Many people with bipolar disorder consider natural and alternative treatments. Let’s look at the research behind some herbs and natural remedies people use for this condition.

For many people living with bipolar disorder, herbal supplements and natural remedies can be a helpful addition to a traditional treatment regimen.

Herbs may be an attractive option, as they can help address common bipolar symptoms that are often untreated or undertreated, such as:

These symptoms often fall outside the realm of typical bipolar medications.

Another draw is that herbs tend to have fewer side effects than many pharmaceutical drugs.

It’s important to note that some herbs people use to treat bipolar disorder aren’t supported by bipolar disorder-specific research. However, these supplements do have research-backed benefits for certain symptoms that are common in bipolar disorder, such as stress and insomnia.

In addition to herbs, several natural remedies and lifestyle strategies can help manage symptoms associated with bipolar disorder. These interventions do not always have clinical research to support their effectiveness. It’s a good idea to discuss natural treatments with a doctor, especially if you’re on bipolar disorder medication.

Ashwagandha (Withania somnifera) is an herb people have used for millennia in Ayurvedic medicine. It’s also known as Indian ginseng, and it may help boost cognition in people with bipolar disorder.

People use ashwagandha to help lower stress, improve stamina, and boost concentration levels.

Ashwagandha belongs to a class of medicinal herbs known as adaptogens, which essentially “adapt” to your body’s needs. These herbs help boost your body’s natural ability to handle mental, emotional, and physical stress.

Many people with bipolar disorder experience cognitive symptoms both during and after mood episodes. These impairments can take a heavy toll on your overall well-being and ability to function.

A 2013 study looked at the effects of taking a standardized extract of ashwagandha on cognition in bipolar disorder. A total of 53 participants took 500 milligrams (mg) per day of ashwagandha for an 8-week period, adding the supplement to their usual maintenance medications.

As a result, participants experienced significant benefits in three tests of cognition.

The researchers suggest that ashwagandha may help improve auditory-verbal memory, reaction time, and social cognition. It also appears to have a solid safety profile with few potential side effects.

According to the National Institutes of Health (NIH), ashwagandha might help reduce stress and anxiety, based on clinical trial evidence. There’s also limited evidence it can help with sleep.

However, the study pointed out several case reports of liver failure tied to the use of Ashwagandha. It was noted that this herb may also affect thyroid functioning, suggesting that it may interact with thyroid hormone medications.

Many people with bipolar disorder experience anxiety and insomnia between mood episodes, even after their primary symptoms are under control.

Valerian is a medicinal herb that people have used as far back as Ancient Greece and Rome. It’s considered a nervine, a type of herb used to help the nervous system.

A 2014 review suggests that valerian may be able to help with these symptoms, as the herb appears to act on GABA receptors in the brain to reduce anxiety and insomnia.

Side effects appear to be minimal and may include daytime sleepiness at higher doses. Sedation may be worse if valerian is taken along with other medications that may cause it.

Lemon balm (Melissa officinalis) is a lemon-scented nervine in the mint family. It may also address symptoms related to anxiety, memory, and insomnia, which may occur between episodes.

People have used lemon balm for centuries in traditional medicine as a mood enhancer, an astringent, and for headache relief, among many other uses.

Research from 2014 indicates that lemon balm may enhance memory and well-being in some people.

One report showed that a single dose of the herb improved memory function and created a feeling of calmness in healthy participants. When combined with valerian, lemon balm was also shown to reduce test-induced anxiety.

Overall, researchers suggest that lemon balm may have the potential to treat mild anxiety and insomnia in people with bipolar disorder.

A 2021 review found that lemon balm might help improve anxiety or depressive symptoms, but the review authors caution that the studies used different methods and that further high quality studies are needed. The studies did not look at anxiety or depression in the context of bipolar disorder.

Rhodiola rosea, or golden root, is an adaptogenic herb that people have used for millennia to help relieve depression, fatigue, and stress.

While it’s been shown to have a positive effect on anxiety, some experts warn against using rhodiola for bipolar disorder as it can trigger manic episodes in some people.

Still, other experts suggest that the herb may be helpful for those taking mood stabilizers and who mostly experience depression with only occasional hypomanic symptoms.

