The Paleo Diet: A Remedy for Bipolar?

Albrecht Dürer's engraving Melencolia I, ca. 1514

A friend, who had been diagnosed as being bipolar, recently told me that he thinks that bipolar is a fake disorder. I was surprised since he’d been diagnosed with the condition since he was a teenager (he’s now 40). He explained why he believed this to be true and to be honest, my journey on this Paleo diet road, has led me to believe the same thing that he was telling me. But not being a doctor, or having seen any studies I could not voice that opinion, certainly not to my friend. But what told me did not surprise me all at. He said that, at least for him, being bipolar was related to diet and exercise.  When he ate better he had fewer episodes of depression and mania.  Can the Paleo Diet be a remedy for bipolar disorder?

What is Bipolar?

From the What is Bipolar website:

Bipolar disorder, also well known as manic-depressive disorder, is a serious mental health condition that causes severe swings in mood. Most people have heard of this disorder and millions of people all around the world have had direct contact with loved ones suffering from this disorder. Yet, people are still wondering: exactly what is bipolar?

The term “bipolar” comes from the idea of moods swinging from one extreme to the other. These extremes seem to be polar opposites, thus the name of the disorder. There are three different mood states that can be experienced by someone with bipolar disorder:

1. Depression
2. Mania
3. Mixed State

The symptoms of bipolar

The depression that bipolar patients go through is much like the depression others experience, but there will be periods of mania as well. This depression often comes with a lack of interest in things that would otherwise interest the patient and severe thoughts of suicide. Many bipolar patients will commit suicide during deep phases of depression so it is important that they be watched closely by loved ones to identify periods of high risk.

Bipolar mania is a state of severe euphoria. The bipolar patient will have an extreme sense of accomplishment and will often take on huge projects. They may decide to go for self improvement and aim for huge amounts of weight loss or they may work around the clock in order to earn large amounts of money.

Mania is often spotted by a person’s lack of need for sleep. They have an enormous amount of energy and will find that they sleep very little. They are also at risk for impulsive acts such as taking off on road trips without telling anyone or going on drug or drink binges. In the manic state they feel no harm can come to them and they have difficult sitting still, staying in one place, or going through ordinary routines of life.

Clearly this is a serious disorder. To be with someone with this condition and to have to watch for the suicidal depression stage is a frightening thought.But so far as I’ve been able to discover the only course of treatment is medication

The Conventional Treatment

The conventional treatment consists of mind altering drugs which “normalize” the mental state. From the National Institute of Mental Health website:

Some of the types of medications generally used to treat bipolar disorder are listed….. Information on medications can change. For the most up to date information on use and side effects contact the U.S. Food and Drug Administration (FDA).

  1. Mood stabilizing medications are usually the first choice to treat bipolar disorder. In general, people with bipolar disorder continue treatment with mood stabilizers for years. Except for lithium, many of these medications are anticonvulsants. Anticonvulsant medications are usually used to treat seizures, but they also help control moods. These medications are commonly used as mood stabilizers in bipolar disorder:
  • Lithium (sometimes known as Eskalith or Lithobid) was the first mood-stabilizing medication approved by the U.S. Food and Drug Administration (FDA) in the 1970s for treatment of mania. It is often very effective in controlling symptoms of mania and preventing the recurrence of manic and depressive episodes.
  • Valproic acid or divalproex sodium (Depakote), approved by the FDA in 1995 for treating mania, is a popular alternative to lithium for bipolar disorder. It is generally as effective as lithium for treating bipolar disorder.23, 24 Also see the section in this booklet, “Should young women take valproic acid?”
  • More recently, the anticonvulsant lamotrigine (Lamictal) received FDA approval for maintenance treatment of bipolar disorder.
  • Other anticonvulsant medications, including gabapentin (Neurontin), topiramate (Topamax), and oxcarbazepine (Trileptal) are sometimes prescribed. No large studies have shown that these medications are more effective than mood stabilizers.

There are very few studies linking diet to the disorder. I found one on Pub Med of which I can only see the abstract:

The ketogenic diet may have mood-stabilizing properties.

Source Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Kentucky 40292, USA.

The ketogenic diet, originally introduced in the 1920s, has been undergoing a recent resurgence as an adjunctive treatment for refractory epilepsy, particularly in children. In this difficult-to-treat population, the diet exhibits remarkable efficacy with two-thirds showing significant reduction in seizure frequency and one-third becoming nearly seizure-free. There are several reasons to suspect that the ketogenic diet may also have utility as a mood stabilizer in bipolar illness. These include the observation that several anticonvulsant interventions may improve outcome in mood disorders. Furthermore, beneficial changes in brain-energy profile are noted in subjects on the ketogenic diet. This is important since global cerebral hypometabolism is a characteristic of the brains of depressed or manic individuals. Finally, the extracellular changes that occur in ketosis would be expected to decrease intracellular sodium concentrations, a common property of all effective mood stabilizers. Trials of the ketogenic diet in relapse prevention of bipolar mood episodes are warranted.

