Dietary supplements are taken by about half of Americans. Knowledge of dietary supplement use is important because they may interact with prescription drugs or other supplements, cause adverse reactions including psychiatric symptoms, or contain inherently toxic ingredients or contaminants. In this article, we shall discuss the nutritional supplements for bipolar disorder.
Bipolar disorder is a mental health condition defined by extreme shifts in mood, sleep, thoughts, and behaviors that occur over periods of days and weeks.
It’s estimated that about 4.4%Trusted Source of U.S. adults will experience bipolar disorder during their life.
Living with bipolar disorder may cause emotional, practical, and social challenges. People with the condition commonly experience periods of depression or mania. Still, episodes are not the same for every person. For example, some people may experience mostly depressive episodes, whereas others experience primarily manic ones.
Although there is no known cure for bipolar disorder, psychiatric medications, and neurostimulation treatments are the only known tools shown to be effective in treating this condition. In addition to medications — with or without psychotherapy — some people may also try lifestyle modifications, alternative medicines, and supplements to alleviate symptoms.
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What are dietary supplements?
A dietary supplement is a product you take by mouth that is intended to increase your intake of a certain ingredient.
Some supplements may help reduce your risk of certain diseases, while others ensure your body has enough of certain vital substances to function.
Still, according to the Food and Drug Administration (FDA)Trusted Source, unlike with drugs, manufacturers are not allowed to market supplements as being able to treat, prevent, or cure disease. It’s important to note that the FDA doesn’t have the authority to review supplement products for safety and effectiveness. It regulates trusted Source dietary supplements “under a different set of regulations than those covering ‘conventional’ foods and drug products.”
Ingredients in dietary supplements may include:
- amino acids
They come in many forms, such as:
Supplements that may help with bipolar disorder symptoms
Eating a balanced, healthy diet is the best way to get the nutrients your body needs, but sometimes a supplement may be needed. If you’re wondering whether taking a supplement may benefit you, it’s highly advisable to speak with your treatment team about your options. They can also advise you on the right dosage and whether supplements may interact with the medications you’re taking.
Omega-3 fatty acids and fish oil
Fish oil is a dietary source of omega-3 fatty acids, which your body needs to help with cell growth or muscle activity. Your body cannot make omega-3s. You need to get them from food. Many foods contain omega-3s. Rich sources include salmon, pecans, and chia seeds. You can also get omega-3s from supplements, which ensure a consistent supply for your body.
Much research has been done on the benefits of fish oil and omega-3 supplements for people with heart disease, high blood pressure, or arthritis. Some evidence suggests that fish oil or omega-3 supplements may also help stabilize mood over time in people with bipolar disorder or lessen depressive (but not manic) symptoms.
- One review articleTrusted Source noted that omega-3s helped lessen depressive symptoms in people with major depression and, to a smaller degree, bipolar depression.
- Another reviewTrusted Source drew similar conclusions about the potential of omega-3s to improve depressive symptoms in people with bipolar depression.
When taking fish oil or omega-3 supplements, some side effects may occur. They’re more likely at higher doses and include:
- abdominal pain
- belching (fish-like aftertaste)
Taking high doses of fish oil may interact with certain medications. Taking antiplatelet drugs (also known as blood thinners), such as Plavix (clopidogrel) or Coumadin (warfarin), along with fish oil may increase your risk of bleeding or easy bruising.
Also, high doses of fish oil may slightly increase your blood sugar levels. In most cases, this effect won’t interact with diabetes medication. Still, if managing your blood sugar has been difficult, fish oil may not be the best option for you.
Vitamins B9 and B12
The vitamins most often cited as influential in mood regulation are the B vitamins, in particularly vitamins B9 and B12.
Vitamin B9 (folate, or folic acid)
Vitamin B9 is known to help your body produce and maintain new cells.
Folate is the natural form of vitamin B9, while folic acid is a synthetic form. Foods that are high in folate include edamame, asparagus, and lentils. Plus, some foods like bread and pasta may be fortified with folic acid.
Some researchTrusted Source suggests a relationship between low blood levels of folate and bipolar disorder. However, the study notes that it’s unclear whether low levels of folate lead to bipolar disorder or whether bipolar disorder may cause low folate levels. Plus, there is no mention of whether supplementing with folic acid would improve bipolar disorder symptoms. Additional research is needed on this topic.