Rhodiola is not recommended for people taking antidepressants or monoamine oxidase inhibitors because it can cause serotonin syndrome. This is a cluster of side effects you can experience if high levels of serotonin build up in your body.

Symptoms of serotonin syndrome may include:

  • irritability
  • rapid heartbeat
  • nausea
  • shivering
  • diarrhea
  • dilated pupils

Passionflower (Passiflora incarnata) is another ancient nervine that people have long used to treat anxiety, insomnia, menstruation issues, and burns. Passionflower may act on GABA receptors in the brain and is considered an effective stress reducer.

A 2020 review suggests that passionflower may help people with chronic insomnia and memory problems. The herb also shows positive effects when people take it during episodes of anxiety, restlessness, sleeplessness, and depression.

It’s thought to affect depression indirectly by helping to reduce stress, which can be a factor that leads to depression. So, it’s possible that it may help relieve depressive episodes because of its stress-reducing properties.

Overall, researchers suggest that passionflower may have the potential to alleviate certain psychiatric symptoms, including stress reactivity, insomnia, and anxiety. Passionflower is typically not recommended during pregnancy due to the risk of inducing uterine contraction.

American skullcap (Scutellaria lateriflora) is another nervine that might help relieve stress and tension. It’s thought this herb can impact mood by acting on GABA receptors in the brain.

American skullcap has strong antioxidant effects and may help protect against neurological conditions, including Alzheimer’s disease and Parkinson’s disease. Similar to valerian and lemon balm, skullcap may help reduce feelings of anxiety and insomnia.

In a 2014 study, 43 healthy participants took 1,050 mg daily of American skullcap. They showed an improvement in mood with no reduction in cognition or energy levels.

There’s not enough evidence on the effects of skullcap in people with bipolar disorder, or on manic or depressive episodes in particular. Scientists need to delve more deeply into these topics.

The following supplements are nutritional supplements, not herbs, but are worth mentioning due to promising evidence regarding bipolar disorder.

These supplements have shown positive results in the treatment of bipolar disorder symptoms.

  • Omega-3 fatty acids from fish oil: The anti-inflammatory properties of fish oil have been shown to reduce depression. In bipolar disorder, omega-3 fatty acids significantly improve symptoms, according to research from 2016.
  • N-acetyl cysteine (NAC): Older research from 2008 suggests that NAC may help with depressive symptoms. More research is needed in this area as subsequent (and shorter) studies did not show the same effects. NAC also protects the kidneys from toxicity due to lithium, a common medication for bipolar disorder. A 2020 review of nutraceuticals in bipolar disorder concluded NAC could be used as an adjunct treatment for bipolar depression under close clinical monitoring.

A 2015 review suggests that cannabis may trigger or worsen manic episodes in people who have bipolar disorder.

Another study from 2018 shows that the following herbs have triggered manic episodes in some people:

Regulation of herbal supplements

Manufacturers are responsible for ensuring the dietary supplements they make are safe, including herbal supplements like the ones we list above. The Food and Drug Administration (FDA) does not screen them for safety and effectiveness.

That’s because the FDA considers dietary supplements a subcategory of “foods,” not as similar to pharmaceutical drugs.

However, the FDA does require manufacturers to label their dietary supplements accurately according to labeling regulations. The organization will take products off the market if they’re found to be unsafe or if the manufacturer makes claims about them that are misleading or false.

You can’t be certain an herbal supplement is safe, effective, or contains what the label says it does.

Consider choosing supplements that have been tested by a well-known third-party organization, such as:

  • ConsumerLab
  • U.S. Pharmacopeia (USP)
  • NSF International

The supplements should say so on the label.

Alternative therapies include practices that can contribute to overall well-being while living with bipolar disorder.

Yoga

Yoga is an ancient practice that, in the United States, typically takes the form of postures, breathing techniques, and meditation. According to the NIH, yoga might help people with depression or post-traumatic stress disorder (PTSD) and can help with anxiety symptoms.

There’s also been research on yoga and bipolar disorders.