And another which may be of interest:

I did find a message board thread that discusses using a ketogenic diet to reduce the symptoms. Some are off of their medications completely. The discussion thread on lowcarber.org, was about following the Atkins’ diet and going into ketosis to reduce or remove the symptoms of bipolar. There is a second thread with more interesting information.  In reading the discussion I noticed people have made a connection between epilepsy and bipolar, both being severe mental disorders. The known and accepted treatment for epilepsy is a a ketogenic diet, basically the Atkins’ diet. From the second thread - a comment on epilepsy and diet:

He had terrible epilepsy, in mid April he had brain surgery done, anatomical hemispherectomy (where they remove half your brain) …… Well the surgery stopped his daytime seizures, which he averaged about 10 dangerous drop seizures everyday. But for some reason (and the doctors don’t know why) he began having nightly seizures after the surgery. He would have about 20+ tiny seizures throughout the night. They tried every anti-epileptic pill imaginable, even lethal doses of Valium. Nothing worked, until one doctor suggested the Ketogenic diet. We were scheduled to start this diet (they require a hospital stay to initiate a fast) but we had to wait a month before we could get in. So during this wait, his doctor said to just start the Atkins diet for the time being. Since he has been in ketosis, his seizures have gone from 20+ per night down to 0-2 per night. Most nights its zero seizures. His dietician says it takes 3 months to get the full affects of the diet, so we still have another month to tweek the diet and get rid of the last little seizures. We tried this diet before surgery, but it didn’t work – now it’s working. At our last check up, his neurologist was absolutely amazed.

Just a note regarding the surgery above – later in the discussion it is revealed that this child’s brain was severally damaged at birth and that the surgery was required to stop the seizures caused by the damaged tissue.

This section of the thread is from a woman who successfully got herself off medication through diet:

After six months in ketosis, I am now off my bipolar meds altogether. It was a bit rough, went off and back on twice, but the third time appears to be the charm. I have been on Lamictal for years, and finally figured out that the skin rash that my doctor said was a fungal infection was the Lamictal rash. It is totally gone. Yay!….

…. I am completely off my meds now, although it took three tries. Three must be the charm, because it has been about two weeks, and I’m feeling pretty good most of the time. When I get agitated or depressed, I just tell myself it may only be for a day or two – and it usually is. I also try to get my keto reading up to at least 40 if I’m having a bad day. I am working with the doc in Louisville, and he said the keto diet is now my medicine, and the higher my reading, the higher the “dose.” So if I have a bad day, I do hamburger with butter all day, and that usually gets things cleared up in a day or so.

He said I have stayed on the diet longer than anyone he has worked with. It isn’t easy, but then, neither is anger and agitation and depression. My mood is much more stable now, and when it is a little rocky, I seem to be able to deal with it in a more rational manner.

This gives one hope that perhaps a very low carbohydrate diet can help with bipolar. When I asked my friend what he’d been doing to alleviate his symptoms, he said that he cuts out the junk food, reduces the starches, eats a lot of vegetables, protein and coconut oil. Sounds about right to me and rather Paleo.

I know this is not much to go on, but if you suffer from bipolar disorder and want to take control of your life, following a ketogenic Paleo diet may be a possible solution. It doesn’t cost much, since you have to buy food and eat anyway.  And you may lose some weight in the bargain. And it might result in you losing your medications and the elimination of the condition. Isn’t that worth the effort? It might just be that the Paleo diet is a remedy for bipolar disorder.

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4 Responses to The Paleo Diet: A Remedy for Bipolar?

  1. C. Valentine November 13, 2011 at 9:57 pm

    My 23yo daughter is Bi-polar & while she was lived with me up to when she turned 20, her diet was ketogenic & she had such calmness & was channeled. The Dr’s found it uncanny. When she went out on her own & started re-consuming the ‘poor man’s'(really, really SAD diet: Ramen, Doritos, pasta) – all the manic cycles started up again & she found herself trying to balance school being on 3 different types of meds. Was not successful until she moved back in & went back on the Keto diet. It took us almost 5 1/2 monthes to get rid of the BP symptoms again & wean her off meds. She is out on her own again & the same thing is happening…I remind her kindly, but she will do what she wants. I believe she will come back to it on her own – I helped give her the tools. ~C

    • Lila Solnick November 15, 2011 at 10:58 am

      That’s amazing C! If ever there WAS evidence that diet has an effect on bipolar. I am sure she will eventually get back to low carb on her own. At some point she will realize how bad she feels. Thanks for sharing!

  2. jaime November 15, 2011 at 9:44 am

    I think minimizing the symptoms of bipolar through diet is a great idea, if it works. But, one should not abandon her medications. Rather one should work in conjunction with ones doctor to modify dosages or medications as needed. Relying on diet alone to “treat” bipolar disorder seems grossly inadviseable. God forbid one is struck with an intense high or low after having “given up” one’s medications. That would be tragic at best.

    I’m sure anyone with half a brain could see the logical, possible outcomes if one subscribed solely to the ideas proposed in this article.

    • Lila Solnick November 15, 2011 at 10:25 am

      Hi Jaime,
      From what I’ve been able to determine, people abandon their medications only after being certain that following a ketogenic diet really helps. That is they’ve not had any extreme highs or lows for a very long time. I had a lengthy discussion with my friend who is bipolar about this last night. He said he is certain that the crappy diet he had as a child and teenager lead to his becoming bipolar. It took 19 years before he figured out what was going on. Once he corrected his diet he became much better and no longer needs meds. But like all things it is a very individual things. Some people may need to stay on meds regardless of diet. But I suspect that most would be able to get off medication if they altered their diet.
      Thanks for commenting!