Treatment-resistant bipolar depression is the frustrating and exhausting experience of trying to treat and manage your symptoms but seeing no improvement. Depressive episodes of bipolar disorder can be hard to treat, even more so than episodes of mania (Poon, et al., 2015). Different doctors and researchers define this condition slightly differently. One common criterion for treatment resistance is the failure of lithium to improve symptoms. Another definition is that someone has tried two or more different medications without success. In either of these situations, someone is said to have treatment-resistant bipolar depression.

If your bipolar depression is unresponsive to treatment, you might not be concerned about the clinical definition of treatment resistance. You are likely more concerned with the fact that your symptoms aren’t decreasing because nothing you do to treat them helps.

There are approaches that help treatment-resistant bipolar depression. Keep reading to discover what can be done to overcome this exasperating condition.

Treatment-Resistant Bipolar Depression: Why Does It Happen?

Sometimes there are underlying reasons for depression that resists treatment. If you can identify one or more reasons treatment isn’t working, you can work to eliminate those obstacles.

Some common reasons that bipolar depression might not respond to treatment:

• Taking medications for other illnesses
• Drinking even small amounts of alcohol or using other substances, including marijuana
• Frequently missing doses of prescribed medications
• The presence of other conditions like hypothyroidism, anemia, sleep apnea, substance use disorders, and personality disorders
• Poor sleep habits (different from insomnia, these are habits we control, such as staying up late watching TV, playing video games, or being on social media)

If any of these factors fit, talk with your doctor about what you’re experiencing. They’re not flaws; they’re just some things in your control that can help you improve your depression. Your doctor can help you identify ways to make changes to improve how your bipolar depression responds to treatment.

Another thing your doctor can help with is medication.

Helping Treatment-Resistant Bipolar Depression with Medication

Medication is the first line of defense in treating bipolar depression. Medication works because it directly treats the brain. Each person responds uniquely to various forms of medication, and finding the right prescription, whether it’s for one type of medication or a combination of medications, is a process that takes patience and time ("What Are the Best Medications, Treatments for Bipolar Depression?").

In some cases, standard bipolar medication doesn’t work; therefore, researchers are searching for other pharmaceutical options. Some medications under review for treatment-resistant bipolar depression include:

• Glutamatergic agents that affect the neurotransmitter glutamate: ketamine, memantine
• Psychostimulants: modafinil
• Dopamine antagonists to enhance dopamine activity: pramipexole, ropinirole
• Opioids: oxycodone

These may be used to replace certain medications or could be added as adjunct medications. If you don’t like the idea of medications that are newly being used for bipolar depression, or if your doctor doesn’t prescribe them, there are other options available to you.

Brain Stimulation for Treatment-Resistant Bipolar Depression

Treatments that directly stimulate the brain have been successful in helping people break through treatment resistance to overcome bipolar depression.

Many of these treatments are newer treatments for which studies are finding positive results. Brain stimulation treatments that you and your doctor might decide to try, if available in your area, include:

• Electroconvulsive therapy (ECT): electric currents are delivered to the brain to induce brief seizures
• Vagus nerve stimulation (VNS): a device implanted in the chest sends electric impulses up the vagus nerve to the brain
• Transcranial magnetic stimulation (TMS)/repetitive TMS (rTMS): Painless magnetic pulses are delivered to the brain to stimulate the nerve cells associated with depression
• Deep brain stimulation: Still under investigation, this procedure involves surgical implantation of electrodes into certain brain areas to create electrical impulses that help regulate brain activity

Simpler Options for Ending Treatment-Resistance in Bipolar Depression

While all the above methods can end treatment resistance in bipolar depression, there are other, simpler, things you can do. Regularly seeing a therapist will help you identify and change negative thoughts that are holding you back as well as build a collection of coping skills.

One of the most beneficial things you can do to overcome treatment-resistant bipolar depression is to maintain a healthy lifestyle: nutrition, exercise, proper sleep, and daily routines. Of course, establishing and maintaining a healthy lifestyle is difficult when you live with bipolar depression. That’s why having a therapist can be an asset. Therapists can help you create and follow a healthy routine to decrease depression.

