support can be the best place to start one’s healing process, but we recommend working with a functional-medicine doctor or integrative psychiatrist that can develop a whole-body protocol that is specific to the individual. Following are some of the recommendations that such a practitioner might recommend.

Calming the Nervous System

A dysregulated nervous system is a common barrier to healing because the body cannot heal if it is in a constant state of fight or flight. Incorporating techniques for stress reduction can improve one’s response to stress; lower levels of cortisol, glucose and insulin; and increase levels of beneficial mood-balancing neurotransmitters. Your practitioner may have you consider techniques and interventions such as:

• Prayer
• Techniques for improving vagal tone
• Techniques for improving heart-rate variability

Removal of Gluten from the Diet

Because non-celiac gluten sensitivity is a common trigger for inducing changes in mood (as discussed above), a practitioner may recommend a trial of removing all gluten from the diet for at least six months. When following such a diet, it can be helpful to keep a food journal.

In the case of food sensitivities, it can often take two to three days for symptoms to arise after a food is consumed, which is why keeping a food journal can be so helpful. It’s important to note that this kind of sensitivity is an immune response and that even the smallest amount of the triggering food must be avoided completely. It’s helpful to read labels and understand ingredients because seemingly innocuous foods such as chewing gum and soy sauce can contain gluten.

Gut-Healing Diets That Balance the Microbiome

Having a healthy microbiome will ensure that the vagus nerve can provide healthy nutrient support to the brain. Most neurotransmitters are actually made in the gastrointestinal system, and having a balanced microbiome can help to ensure the unimpeded manufacture of neurotransmitters. Certain gut-healing diets such as the Gut And Psychology Syndrome (GAPS) diet, the Specific Carbohydrate Diet (SCD), the Body Ecology Diet (BED), and the Paleo/primal diet were designed to help balance the microbiome and thus improve symptoms of not only gastrointestinal issues but also of psychiatric disorders.

All diets should be high in healthy protein, healthy fats, vegetables, nuts, seeds and legumes to help support mood balance. In addition, removing all sugar, chemical preservatives, GMOs, vegetable oils, trans-fatty acids and hydrogenated fats from the diet can help as well. We cal this “eating a clean diet”. We recommend that you do not cook with copper, aluminum or Teflon cookware to avoid leaching of these harmful chemicals into the diet.

Glucose-Optimizing Diets

Because blood-sugar dysregulation is a common trigger for bipolar disorder episodes, learning to optimize blood sugar may help to improve symptoms.

Paleo Diet

While no clinical trials (so far) confirm the Paleo diet as a treatment for bipolar disorder, theoretically it should help because it can help to stabilize blood sugar, lower inflammation and help heal the gut microbiome.

Ketogenic Diet

The ketogenic diet is well known for controlling blood sugar and insulin levels. This pilot study found that participants with bipolar disorder who followed a ketogenic diet for six to eight weeks experienced significant improvements in mood, energy, impulsivity, and anxiety. In addition, those with higher ketone levels had better mental health outcomes. Several other case reports (see Sources & References, below) provide additional confirmation that a ketogenic diet is worth considering for those with bipolar disorder.

Nutrient Supplementation

Individual supplements may help lessen the need for medication or replace it entirely on the advice of a physician. We strongly advise working with an integrative psychiatrist or functional-medicine doctor to evaluate individual needs for the following nutrients. Some interactions between prescribed medicine and supplements could cause mania or rapid cycling, so caution and the guidance of a knowledgeable practitioner are paramount.

Lithium Orotate

Lithium orotate is a dietary supplement that some studies (see Sources & References, below) have shown that people with bipolar disorder may help stabilize mood and reduce symptoms such as mania and depression. Mood-stabilizing effects can sometimes be seen at low doses (typically 5–20 mg per day) with fewer side effects than prescription lithium carbonate, due to its potential for better bioavailability and cellular uptake. However, lithium orotate is not FDA-approved for treating bipolar disorder. Those taking lithium carbonate should not stop or replace prescribed lithium without consulting a healthcare provider.

Folate

Several studies (see Sources & References, below) have shown that folate, a methylated form of vitamin B9 – also known as L-methylfolate, shows promise for those going through manic episodes of bipolar disorder. However, it is likely that this supplement would be most helpful for those with an MTHFR genetic mutation, discussed below. Folate supplements can interfere with the effects of anticonvulsants, so be sure to consult with your doctor before supplementing.

Vitamin D

People with bipolar are 4.7 times more likely to have a vitamin D deficiency. In a small study, 94% of patients with bipolar disorder had a vitamin D deficiency. A 2023 meta-analysis and several clinical reports indicate that vitamin D supplementation is associated with improved mood stability and reductions in depressive episodes.

