Other Treatment Approaches for Bipolar Disorder
Other news on the treatment front is the emergence of nutritional approaches. “The public is ready for nutrients to be on the scene,” observes Stoll. “Most medical symposia on bipolar disorder now include a section on natural treatments.”
His studies, and others’, have demonstrated therapeutic value in omega-3 fatty acids, notably eicosapentaenoic acid (EPA), folic acid and other B vitamins, and the mineral magnesium. Other nutrients are under study. “These are not going to work by themselves in most people,” Stoll reports, “but they are adjuncts to medicines. You can get away with fewer medicines and maybe lower doses.”
Stoll has explored supplements of the amino acid taurine. The results of the study have not yet been published, but Stoll did say that “it works really well for bipolar disorder.”
Helpful as nutritional support may be, it can only benefit those patients who can afford it. Nutrient use is not reimbursed by insurers, and the cost can add up. Bipolar disorder is already one of the more expensive conditions requiring treatment, with some medications ringing the cash register at $15 a pop, day in and day out. Stoll cites the case of a bipolar patient of his whose multiple medications alone cost $1100 a month.
Nevertheless, a shift in the Western diet may explain part of the changing face of bipolar disorder. “We think it’s the omega-3 story, why the age of onset is dropping and the disorder is affecting more children,” says Stoll.
“In the last 100 years, we’ve changed our diet, consuming more processed food and shifting to omega-6 fatty acids over omega-3s,” with which they compete for uptake by the body. “It affects cell membranes and physiology in a way that’s harming us and our children. Each generation is more depleted of omega-3s than the previous one.” He points to evidence gathered by researchers at the National Institutes of Health correlating psychiatric disorders in children with a rise in omega-6 consumption, such as from soy oil, ubiquitous in fried foods.
Difficult as bipolar disorder is to control in adults, it’s even more daunting in children and adolescents. The irritability, excitability and impulsivity that mark the disorder often overlap with the signs of attention deficit hyperactivity disorder. But treatment for the latter can kick off frankly manic episodes.
And to what adolescent striving to define an identity do inflated self-esteem and grandiosity not appear attractive? To say nothing of the boost in energy and reduced need for sleep? It is the depression phase that generally motivates them to accept care.
Increasingly, experts agree that in both children and adults the course of the disorder depends not merely on correct diagnosis and medication but on extensive education and psychotherapy involving the whole family. The goal is to lessen the stress level impinging on patients. “Stress definitely worsens the disorder,” says Stoll.
At the very least, proven psychotherapies, such as cognitive behavioral therapy, interpersonal therapy and especially family-focused therapy, help patients resolve the work and relationship problems that are both cause and effect of episodes. Studies show such treatment reduces the number of mood episodes patients experience.
Psychotherapy appears to be especially useful in teaching self-management skills, basic equipment for keeping everyday ups and downs from becoming full episodes. Valuable as drug treatment is, it will never carry sufferers completely to the finish line.
This content is Copyright Sussex Publishers, LLC. 2007. This content is intended for personal use and may not be distributed or reproduced without the consent of Sussex Publishers, LLC. Please contact licensing@psychologytoday.com for more information.
Last reviewed: By John M. Grohol, Psy.D. on 19 Sep 2007