Keep in mind, too, that treatment resistance isn’t treatment failure. Notice positive changes. Embrace even small improvements. An accumulation of tiny changes leads to the realization one day that your bipolar depression is no longer resistant to treatment; in fact, it might not be around at all.

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Creating a positivity wall is a highly effective way to improve your outlook on life. Whether you want to become more positive, boost your confidence or achieve a specific goal, looking at a wall of beautiful images and quotes will only bolster your mind's power. Here, you will learn how to make a positivity wall and the benefits that come along with it.

What Is a Positivity Wall?

A positivity wall is a display of positive images, quotes, and affirmations in your home or workplace. The purpose of this wall of positivity is to give you a visual focus for your life. That way, you'll have a selection of inspiring images to look at when you feel depressed or unmotivated ("Positivity for Depression: Is That Even Possible?"). After all, it’s easier to think more positively when you are faced with visual reminders of what makes you feel good.

Do Positivity Walls Work?

We now know that positive thinking supports brain growth and encourages the reinforcement of new synapses. In other words, focusing on the positive rather than the negative is not only good for your mental wellbeing, it’s also good for your physical health ("Does False Positivity, Fake Positivity Help or Hurt You?").

According to Traci Stein, Ph.D., a clinical psychologist and adjunct professor at Columbia University’s Teachers College:

“Psychologists have known for decades that the images you create in your mind can have a potent effect on your body; now researchers are proving it.”

And what better way to create positive images in the brain than to fill your home with positive words and images? Positivity walls are particularly effective because they help you visualize goals that are deeply personal. Over time, you will learn what words and images build you up and make you feel that you’re ready to take on the world.

How to Make a Wall of Positivity

It’s easy to make your own positivity wall, but there is no set way of doing it. Only you can decide what you want to display and how you want it to look. You might choose inspirational quotes, images, spiritual passages, photographs of people you love, positive wallpaper, decals, or all of the above.

Before you make a start on your wall, create a mock-up in your journal or scrapbook. That way, you can decide which layouts you like best, whether you’re more driven towards words or images, and If you want a particular color scheme for your wall of positivity.

Here are some positivity wall ideas to get you started:

• Chalkboard wall: If you own your apartment or have permission to paint, you can create a chalkboard wall in your home using a pot of chalkboard paint. Once it’s dry, you can write and draw on your wall using erasable chalkboard pens. This way, you can keep your ideas and quotes fresh according to what inspires you.
• Gallery wall: A gallery wall is typically a collection of framed images or quotes arranged artfully. You can create a gallery wall anywhere in your home, but it is most effective where you will see it often – for instance, above your desk.  
• Poetry wall: If you’re driven by uplifting literature, a wall of inspirational poems and quotes from your favorite novels could be just what you need to help you refocus and make you feel more positive. Why not write them out in your best handwriting or learn calligraphy to make your wall even more personal and allow the quotes to sink in?
• Affirmations wall: Some people find writing down their affirmations much more effective than saying them out loud. Spend time researching affirmations online or create your own – for example, “I am strong and capable” or “I am resilient.”

Anyone Can Make a Positivity Wall

Positivity wall art is a fun way to encourage optimism and care for your mental health, and anyone can do it. Thanks to the free printables available on sites like Pinterest, it doesn’t have to be an expensive project and you don’t need artistic skills or equipment to get started.

Creating a positivity wall is a creative and proactive way to help you become a more positive person. You can also change and rearrange the components of your wall to incorporate new goals and passions so that it grows with you. What’s on your positivity wall?

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Bipolar depression with anxiety is a common combination. About 75 percent of people with bipolar II disorder have at least one anxiety disorder (American Psychiatric Association, 2013). Anxiety disorders like generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder are the most common disorders that occur alongside bipolar II disorder; further, symptoms of these anxiety disorders are more likely to flare during a period of bipolar depression than an episode of mania. Given that bipolar depression with anxiety occurs quite frequently, it’s important to know more about these conditions, how this combination can affect people, and what treatments work.  

Anxiety greatly influences someone’s experience with bipolar depression, including the symptoms they experience and how they respond to treatment. Both disorders worsen each other. Episodes of depression and anxiety are longer and more severe than when they occur on their own. The long-term outlook is worse, too, largely because it can be harder to treat comorbid anxiety and bipolar depression.