It is likely that supplementation would help those who are most deficient. Supplementation with vitamin D should not be seen as a cure for bipolar disorder or a replacement for medications but as an adjunct therapy that can bring the body back into balance so that common triggers are not as problematic.

Omega-3 Fatty Acids

A six-month pilot of a randomized controlled trial showed that high-dose, EPA-predominant omega-3 supplementation significantly reduced the recurrence of bipolar depression compared to placebo. However, omega-3 supplementation does not appear to help with bipolar mania. As always, consult with a healthcare practitioner before supplementing with omega-3 fatty acids as part of an overall treatment plan.

N-Acetyl Cysteine

N-acetyl cysteine (NAC) helps restore levels of glutathione, a powerful antioxidant. Given that neuroinflammation can be a trigger of bipolar disorder and that NAC can counteract the inflammation, it makes sense that NAC can help lower symptoms of bipolar disorder. Indeed, an open-label trial of children with bipolar disorder found that supplementation with NAC reduced manic episodes in 54% of participants after 12 weeks, while 62% of patients had less depression symptoms.

In addition, a systematic review and meta-analysis of randomized controlled trials found that “treatment augmentation with NAC for bipolar depression appears to be superior to placebo”. While NAC is not a replacement for standard medication, it may offer meaningful support when used alongside it. Always consult a healthcare provider before starting NAC, especially if on other psychiatric medications.

Zinc

A meta-analysis of 24 studies of patients with Major Depressive Disorder (MDD) found significantly higher levels of copper in these patients, suggesting elevated copper may be a biomarker for MDD or bipolar disorder.

Excess copper can cause mood changes such as depression and irritability. Copper and zinc compete with each other in the body because they both commonly exhibit an electrical valence of two and thus share the same absorption pathways in the small intestine. Supplementation of zinc is common by functional-medicine practitioners is common when there copper levels are elevated. Indeed, zinc supplementation may help mitigate symptoms in bipolar disorder, particularly by modulating key neurotransmitters involved in mood regulation. This may because zinc helps regulate glutamate, an excitatory neurotransmitter that has been found to be elevated in those with bipolar disorder.

In addition, zinc also boosts GABA, the calming neurotransmitter that helps put the brakes on neural overactivity caused by glutamate and other factors. Zinc is not a replacement for medication and its supplementation should be evaluated as part of a whole-body treatment plan by a knowledgeable practitioner.

Magnesium

Supplementation with magnesium can help with mood stabilization, symptoms of depression and the improvement of sleep quality. Magnesium can reduce “glutamate release and by its action upon NMDA receptors, and results in an augmentation in the activity of the GABAergic systems.” Magnesium is not a replacement for standard treatments, but may serve as a safe adjunct therapy, especially in cases of deficiency. Always consult a healthcare provider before starting supplementation due to potential interactions and individual variability.

Inositol

Inositol supplementation shows potential for helping with certain symptoms of bipolar disorder, particularly depression. Research on inositol for bipolar disorder is still nascent, and it should not be a replacement for standard treatments, but supplementation of it guided by a functional-medicine practitioner or integrative psychiatrist could be helpful if done thoughtfully as part of an overall treatment plan.

Photobiomodulation

Photobiomodulation (PBM) uses low level red or near-infrared light usually in the 600 nm range. As the light is absorbed into the body through the skins, it can strengthen the mitochondria to initiate healing in many areas of the body. Mood disorders such as bipolar disorder show strong evidence to mitochondrial dysfunction, oxidative stress and neuroinflammation. PBM is being increasingly studied in functional psychiatry and neurology as an effective and promising tool to address these symptoms. 

Moreover, PBM has been found to improve cerebral blood flow, increase cell to cell communication to improve brain network connectivity, and modulate natural brain wave patterns. Another important function of PBM is the ability to increase serotonin levels. Serotonin is instrumental in regulating mood, sleep, digestion and appetite. Serotonin is one of the catecholamine hormones and neurotransmitters that are responsible for the fight or flight stress response. Serotonin helps regulate mood, sleep, digestion and appetite. Low serotonin has been found to be an underlying factor in symptoms of anxiety and depression in bipolar disorder.

Cognitive Behavioral Techniques

Trauma is probably the most impactful stressor for bipolar disorder. Childhood trauma in particular can leave long-lasting effects that are risk factors for developing bipolar disorder and experiencing acute episodes. 

One very effective psychosocial approach to this type of trauma is cognitive behavioral techniques such as CBT or Dialectical Behavioral Therapy (DBT). These therapies can help a patient manage stress and build physiological and psychological resilience to potential stressors in everyday life to help manage this disorder. 

Another very successful intervention is the practice of mindfulness. This practice can help those with bipolar disorder to reduce symptoms of anxiety and depression, especially when combined in conjunction with CBT.

