Dante Carrillo
Bipolar disorder is a mental health condition that affects approximately 1-4% of the population, and is characterised by alternating episodes of mania or hypomania and depression. While medication and therapy are the standard treatments, diet and nutrition are also thought to play a role in managing the condition. Research suggests that a healthy diet may aid therapy for depressive episodes, while a poor diet can contribute to heightened inflammation, which may negatively impact symptoms. For example, caffeine and sugar can increase anxiety and make it harder to sleep, while alcohol can cause dehydration and negatively affect mood. On the other hand, whole grains, magnesium, omega-3 fatty acids, and high-fibre foods may all help to manage bipolar disorder.
| Characteristics | Values |
|---|---|
| Inflammation | High-fat and high-sugar diets can increase inflammation and negatively change immune systems |
| Caffeine | Can cause jittery feelings and amp up anxiety levels, triggering manic episodes |
| Alcohol | Can cause dehydration and negatively affect mood, and interfere with medications |
| Obesity | Linked to bipolar disorder, with a large study of Californian adults finding that those who consumed more fast food reported more mental distress |
| Sleep | Sleep issues are common in bipolar disorder, and saffron may help improve sleep quality and duration |
| Omega-3 fatty acids | Found in fish, fish oil supplements, eggs, and nuts, they can help decrease feelings of depression |
| Magnesium | Found in whole grains, beans, and dark leafy vegetables, it has an effect similar to lithium, a common bipolar medication |
| Salt | Necessary to regulate levels of bipolar medication in the bloodstream |
| Whole grains | May have a calming effect and boost serotonin production |
| High-fiber foods | Help to maintain healthy blood sugar levels |
| Refined carbohydrates | Can make an already unbalanced mood more erratic |
| Fast food | Linked to psychological distress |
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What You'll Learn
The importance of omega-3 fatty acids
Several studies have shown that omega-3 fatty acids can help decrease feelings of depression in people with bipolar disorder. Omega-3 fatty acids are an essential part of nerve cells and improve signalling between those cells. They also decrease a type of chemical damage to brain cells called "oxidative stress".
The omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) play an important role in brain functioning and have been shown to reduce the risk of cardiac death. EPA and DHA are found in seafood, which is probably our most important dietary source of omega-3. They are also available as dietary supplements, such as fish oil capsules, although these may not provide the same benefit as a diet rich in omega-3 fatty acids.
Vegetarians can try getting their omega-3s from eggs or nuts instead. It's important to note that the body also needs omega-6 fatty acids, but a high level of omega-6s in the body appears to cancel out some of the benefits of omega-3s. Therefore, the balance between omega-3 and omega-6 fatty acids is key.
In addition to omega-3 fatty acids, other dietary considerations for people with bipolar disorder include reducing caffeine, sugar, and refined carbohydrate intake, as these can negatively impact mood and sleep. Obesity and bipolar disorder are also associated, with a large study of Californian adults finding that those who consumed more fast food were more likely to report moderate to severe mental distress.
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Magnesium and mood stabilisation
Diet can play a role in managing bipolar disorder. While it cannot cure the disorder, it can help get symptoms under control. Research indicates that a very low-carb, high-fat keto diet may be advantageous for people with bipolar disorder. It may help stabilize mood and lower the incidence of depression. However, it is important to consult with a doctor before making any significant dietary changes, especially when following a strict regimen like the keto diet.
Magnesium is a mineral that is important for the health of all cells. It has been shown to have an effect similar to lithium, the most common bipolar medication. Magnesium can increase the effectiveness of antidepressants and antipsychotic medications, which are frequently used to manage bipolar disorder symptoms. It can also help reduce stress by regulating the body's stress response and keeping cortisol levels in check.
There is some evidence that magnesium deficiency may be linked to mood disorders. A pilot study of Magnesiocard®, a magnesium aspartate hydrochloride preparation, found that it had clinical results at least equivalent to those of lithium in about 50% of patients with rapid cycling bipolar affective disorder. Another study found that Mg-depleted mice exhibited enhanced depression- and anxiety-related behavior, which was reversed by known antidepressant and anxiolytic substances.
Magnesium-rich foods include whole grains, beans, nuts, and dark leafy vegetables like spinach. However, it is important to note that magnesium cannot replace lithium entirely, and it should be used as a supplement to traditional treatment approaches such as medication and therapy.
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The impact of caffeine and alcohol
While there is evidence that diet can play a role in managing bipolar 2 disorder, this discussion will focus on the impact of caffeine and alcohol.
Caffeine
Caffeine is a stimulant that can produce jittery feelings and amp up anxiety levels. It can also negatively impact sleep, and according to the International Bipolar Foundation, it may even trigger manic episodes in some people with bipolar disorder. Studies suggest that this is due to the impact of caffeine on sleep, as sleep disturbances can affect mood, life quality, and treatment outcomes in people with bipolar disorder. Patients with bipolar disorder are routinely advised to limit caffeine intake.