Bipolar Depression with Anxiety: Symptoms and Effects

Bipolar depression and anxiety bring out the worst in each other, making things very difficult if you are dealing with both conditions. As a result, you might experience symptoms like heightened worry and fear, anxiety attacks, and more severe depression.

These two co-occurring disorders create undesirable effects that interfere in life, such as:

• Avoiding people, situations, and events that increase anxiety
• Deepened depression due to isolation created by anxious avoidance
• A dark view of the world because of depression’s negative thought patterns
• Increased worry, fear, and agitation because of this dark worldview
• Increased likelihood of substance abuse
• Decreased quality of life
• Suicidal ideation, action

Anxiety disorders are difficult to live with. So, too, is bipolar depression. Unfortunately, when they occur together, treatment is more difficult than it is for each one separately. While difficult, it’s not impossible. Treatment is available, and with patience, you can find the right approach for your bipolar depression with anxiety.  

Anxiety and Bipolar Depression: Treatment Options That Work

Each person dealing with bipolar depression and anxiety is unique. A treatment approach that works for one person might not work at all for another. While there isn’t a single treatment that works for everybody, there is something for almost everyone. It’s a matter of knowing and considering your options and working with your doctor to find the most effective approach to your mental health.

Effective treatment options for bipolar depression with anxiety include:

• Depression and anxiety medication, often a combination of different prescriptions
• Individual therapy
• Family therapy

Medication for Bipolar Depression with Anxiety

Medication is almost always the starting point. Your doctor might begin by prescribing a mood stabilizer. Next, they might prescribe an antidepressant to treat anxiety, although in bipolar disorder, antidepressants can trigger mania or induce a chronic state of depression. If you do use an antidepressant, your doctor will monitor you carefully and adjust your medications as needed.

As an alternative to antidepressants, your doctor may have you try benzodiazepines to treat your anxiety. Benzodiazepines don’t aggravate depression or mania, but they do carry the risk of tolerance and dependence. Finally, you might also receive a prescription for an atypical antipsychotic.

If one medication doesn’t work, you don’t have to feel defeated. Each class of medication used (from mood stabilizers to antipsychotics and everything in-between) has numerous medications within it. Finding the right combination is often a matter of trial and error.

You might want to talk to your doctor about side effects. Having both disorders can make you more sensitive to medication side effects, especially when the medication is new for you. Being aware and communicating with your doctor will help you find a medication that works without intolerable side effects.

Medication is almost always the first line of treatment for bipolar depression with anxiety. In addition to medication, therapy can be very effective in decreasing symptoms and improving lives.

Therapy for Anxiety and Bipolar Depression

Therapy, both individual and family, is helpful in bipolar depression and anxiety treatment. Individual therapy lets you address challenges and create coping skills. Family therapy does this, too, but it’s done as group therapy with the entire family present. Both help people improve the quality of their lives. Some types of therapy that have been shown to help include:

• Cognitive behavior therapy
• Relaxation training
• Interpersonal and Social Rhythm Therapy (tracking activities, and creating stable, reliable routines)

Medication and therapy are effective treatment approaches for managing bipolar depression with anxiety. While finding the right treatment isn’t always a quick, easy process, it is possible to do so. You can minimize the effects of these disorders and live a quality life.

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“Do I have depression?” What a great question! With more awareness surrounding depression, perhaps you’ve read something that makes you wonder if what you’re experiencing is, in fact, depression or a depressive disorder. “Depression” is the short form of “major depressive disorder” but depression is also a common feeling that pops up when sad and distressing life events occur. The difference between depression and a depressive disorder is the degree to which it influences your life.

Do I Have Depression Symptoms?

First, let’s consider some of depression’s symptoms. Depression is more than sadness although feeling sad can certainly be part of depression. Symptoms also include anger, helplessness, fatigue, and even numbness of your emotions.

Depression may also have physical symptoms. They can include muscle and joint pain, stomach problems, abdominal pain and headaches among others.

Depression can affect men and women differently. If you think you do have depression, take a look at depression in women or depression in men for gender-specific depression symptoms.

Learn more about the possible effects of depression on your life.