Another review article concludes that there may be potential benefits for mania symptoms from folic acid nutraceuticals, which are similar to supplements.
It’s important to keep in mind that taking too much folic acid in supplemental form may have harmful effects. For example, it may cause unmetabolized folic acid to build up in your bloodstream. It’s best to get vitamin B9 through foods.
Vitamin B12, primarily found in meat, eggs, and dairy, helps your body turn food into energy. Some studies suggest that this vitamin may help ease depressive symptoms, but studies specifically on its effect on depressive symptoms in bipolar disorder are lacking.
One studyTrusted Source focusing on dietary intake suggests that there may be an association between depression and your body’s level of vitamin B12.
The researchers found that people who had higher levels of vitamin B12 (and B9) through sufficient dietary intake had a lower risk of depression compared to people who didn’t get enough vitamin B12 (and B9). People in the latter group consequently had lower blood levels of these vitamins. It’s important to note that this study did not specifically look at depressive symptoms in bipolar disorder.
Many people can get enough vitamin B12 through a regular balanced diet, but taking a supplement may be necessary in some cases. For example, people who eat a strict vegan diet may be at a higher risk of not getting enough vitamin B12, as it’s primarily found in animal-derived foods. Other factors like age or certain medical conditions may also influence whether your body can absorb enough vitamin B12 from the foods you eat.
It’s important to be aware that your body can only absorb a small percentageTrusted Source of vitamin B12 from supplements.
Vitamin B12 is water-soluble, which means that your body usually excretes excess vitamin B12 in the urine. Therefore, it has a low risk of toxicity and is generally considered a safe trusted Source, even at large doses.
Still, you may need to take vitamin B12 at a separate time of day from other medications or supplements, as B12 may affect how well other medications work and vice versa. It’s always best practice to speak with a healthcare professional about all the medications and supplements you’re taking prior to adding a new one to your routine.
Other supplements that may be beneficial
There are a few other supplements that some people try as an adjunctive treatment for bipolar disorder. Still, research for these supplements is very limited, which means we cannot draw conclusions as to whether they’re really effective.
Creatine is an amino acid located in your body’s muscles as well as in the brain. Your body uses creatine mainly in the process of storing energy in your brain and skeletal muscles.
One review articleTrusted Source indicated that in some studies, creatine has been shown to have a potential antidepressant effect. On the other hand, the article noted that creatine may increase the risk of developing mania or hypomania in people with bipolar disorder. So, while creatine may help with depressive episodes, it could negatively affect mania.
If you’re considering adding creatine to your diet, it’s important to ensure that your treatment team is aware, especially since creatine may worsen some symptoms of bipolar disorder.
Magnesium is a mineral that is important for many bodily systems, such as nerves, bones, and muscles.
One review articleTrusted Source on the effects of magnesium in mood disorders found that magnesium supplements may be beneficial for depressive symptoms, but the results were mixed and not specific to people with bipolar disorder.
Vitamin C is a nutrient that is important for your body’s muscles, blood vessels, bones, and connective tissues.
An older articleTrusted Source on the relationship between vitamin C and bipolar disorder noted that while low levels of vitamin C have been linked with poor mood and cognition, research is limited. The researchers do indicate that some evidence points to vitamin C decreasing manic symptoms in people with bipolar disorder.
Vitamin D is a nutrient your body needs to help build and maintain healthy bones. Other benefits include anti-inflammatory, antioxidant, and neuroprotective properties.
One studyTrusted Source noted that people with bipolar disorder may be more likely to have low levels of vitamin D.
Plus, a recent review article states that vitamin D supplements may help reduce depressive and manic symptoms in people with bipolar disorder.
Probiotics are certain types of healthy bacteria that can provide health benefits in your gut and other areas of the body. Having the right balance of healthy and harmful gut bacteria — known as the gut microbiome — can improve digestion and immune function.
What’s more, there may also be a link between balanced gut bacteria, gut microbiome, and bipolar disorder. One review mentions a study in which people with bipolar disorder who took probiotics noticed a reduction in mania symptoms.