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Complementary and alternative medicine (CAM) therapies—which include many natural products—are widely used alone or in combination with psychotropic drugs to treat or self-treat mental illness. I briefly review the limitations of conventional pharmacological therapies in this article. To provide the best clinical advice to patients with bipolar disorder about the range of available treatment choices, psychiatrists and other mental health professionals should be knowledgeable about the evidence that supports conventional pharmacological treatments as well as promising CAM and integrative treatment strategies.
A significant percentage of patients with bipolar disorder rely on maintenance antidepressant therapy to control depressive mood swings, which significantly increase the risk of mania.
The limited effectiveness and safety issues associated with conventional psychotropics in the management of bipolar disorder have resulted in high relapse rates in individuals taking mood stabilizers and other psychotropic medications, with associated impairment in social, academic, and occupational functioning, and increased risk of suicide.14 These issues underscore the urgent need to identify more effective, better-tolerated treatments for bipolar disorder and invite rigorous and open-minded consideration of emerging research findings for promising CAM and integrative treatments. Table 1 summarizes significant findings and comments on unresolved research and treatment issues for the natural products reviewed in this article. Placebo-controlled trials have evaluated v-3s in bipolar disorder as both a monotherapy and an adjuvant to mood stabilizers. James Phelps, MD is Director of the Mood Disorders Program at Samaritan Mental Health in Corvallis, Ore.
Thanks to its omega-3 fatty acids, flaxseed oil may help if you suffer with bipolar disorder. The majority of older adults with a diagnosis of any mood disorder (64%) had not discussed use of herbals or other natural products with their physicians. My goal is to identify factors that lead increasing numbers of patients with bipolar disorder to use CAMs alone or in combination with conventional pharmacotherapy (ie, as integrative treatments).

While conventional pharmacological treatment is necessary for patients in the acute phase of bipolar illness, medications alone do not make up an adequate maintenance strategy for stable bipolar patients.
John's wort may help with the depression associated with bipolar disorder, according to the Mayo Clinic.
Omega-3s can improve brain function as well as depression associated with your bipolar disorder, according to the Mayo Clinic.
I then examine the evidence base for select CAM and integrative modalities currently used to treat or self-treat bipolar disorder. For example, regular exercise, adequate sleep, good nutrition, a strong social support network, and a predictable low-stress environment are known to significantly reduce relapse risk in bipolar patients who are being treated with mood stabilizers.8,9 Integrative mental health care embraces the perspective that tailoring an individualized treatment plan to each patient’s unique history, symptoms, preferences, and financial constraints increases the patient’s motivation to stay in treatment, which improves adherence and results in better outcomes.
His Web site,, gathers no information on visitors and produces no income for him or others. Mood shifts occur just few a times a year in some people and as often as several times a day in others, according to the Mayo Clinic.
It may even work as well as selective serotonin reuptake inhibitors (SSRIs), according to University of Maryland Medical Center (UMMC). In fact, this disorder appears less common in places in the world where people consume fish rich in omega-3s on a regular basis. Finally, I offer provisional guidelines for the safe, judicious use of select CAM therapies as adjuvants in both phases of bipolar disorder. Use herbal remedies under the supervision of a doctor, especially if you take medicine for bipolar disorder or any other condition.

SSRIs are a common type of antidepressant that include citalopram, fluoxetine and sertraline.
Your body converts this into eicosapentaenoic acid, or EPA, and docosahexaenoic acid, or DHA--the omega-3s found in fish oil, according to UMMC. John’s wort may make more serotonin, norepinephrine and dopamine available to your brain.
S-adenosyl-L-methionine, commonly called SAMe, also may be useful if you have bipolar disorder because it supports brain function and helps to alleviate depression, according to the Mayo Clinic. However, the jury is still out on whether SAMe provides benefits for people with bipolar disorder.
However, use it with care because it can interact with medications, including antidepressants. John's wort, use caution with this supplement because SAMe may trigger mania in some people, say the experts at the Mayo Clinic. John’s wort points to its effectiveness for mild to moderate, but not severe, depression, according to UMMC.

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