“Do I Have Depression?” Quizzes and Tests

While only a doctor or mental health professional can diagnose depression, we have some depression tests and quizzes on our site which act as symptom checkers. You can print those out and bring them to your next doctor visit.

These tests will provide answers if you suspect you do have depression. The depression quizzes cannot diagnose depression, but they can give you a starting point for an open discussion with your doctor.

Free Online Depression Test.

Short Depression Test

Cognitive Symptoms of Depression Test

Depression Test for Teenagers

How Do I Get Depression Diagnosed?

You must visit your doctor or a mental health professional to receive a depression diagnosis. There are different types of depression that your doctor will consider, including major depressive disorder (clinical depression), dysthymia, and bipolar depression. Your doctor will carefully consider the criteria of depression in “The Diagnostic and Statistical Manual, ed. 5” (DSM-5) to reach a diagnosis.

Why Do I Have Depression?

There is not one cause of depression – there are many. Your genetics, biology, environment and life events can all cause depression. Even medications can cause depression. Additionally, some foods, hormones, and social media could have caused your depression. The point is that you did nothing to cause your depression, but you can do a lot to counteract it.

What Depression Treatments Are Available?

The best depression treatments are those that you and your doctor decide upon and try. Sometimes, your initial depression treatment may not work, but you can keep trying until you find the combination of therapy (i.e. EMDR, cognitive behavioral therapy, etc.), depression self-help and depression medication that will help you the most.

If you are experiencing bipolar mania and not eating, you are not alone.  Many people in a manic phase of bipolar disorder have a loss of appetite. Sometimes because of forgetfulness, or perhaps an increased sense of contentment, bipolar mania and not eating are commonly linked.

Bipolar Mania and Not Eating

If bipolar mania is causing you not to eat, it is imperative you identify ways to get back to nourishing your body in a healthy way. Diet and nutrition are vital aspects of everyone’s mental health. Yet when it comes to those with bipolar disorder, a healthy diet is essential to symptom management and thus, the overall quality of life.

Of course, the severity of one’s bipolar disorder (and the length of time in the manic phase) can affect the level to which appetite is affected. For some, a loss of appetite can last a day or two, while others experiencing bipolar mania may not want to eat for weeks.

Bipolar, Manic, and Loss of Appetite

Being in a bipolar manic state and not eating due to loss of appetite can be very dangerous. Although you may not be feeling your regular hunger cues, it is essential you continue to incorporate a healthy diet and eat on a consistent basis throughout the day (Do Vitamins for Bipolar Help at All?). Following a healthy diet for bipolar will not only help you stave off the potential physical problems of not eating, but it can also aid in the management of your bipolar mania symptoms. A healthy bipolar diet consists of:

• Beans – beans are rich in magnesium, and according to much research, magnesium has shown to reduce mania symptoms. So, if you have bipolar mania and are not eating, beginning to incorporate beans could be a good place to start.
• Salt – using salt consistently, as those with bipolar have a sodium imbalance in the brain. Sodium imbalances can lead to mental confusion, mood swings, sweating, fever, and diarrhea.
• Omega-3’s – found in mackerel, herring, trout, salmon, and tuna.  Omega-3’s are synonymous with healthy brain function, and healthy brain function which can help with the impulsivity associated with bipolar mania.
• Turkey – tryptophan is an amino acid found in turkey.  Although it has become synonymous with the sleepy feeling experienced by many after Thanksgiving dinner, tryptophan helps in the production of serotonin.  Many also believe tryptophan aids in bipolar mania symptom management.  If you do not like turkey, tryptophan can also be found in eggs, tofu, and cheese.

If you trying to stay consistent with your diet when in a manic phase and experiencing a loss of appetite, it is important to know there are certain things to stay away from.  Following a healthy diet for bipolar disorder means cutting out:

• Caffeine – caffeine can cause sleep interruption and loss of appetite, which can worsen bipolar symptoms overall.  Additionally, caffeine in itself can trigger bipolar mania (Coffee and Bipolar Disorder Don’t Mix).
• Alcohol – alcohol not only negatively impacts the effectiveness of bipolar medications, but it can also exacerbate mood swings.  Plus, if you have bipolar mania and loss of appetite, alcohol may contribute to the impulsivity you might be experiencing.