A 2022 review found yoga might help with symptoms of bipolar disorder and depression, but the practice comes with some risks. Techniques of fast breathing and slow and contemplative techniques might particularly affect those with bipolar disorder. Hot yoga can increase the risk of side effects from antipsychotic medications.

Massage therapy

Massage therapy is one complementary treatment people might use to support their mental health.

Research on massage is limited, but a 2018 article reviewed some small studies on massage’s potential for positive impacts on the brain, such as promoting relaxation. The data suggests that massage might help relieve symptoms of depression or anxiety.

Acupuncture

There has been limited research on the use of acupuncture in bipolar disorder, but it is promising.

A 2022 study of 21 people with treatment-resistant bipolar disorder showed positive results after they received weekly acupuncture for 12 weeks. They experienced decreases in depression and anxiety and improvements in physical symptoms.

Meditation

Some research has been done on mindfulness-based cognitive therapy (MBCT) in bipolar disorder. MBCT combines elements of talk therapy with mindfulness practices.

Practicing mindfulness is achieved through the practice of meditation, yoga, or specific exercises where a person is in a state of nonjudgmental awareness of the present moment.

A 2020 review found that MBCT can help with the relief of depression and anxiety in people with bipolar disorder. The authors noted the effectiveness was time-limited and inconsistent, with more studies needed.

Interpersonal and social rhythm therapy (IPSRT) is a form of therapy where people aim to improve mood regulation by understanding their social and biological rhythms.

A 2020 study found that IPSRT can improve clinical symptoms of bipolar disorder. In the study, 44 people with bipolar disorder received either IPSRT or a control condition.

Those in the study who received IPSRT showed an improvement in manic, anxiety, and depressive symptoms. The improvement remained stable over 6 months in the study.

Extension of daily light exposure through bright light therapy is an established treatment for seasonal affective disorder (SAD). It also might have use in other mental health conditions, such as bipolar depression.

A 2017 study found that bright light therapy at midday helped relieve bipolar depressive symptoms. There were 46 people with bipolar depression who received either the bright light therapy treatment or a control condition.

After 6 weeks, 68.2% of people who received bright light therapy experienced depression remission compared to 22.2% of those in the control group.

There is a risk of switching to mania with bright light therapy. However, this risk is less than that with antidepressants.

Changes to lifestyle are other options for people living with bipolar disorder. These refer to your daily activities connected to health and well-being.

Regular exercise

Exercise might help manage symptoms of bipolar depression. A 2023 study looked at the effects of exercise in people with bipolar disorder experiencing a depressive episode.

The 15 people in the study participated in structured aerobic and strength training exercises three times a week for 12 weeks. By the end of 12 weeks, 9 people had a more than 50% reduction in depressive symptoms. Of the 9, 5 had symptoms reduced enough to fulfill the criteria for complete remission.

Physical activity can also help with weight management. Weight gain is a side effect of some medications used in bipolar disorder treatment and is associated with lower quality of life.

Getting enough sleep

Disruption in sleep patterns can trigger a mood episode in bipolar disorder, specifically an episode of high mood. Disruptions can include international travel, which induces time changes, and shift work.

Staying with a regular sleep pattern might help prevent mood episodes.

Eating a balanced diet

A balanced diet might also help with the management of bipolar disorder. A 2023 review found a number of foods are associated with the improvement of bipolar disorder symptoms, including:

  • omega-3 fatty acids
  • seafood
  • folic acid
  • zinc

Fruits, vegetables, and whole grains are also essential parts of a healthy diet, as people with bipolar disorder are at a higher risk for metabolic conditions.

Herbal supplements and natural remedies are helpful options for many people living with bipolar disorder. You may find they work well as a complementary treatment to your traditional treatments. However, they don’t replace regular treatment for bipolar disorder.

It’s important to note that bipolar symptoms vary widely, and what works for one person may not work for another.

Many of these herbs and therapies work well because they affect your body’s biology, sometimes the neurotransmitter systems in your brain. Because of this, it’s wise to use caution when taking them — just as if you were trying a new medication.

Consider speaking with a licensed healthcare professional before trying a supplement to assess possible risks, medication interactions, and the correct dosage. Some herbs can interact with current medications or trigger undesired effects in some people.