Alcohol
Alcohol use disorder is a frequent co-occurrence with bipolar disorder. Alcohol can cause dehydration, negatively impacting mood and interfering with medications. It is also associated with an increased risk of bipolar disorder. While it may seem that alcohol would help take the edge off a manic episode, it can actually make you feel more on edge.
Both caffeine and alcohol can negatively impact individuals with bipolar 2 disorder. While caffeine can increase anxiety and disrupt sleep, alcohol can cause dehydration, negatively affect mood, and interfere with medications. It is important for individuals with bipolar 2 disorder to be mindful of their consumption of these substances and to seek professional advice if needed.
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The effects of sugar and refined carbs
Diet can play a role in managing bipolar disorder symptoms, and certain food choices may help manage manic episodes. Sugar and refined carbs can have a negative impact on bipolar disorder.
Firstly, a diet high in refined sugar can make it harder to control weight and obesity, as well as making some bipolar disorder drug treatments less effective. A 2013 report in the Annals of Medicine found that people with bipolar disorder are three times more likely to have type 2 diabetes, and excessive weight puts you at risk of developing diabetes. A 2016 multicenter study also found that a diet high in refined sugar can make some bipolar disorder drug treatments less effective.
Secondly, bipolar patients may be more prone to obesity, as imbalances of serotonin in their brains may lead them to crave more unhealthy carbohydrates. A diet high in carbohydrates has been linked to metabolic syndrome, which is a cluster of risk factors that includes increased blood pressure, high blood sugar, excess body fat, and abnormal cholesterol or triglyceride levels. Qi Sun, an associate professor of nutrition and epidemiology at the Harvard School of Public Health, states that "refined carbs are very rapidly absorbed into the bloodstream, where they boost sugar levels substantially". Excessive carbs contribute to insulin resistance, where cells stop responding normally to the hormone insulin. Insulin resistance is a key factor in metabolic syndrome, which people with bipolar disorder are at a higher risk of developing.
Thirdly, sugar highs and lows can make an already unbalanced mood even more erratic, and sugar crashes can make a depressive phase much worse. Sugar is broken down too fast, and the body cannot use it for energy. In contrast, complex carbohydrates are broken down slowly and provide a more controlled release of neurotransmitters, keeping blood sugar more stable and helping to prevent type 2 diabetes.
Therefore, it is recommended to cut back on sugar and refined carbs, and swap simple carbohydrates for complex ones, such as whole grains, fruits, and vegetables.
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Foods that are slow to digest
While food cannot cure bipolar disorder, diet and lifestyle changes can help manage symptoms. Research indicates a link between diet and bipolar disorder symptoms. For instance, caffeine and sugar can negatively impact bipolar disorder. Caffeine is a stimulant that can cause jitteriness and amp up anxiety levels, potentially triggering manic episodes. Sugar can make an unbalanced mood even more erratic and worsen depressive phases. On the other hand, whole grains, which are slow to digest, can have a calming effect on the mind.
Slow-digesting foods are those that rank low on the glycemic index (GI), a measure of how quickly a food containing carbohydrates is digested and converted into glucose in the body. Low-GI foods take longer to digest, helping you feel fuller for longer and maintaining a steady level of glucose in your bloodstream. This can have positive effects on your health, including improved weight management and a reduced risk of chronic disease.
- Whole grains, such as 100% stone-ground whole wheat or pumpernickel bread, wheat and corn tortillas, quinoa, brown rice, rolled or steel-cut oatmeal, oat bran, barley, and bulgur. Barley and oats have the lowest GI values.
- Starchy vegetables like peas, carrots, parsnips, and yams.
- Most other vegetables, including artichokes, asparagus, broccoli, cabbage, cauliflower, celery, eggplant, greens, okra, peppers, squash, and zucchini.
- Beans and legumes, including baked beans, black-eyed peas, black beans, chickpeas, kidney beans, navy beans, lentils, soybeans, and peanuts.
- Nuts and seeds, such as walnuts, almonds, pistachios, pine nuts, hazelnuts, cashews, sesame seeds, amaranth, sunflower seeds, and sprouted seeds. Peanut butter and unsweetened butters made from low-GI nuts are also slow-digesting.
- Dairy products, which supply natural sugar in the form of lactose.
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Frequently asked questions
Whole grains, beans, nuts, eggs, dark leafy vegetables, and fatty acids like Omega-3s are all foods that can help manage bipolar 2 disorder.
Foods with artificial sweeteners, high sugar content, high caffeine content, and high amounts of refined carbohydrates can negatively impact bipolar 2 disorder.
Diet can influence inflammation levels, energy levels, and stress levels, which can all impact bipolar 2 disorder symptoms. A good diet may also boost the effectiveness of treatments for bipolar 2 disorder.