If bipolar mania and not eating go hand-in-hand for you, beginning to incorporate a diet consisting of the above-mentioned foods can be helpful.  Yet, if you find you are having difficulty managing your bipolar and loss of appetite, it is important to seek the advice of a medical professional.

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Using vitamins for bipolar disorder symptom management is one of the newer approaches to natural treatment for mental illnesses. The question is: Do they help and is there any real science behind claims that vitamins for bipolar disorder should be part of your treatment regimen?

Vitamins for Bipolar

Using vitamins for bipolar is, according to some small studies, an effective way to help ease difficult symptoms associated with bipolar disorder. Research indicates particular vitamins help bipolar mania, and others help the depression associated with bipolar disorder.

• Vitamin B1 (aka thiamin) - many use vitamin B1 to manage the irritability and anxiety associated with bipolar disorder. Additionally, there are some newer studies that indicate the use of vitamin B1 is helpful in alleviating depressive symptoms.
• Ginkgo Biloba – this supplement is a popular natural approach in the treatment of bipolar disorder. An extract of the ginkgo tree, it is often used by those looking to improve their memory. Yet this is also one of the top vitamins for bipolar disorder in that it enhances blood flow to the brain. Although more research is needed, it is thought that this increased blood flow allows the brain to receive more oxygen and vital nutrients, making ginkgo biloba one of the best vitamins for bipolar mania management.
• Fish Oil – one of the most studied vitamins for bipolar disorder, fish oil has shown beneficial in managing the depression often associated with bipolar. Research around this supplement grew out of the notion that increasing one’s fish
• Folic Acid – also referred to as folate, folic acid is a B vitamin. Research indicates some success in the use of B vitamins for bipolar disorder treatment.  Studies on the connection between bipolar and folic acid grew from the awareness that increased depression and manic episodes occurred in those who were deficient in this vitamin. The recommended dosage of folic acid is 0.4mg, and while this is possible to get through a nutritious diet, many also take folic acid supplements.  Folic acid is considered “water-soluble” which means any excess is simply excreted through urination.
• St. John’s Wort – St. John's wort is a natural remedy that is actually a flower and has been studied in terms of its effectiveness for a wide range of ailments and disorders. Some studies have shown positive results in promoting mood stabilization and treating depression.
• Vitamin D – most people are vitamin D deficient, even though this vitamin is easily incorporated by incorporating certain foods into a bipolar diet, and of course, the sun.  Vitamin D has been well researched and has shown to be essential in optimal cognitive function and brain development. Through this research, psychiatrists and researchers have identified a link between a deficiency in vitamin D and psychiatric illness.  Thus, for those with bipolar disorder, it is recommended to increase the time outside in the sun, and/or take a vitamin D supplement.

While there is conflicting evidence on the effectiveness of using vitamins for bipolar disorder, some people have seen benefits (see also: Bipolar Diet: How Different Foods Affect Bipolar Symptoms). So, if you are looking for a more natural way to treat your bipolar disorder, trying vitamins or nutritional supplements could be an option. Nonetheless, it is always advised to consult a medical professional prior to incorporating any new treatments into your regimen or discontinuing any treatment.

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Coffee and bipolar disorder have, up until recently, had very little connection in the mental health research realm.  Yet, as studies emerge, it is becoming more clear that caffeine can have a negative effect on those with bipolar disorder.  While there is evidence supporting this notion, more research is needed to confirm the harmful link between coffee and bipolar symptoms.  Nonetheless, the information that is available regarding coffee and bipolar is compelling.

Relationship Between Coffee and Bipolar Disorder

The relationship between coffee and bipolar disorder is not a positive one.  In fact, several studies show individuals with bipolar disorder who also drink coffee are far more likely to experience a significant increase in bipolar symptoms. Some of the noted effects, in terms of the bipolar disorder - caffeine interaction include:

