Friday, November 3, 2017

Denial

"People expect me to deny my Bipolar Disorder, my experiences with it and its effects. Mostly [they do this] just to make them feel better."  (N. Tracy)

Talk to your doctor about any complementary or integrative health therapy you want to try to make sure you're doing so safely. Managing bipolar disorder may require multiple strategies, including medication and complementary therapies.Consider adding approaches with some science behind them, like St. John’s wort, SAMe, or fish oil supplements, or traditional Chinese medicine.Bipolar Disorder requires managing two distinct categories of symptoms. Manic symptoms may include impulsive behavior, excessive irritability, and anxiety. Depressive symptoms may include a low mood, poor appetite, and emotional indifference.

There aren't many complementary or alternative medicine (CAM) remedies for manic behavior. People who have Bipolar Disorder spend the majority of their time depressed rather than manic. Antidepressants should be taken if they are needed.  The non-pharmacological treatments (combined with prescribed medications) have shown benefit for bipolar depression as follows: [i]

1.   Eye Movement Desensitization and Reprocessing Therapy (EMDR): EMDR uses a supervised program of eye movements, combined with actively remembering traumatic experiences to improve symptoms. This approach can be helpful to people who have Bipolar Disorder and a history of trauma. 

 
2.   Interpersonal and Social Rhythm Therapy: This technique teaches people with Bipolar Disorder to maintain a more regular schedule in all aspects of life, including sleeping, waking, eating, and exercise. It has been shown to improve daily functioning.

 

3.   Light Therapy: People with Bipolar Disorder may have interrupted circadian rhythms, which means their daily biological clock isn’t working well. A number of strategies may help to reset this internal clock and improve bipolar management.

These include timed exposure to periods of light and darkness and a forced change in sleep times. Be sure to discuss these or other similar strategies with your doctor before you try them on your own.

 
4.   Meditation: People who meditate using a supervised mindfulness-based cognitive therapy approach may see a reduction in depression that directly correlates to how many days they meditate. The more they meditated the fewer symptoms they had.

 

5.   Omega-3 Fatty Acids: People with Bipolar Disorder may have extra motivation to start eating more fish that are heavy in Omega-3s (such as Salmon, Mackerel, and Sardines), or they may want to consider taking Omega-3 supplements.

 

The anti-inflammatory effects of Omega-3 fatty acids could help regulate mood. Adding about 300 milligrams of Omega-3s each day to a depression treatment plan can enhance results. In the brain, we think Omega-3s might help with moving neurotransmitters in and out, which may help stabilize moods.

6.   Rhodiola Rosea: This herb has been used for years to help manage stress, and has also demonstrated positive effects on people struggling with depression. While it doesn't ease depression to the extent that an antidepressant will, Rhodiola has fewer side effects. It is a good addition for someone who is on antidepressants and feels like they don't have a lot of energy.

 
7.   S-Adenosyl methionine (SAM-e): SAM-e is a coenzyme found naturally in the body that has been shown to reduce symptoms in people with major depressive disorder.  Sam-e should be used with caution in people with Bipolar Disorder who are suffering from depression because it can actually provoke mania.

 
It should be used only under the direct supervision of a physician. Several clinical trials are now underway to determine the best way to use Sam-e in people with depression-related disorders as well as Bipolar Disorder.

8.   St. John's Wort: This herb is one of the better-known natural mood enhancers. Evidence is mixed on whether St. John's Wort actually has a positive effect on major depression or Bipolar Disorder. St. John’s Wort may help with depression, but can also cause psychosis.

It could interact with many other medications people with Bipolar Disorder may be taking. St John’s Wort has been shown to have similar side effects to some antidepressant medications because it appears to affect the body in a similar way.

9.   Traditional Chinese Medicine: This approach relies on certain herbal combinations and comprehensive changes in diet and daily habits. There is not enough evidence yet to support or rule out Chinese herbal preparations. Some combinations may benefit mood disorders. Work with a practitioner trained in the field in collaboration with your doctors.

 “Bipolar is like being in a roller coaster ride. Sometimes you can predict drop offs and others you just have to hang on because the next turn sends you into an unexpected spiral. Sometimes you are laughing and throwing your hands in the air and then other times you are clinging, simply holding on for dear life screaming it the top your lungs.” (HealthyPlace.com)[ii]



[i] Most of these therapies are safe, and there is limited evidence of negative interactions with prescription medications. Regardless, patients and their family members should actively research these products and discuss options with a psychiatrist before taking them, especially because complementary therapies do not undergo the Sam-e strict review process as pharmaceutical medications.
 
[ii] Adapted from: “9 Natural Therapies for Bipolar Depression” by Sara Calabro
 

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