Movement and Exercise

Increased oxygen to the brain can improve its function. Movement and exercise can increase levels of oxygen in the brain, thus potentially improving symptoms of depression while increasing overall quality of life. Getting neurotransmitters to release the “feel-good chemicals” boosts can be helpful for those with this disorder. 

Movement and exercise can also help control glucose levels and insulin sensitivity, thus controlling another mechanism that could potentially trigger symptoms of bipolar disorder. 

Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation (TMS) is a non-invasive therapy approved by the FDA for treatment of depressive disorder since 1985. TMS uses magnetic pulses to stimulate specific parts of the brain at a standard threshold and frequency. Since depression is part of the depressive episode experienced by people with bipolar, TMS can be helpful especially when individuals with bipolar have not responded to other treatments. TMS now is being examined as a possible therapeutic approach for bipolar. Typically, TMS treats the following symptoms for depression, many of which overlap with symptoms of bipolar disorder:

• Difficulty making decisions
• Suicidal ideations
• Appetite or weight fluctuations
• Lack of energy
• Lack of interest in activities you previously enjoyed

Sleep

Sleep is critical for everyone but especially someone with a mood disorder such as bipolar disorder. Lack of sleep may trigger episodes and cause relapses in behaviors. Mania is associated with reduced sleep while depression is associated with increased sleep and fragment REM sleep. Disruptions in circadian rhythm could trigger episodes. Changes in sleep patterns can indicate that an episode is present but can also have more far-reaching implications in bipolar.

Cognitive deficits are linked to poor sleep, affecting memory, executive function and making it difficult to maintain work or social commitments. Nightmares and insomnia may increase the risk for suicide ideation and attempts. Poor sleep also contributes to increased obesity, cardiovascular disease and diabetes in individuals with bipolar. Therefore, sleep is essential to a healthy lifestyle for bipolar disorder.

Check for Lyme Disease and Autoimmunity

Those with bipolar disorder would do well to have themselves checked for autoimmunity and Lyme disease. It’s helpful to work with a Lyme-literate practitioner that Lyme disease is a clinical diagnosis, meaning that all tests could be negative, but if the patient presents with enough symptoms, the practitioner could still diagnose it as Lyme disease. Be sure to work with a practitioner who uses more than the Western blot test and tests for Lyme co-infections. Find out more about these tests and co-infections here.

Positive Outcomes for Bipolar Disorder

Addressing underlying causes to physical symptoms can change the way the brain functions and can help improve outcomes for those with bipolar disorder. Regulating the immune system, addressing nutritional imbalances, reducing neuroinflammation and oxidative stress, balancing the endocrine (hormonal)system, shifting the sympathetic nervous system (fight or flight) to parasympathetic (rest and digest), addressing micronutrient abnormalities, increasing neurotransmitter functioning to improve better signaling, regulating hormones, supporting genetics SNPs can all potentially produce more positive outcomes for individuals with bipolar. Although neurotransmitter functioning is fundamental and pivotal to the core functioning of bipolar disorder, healthcare practitioners can better help a patient by seeing the overall picture of a person and by considering the role of environmental and biological factors as well as the genetic predispositions when treating bipolar disorder.

About Maria Rickert Hong CHHC

Prior to working on Wall Street, she was a marketing specialist for Halliburton in New Orleans, where she also received her MBA in Finance & Strategy from Tulane University.

She is the author of the bestselling book Almost Autism: Recovering Children from Sensory Processing Disorder and the co-author of Brain Under Attack: A Resource for Parents and Caregivers of Children with PANS, PANDAS, and Autoimmune Encephalitis. She is a co-author of Reversal of Autism Symptoms among Dizygotic Twins through a Personalized Lifestyle and Environmental Modification Approach: A Case Report and Review of the Literature, J. Pers. Med. 2024, 14(6), 641.

Maria is also a Certified Holistic Health Counselor. Her work can be found on DocumentingHope.com, Healing.DocumentingHope.com, Conference.DocumentingHope.com and MariaRickertHong.com

About Teresa Badillo

She won a court case in 1995 against the Rockland County School District in New York to enable ARC Prime Time for Kids to be the first school using Applied Behavioral Analysis teaching method for autism that was paid for by the Rockland County School District. The following year she was instrumental in getting the New York Minister of Education to approve an extension of the ARC license from 5 to 21 years.

She has worked over the years in a number of alternative medical practices with doctors and practitioners organizing various biomedical intervention options for children with autism. Since the mid 1990s, Teresa has served on several boards:

• Foundation for Children with Developmental Disabilities
• The Autoimmunity Project
• Developmental Delayed Resources
• Epidemic Answers

She continues to consult and advise parents on all different areas of autism especially nutritional protocols. Since 2006 she has worked with NutraOrgana, LLC and BioCellular Analysis Testing. She currently researches, writes the newsletter and blogs Teresa’s Corner for The Autism Exchange (AEX). She also writes blog posts and pages for Documenting Hope.

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