• Sleep Disturbance - it is not uncommon for caffeine to affect a person’s sleep cycle. And while a disrupted sleep cycle is undesirable for anyone, individuals with bipolar disorder may be affected on a greater scale. Sleep is essential for mood management and emotion regulation, two aspects of mental health that are already difficult for those with bipolar disorder. Not only can coffee impact sleep cycle, but ongoing use can increase one’s chances of developing insomnia alongside bipolar disorder.
• Suicidal Ideation - beyond interruption of sleep, coffee and bipolar seem to have another, more serious, negative association. An Italian study from 2009 revealed that caffeine consumption increased suicidal thoughts and attempts amongst individuals with bipolar disorder.
• Bipolar Caffeine-Induced Mania – people consume caffeine to feel energized, awake, and alert. But when it comes to coffee and bipolar disorder, those who are diagnosed should be very careful. A person with bipolar is far more sensitive to any substance that mimics that of an amphetamine, and coffee is one of those substances. Caffeine raises dopamine levels in the brain, which can cause increased anxiety, restlessness, and thus induce mania or hypomania (which can then bring on a loss of appetite when you have bipolar disorder). Also, when it comes to coffee and bipolar, some studies indicate that the sleep disturbance caused by caffeine can, in itself, bring on a manic episode.

No matter who you are, consuming coffee (or caffeine of any kind) can potentially affect your internal chemistry and brain function (Do Vitamins for Bipolar Help at All?). Caffeine is rapidly absorbed by the gastrointestinal tract and easily passes the blood-brain barrier. This means its effects take place almost immediately. Therefore, it shouldn’t be surprising that coffee and bipolar disorder do not mix.

While it is imperative to be cognizant of the potential dangers of coffee and bipolar disorder, it is also important to be aware of other forms of caffeine consumption. Considering the wide range of beverages, supplements, and even food products containing caffeine, it is best to check the ingredient labels of anything you are unsure about.  Whether you are on prescribed bipolar medication or not, it is advisable to check with a medical professional if you enjoy coffee and bipolar disorder is a diagnosis you have been given.

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A bipolar diet is a quick and natural way to manage some of the challenging symptoms of bipolar disorder (some bipolar symptoms can cause appetite loss).  When someone receives a bipolar disorder diagnosis, a combination of bipolar medication and psychotherapy is the most commonly prescribed treatment regimen.  Research has shown these are the most effective approaches to the overall treatment of bipolar disorder. However, including a bipolar diet, (along with getting enough sleep and adequate exercise) can help in terms of decreasing some bipolar disorder symptoms and improving your overall quality of life.

Bipolar Diet

A bipolar diet, depending on specific symptoms and overall health, may look slightly different from person to person and might include the ketogenic diet for bipolar. Nonetheless, there are common suggestions when it comes to a general bipolar diet plan.

• Omega-3 Essential Fatty Acids – one of the most well-researched aspects of the bipolar diet, omega-3’s, like those found in wild Alaskan salmon and other kinds of fatty fish, are shown to decrease depressive symptoms. Because those with bipolar almost always experience periods of depression, making sure you get enough omega-3 essential fatty acids is vital.  Other fatty fish options with high levels of omega-3 fats are sardines, anchovies, oysters, albacore tuna, and Pacific halibut.
• Magnesium – lithium is one of the most common mood stabilizers prescribed to those with bipolar, and magnesium functions in much of the same way as lithium. Adding magnesium to your bipolar diet plan, you may notice decreased manic symptoms. Also, boosting your magnesium intake can positively affect sleep quality. Foods high in magnesium include black beans, pumpkin seeds, spinach, swiss chard, soybeans, and sunflower seeds.
• Healthy Fats –found in avocados, low-fat dairy, nuts, and fish provide the nutrients essential to healthy brain function and emotion regulation, thus being a staple on the bipolar diet food list.

As with any diet, those on a bipolar disorder diet may want to avoid some foods as well.

• Refined Carbohydrates – carbs come in many forms, but in general, refined carbohydrates are usually those found in manufactured foods.  Although a bipolar diet suggests nixing the refined carbs, eating whole grains (like barley, oats, quinoa, etc.) is just fine.
• Refined Sugar – mood swings are inherent to bipolar disorder, so eating anything that could exacerbate these ups and downs is a big no-no.  Refined sugar, which spikes insulin levels, does just that.  Of course, there are ways to satisfy a sweet tooth on a bipolar diet; try using stevia (a naturally sweet herb that does not affect insulin) instead of artificial or refined sugars.
• Alcohol – drinking alcohol can be detrimental to those with bipolar for various reasons.  Alcohol has been known to negatively interact with many bipolar medications and can cause a person to become quite ill.  Other reasons to steer clear of alcohol when following a bipolar diet is its likelihood of causing sleep problems as well as increasing prevalence and severity of mood swings.
• Grapefruit – although dependent on the specific medication, many anticonvulsants (frequently prescribed for bipolar disorder) negatively interact with grapefruit and grapefruit juice.  Beware of this if medication is part of your treatment plan.

