Can You Manage Bipolar Disorder Without Medication?

Many people want to know, “Can you manage bipolar disorder without medication?” The answer to this is both simple and complex. Managing bipolar disorder without medication is possible for a few, but not many. Read below about possible options for managing bipolar without medications (Do Real, Natural Bipolar Medications Even Exist?).

(Note that if you’re cycling, any type of antidepressant, pharmacological or not, can be dangerous. But if you’re dealing with a prolonged bipolar depression, then these options might be right for you.)

Options for Managing Bipolar Depression Without Medication

Mood stabilizers are the primary treatment for bipolar disorder, but even with them, and certainly without them, bipolar depression can be hard to manage. However, there are options that act as antidepressants that are not pharmacological in nature.

According to Jim Phelps, MD, a noted bipolar specialist, these include:

• Bipolar-specific psychotherapy – many psychotherapies have been shown to be useful in bipolar disorder treatment. These include:
  • Prodrome detection therapy – seeing the signs of a bipolar mood before it is full-blown
  • Psychoeducation – becoming educated about bipolar disorder
  • Cognitive therapy – involves multiple areas of therapy, including building a support team and coping with depression
  • Interpersonal and social rhythm therapy – involves improving personal interactions and creating a routine to help with bipolar disorder
  • Family-focused therapy – involves multiple types of therapy, including psychoeducation and diagnosis acceptance. This therapy also gets the family involved with the person with bipolar disorder.

• Exercise – this is very difficult for most people in a depression to do. Nevertheless, it has been shown that aerobic exercise does create an antidepressant effect. Of course, there are many other benefits to exercise as well such as improved heart health and weight loss.
• Light manipulation – this includes controlling the hours of light and darkness per day as well as when it occurs. Control of blue light (such as the light from electronics) is particularly important. Light manipulation may also work to stabilize mania as well.
• Omega-3 fatty acids (sometimes just called “fish oil”) – research shows that omega-3 supplements do work as antidepressants, but it has a small effect and it takes a long time to work. Also note an omega-3 supplement must:
  • Be highly concentrated so you can get to 1,000 mg (1 gram) of eicosapentaenoic (EPA) per day in two or three pills each day
  • Be at least 60% EPA

• N-acetylcysteine (NAC) – an over-the-counter amino acid that may work to treat bipolar depression but likely is subject to tolerance, like most medications. (Tolerance is when the medication works but then spontaneously becomes ineffective.)
• Thyroid hormone – getting one’s thyroid hormone in an optimal range for bipolar disorder can reduce symptoms. While this does require testing and a prescription, the medication is not psychopharmacological in nature.

Options for Managing Bipolar Mania Without Medication

There are few options for the management of bipolar mania without medications. The following are those with some evidence:

• Magnesium – there is some evidence that magnesium, when combined with a mood stabilizer, effectively treats manic or rapid-cycling states. However, magnesium has been used as an injection; there is no evidence for oral monotherapy use.
• Select amino acids – there is preliminary evidence that leucine, isoleucine, and valine may provide improvement in people with acute mania. See here for more information.
• Phosphatidylcholine (choline) – may reduce the severity of mania and/or depression.
• Proprietary multi-nutrient formula – there is some very early evidence that a proprietary formula containing 36 separate constituents, including chelated minerals, vitamins, and trace elements, may reduce symptoms of mania, depressed mood, and psychosis in bipolar patients.
• Reserpine – an herb that may treat bipolar mania but probably only adjunctive to lithium.

Managing Bipolar II or Bipolar I Without Medication

In short, in almost all of the above cases, the evidence is only preliminary and only available for adjunctive to traditional medication treatment (see also Natural Herbs, Supplements for Bipolar Disorder). While it is understandable that some people may want to manage bipolar disorder without medication, it’s just typically not possible.