Electroconvulsive Therapy (ECT)

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In situations where medication, psychosocial treatment, and the combination of these interventions prove ineffective, or work too slowly to relieve severe symptoms of bipolar depression such as psychosis or suicidality, electroconvulsive therapy (ECT) may be considered. ECT may also be considered to treat acute episodes when medical conditions, including pregnancy, make the use of medications too risky. ECT is considered a highly effective treatment for severe depressive, manic, and/or mixed episodes.

Although it has proved to be a highly effective treatment, doctors are reluctant to use it except as a treatment of last resort because of the side-effects (confusion and memory problems) and possible complications of ECT, particularly when repeated treatments ("maintenance ECT") are needed. The possibility of long-lasting memory problems, although a concern in the past, has been significantly reduced with modern ECT techniques. However, the potential benefits and risks of ECT, and of available alternative interventions, should be carefully reviewed and discussed with individuals considering this treatment and, where appropriate, with family or friends.

Nutrition and Dietary Supplements for Bipolar Disorder

Note: There are no natural treatments that can substitute for medications in the treatment of bipolar disorder. Antidepressant drugs may cause manic episodes in people with bipolar disorder. For this reason, herbs and supplements with anti-depressant properties might also be risky. Case reports suggest that SAMe, St. John's Wort, and inositol can indeed trigger manic episodes.

The supplement L-glutamine, while not normally considered to have antidepressant properties, has reportedly triggered episodes of mania in two people not previously known to have bipolar disorder. A ginseng product has also been associated with an episode of mania.

The supplement chromium is often sold in the form chromium picolinate. Picolinate can alter levels of neurotransmitters. This has led to concern among some experts that chromium picolinate might be harmful to people with bipolar disorder.

It has been suggested that the drug lithium works, in part, by reducing the body's level of vanadium. For this reason, it might be advisable for people with bipolar disorder to avoid using supplements that contain vanadium.

Finally, numerous herbs and supplements may interact adversely with drugs used to prevent or treat bipolar disorder. For example, people who use lithium should avoid herbal diuretics.

For more information on the potential risks, please discuss any treatments with your doctor before taking them.

Omega 3 for Bipolar

Omega-3 fatty acids may be a possible treatment for the depressive phase of bipolar disorder, particularly as a supplement to medication. An initial clinical trial by Stoll et. al. produced positive results. However, since 1999 attempts to confirm this finding of beneficial effects of omega-3 fatty acids in several larger double-blind clinical trials have produced inconclusive results.

Vitamins and Mineral Supplements

Various small studies are finding single nutrients or nutrient combos can have affects ranging from subtle to pronounced. One pilot study found a certain supplement combination dramatically improved symptoms in bipolar patients. Larger studies are planned. And it isn't just about mood. Antioxidants, for example, can improve memory and protect against free radicals that can damage neurons. Use under a doctor's supervision. Consulting a nutritionist is also recommended. It is advisable to use supplements as a complement to medications rather than as a replacement.

Acupuncture for Treating Bipolar Disorder

Ayurveda

Ayurvedic medicine is described as "knowledge of how to live." It incorporates an individualized regimen—such as diet, meditation, herbal preparations, or other techniques—to treat a variety of conditions, including depression, to facilitate lifestyle changes, and to teach people how to release stress and tension through yoga or transcendental meditation.

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Reviewed: 03/2006