Although following a bipolar diet will not cure your bipolar disorder, it may help manage symptoms and improve quality of life.  When considering any change in your lifestyle, including your diet, or change to your treatment regimen, you should first discuss these things with your doctor prior to making any changes.

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A ketogenic diet for bipolar disorder is gaining popularity in terms of natural approaches to the treatment and management of difficult mental illness symptoms.  Many with bipolar disorder use medication as their primary treatment, and mood stabilizers are amongst the most widely prescribed.  Studies around a ketogenic diet for bipolar disorder have demonstrated this specific food regimen can function as a natural mood stabilizer. (Note: HealthyPlace is not advocating or recommending a ketogenic diet for bipolar disorder. Never stop or start any bipolar treatment or regimen without first discussing it with your doctor.)

Bipolar Ketogenic Diet

The ketogenic diet (aka keto diet) was not first designed for managing bipolar disorder.  The keto diet, which originated in the 1920s, was popularized as an effective approach to weight-loss.  Yet increasingly, people are using this diet as a way to manage various brain conditions and mental health disorders, including bipolar disorder (see also: ketogenic diet and depression, and ketogenic diet and ADHD).  The research available, while slim, does indicate that a keto diet can help manage certain symptoms of bipolar disorder.  This may be because certain dietary changes have been shown to positively affect the brain’s neurotransmitter function, which plays a large part in mood management and emotion regulation.

The function of a bipolar ketogenic diet is to replace the high-carbohydrate, high-sugar diet that many Americans consume today.  A diet consisting primarily of carbs and sugar causes the brain to flood with glucose and free radicals, which can deplete our body’s natural antioxidants, leading to inflammation of the brain.  Yet, if following a ketogenic diet for bipolar disorder, the brain pulls its energy from ketones, and far fewer free radicals are produced, allowing the brain’s neurotransmitters to function at optimal levels.  When the body gets its main source of energy from ketones, it is in a state referred to as “ketosis.”  Ketosis is the state in which the most benefits (in terms of bipolar management) are seen.

What is a Ketogenic Diet?

In general, a ketogenic diet for bipolar disorder consists of very few carbohydrates, which helps keep insulin and blood sugar levels stable.  Additionally, a ketogenic diet for bipolar disorder incorporates a moderate amount of protein and a lot of healthy fats. Thus, someone following a ketogenic diet should aim to eat good foods for bipolar disorder, such as the following:

• Meats – beef, lamb, fish, poultry, and eggs
• Vegetables – aim for the “above ground” veggies, such as broccoli and cauliflower, and leafy greens like kale and spinach
• High-fat dairy – butter, cream, and hard cheeses
• Nuts/Seeds – the best options when following a bipolar ketogenic diet are macadamias, sunflower seeds, and walnuts
• Healthy fat – avocado and coconut oil are both great sources of healthy fat

Just as there are  certain foods to include in a ketogenic diet for bipolar disorder, there are also some to avoid (or at least decrease intake of) including:

• Wheat – a keto diet for bipolar disorder is low in carbohydrates, so avoiding things like pasta, bread, and cereal is recommended
• Starch – potatoes, legumes, and beans are all in the starch family, and to be avoided
• Fruit – high in sugar and carbs, most fruit is to be avoided on this diet

Dietary changes can be difficult, and results may take time.  Nonetheless, if you are looking for a natural way to treat and/or manage your bipolar disorder symptoms, trying a ketogenic diet may be beneficial.  Nonetheless, if you are taking bipolar medication, it is important to note bipolar diets that are very low in carbohydrates can affect and alter the way the medication is processed in the body.  Thus, it is highly recommended to seek medical advice prior to switching to a ketogenic diet for bipolar disorder.

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