Can You Manage Bipolar Without Medication?
Being diagnosed with bipolar disorder can be devastating. It’s something that no one wants. It can be overwhelming knowing that you will have to take bipolar mood stabilizers for the rest of your life. So, can you manage bipolar without medication? It’s possible, but exceedingly rare, especially for people with more severe forms of the condition, such as bipolar 1.
What Is Bipolar Disorder?
Bipolar disorder involves alternating episodes that are characterized by mania or hypomania and depression. The intensity and frequency of these states vary from person to person. Bipolar 1 can be more severe and involves periods of high mood and energy (mania) and may include episodes of depression, as well. Bipolar 2 is characterized by less extreme highs or hypomania.
Without bipolar mood stabilizers, this condition can be so severe that a person may need to be hospitalized. The disorder can result in serious problems in relationships, work, and other areas of life. As a result, most people diagnosed with bipolar disorder have to stay on medications.
Medications for Bipolar
The first-line treatment for bipolar disorder is almost always medication. Mania and hypomania are typically treated with antipsychotics and bipolar mood stabilizers. Depressive episodes are often treated with mood stabilizers, as well.
One of the most studied and effective bipolar mood stabilizers is lithium. However, this medication carries with it the risk of thyroid and kidney damage. Therefore, frequent blood tests are required. This, along with adverse effects, can make some people stop taking lithium.
All about bipolar medications.
Why Do People Stop Taking Their Medications?
In studies, the majority of people who stop taking their medications do so because of side effects. The medications that are used to treat bipolar disorder can have some pretty nasty side effects, including diabetes, weight gain, movement disorders (tardive dyskinesia and akathasia), sedation, sexual dysfunction, and thyroid and kidney dysfunction.
Besides side effects, people may stop taking medications because they believe that the disorder is gone (due to sustained symptom remission) or they may believe that they never had bipolar in the first place.
Can You Manage Bipolar Without Medication?
There’s very little research evidence for people successfully managing bipolar without medication. For the most part, people who are flourishing with bipolar disorder are taking meds. The few studies that have looked at those managing bipolar without medication have found that they are not managing the disorder well at all. They are continuing to have hospitalizations and manic and depressive episodes.
People who choose not to take medications face the risk of damage to their personal life, work, and other areas of life due to manic episodes. Depressive episodes can result in an increased risk of suicide and self-harm.
Why It’s So Hard To Manage Bipolar Without Medications
Bipolar disorder is a brain disease. It’s associated with imbalances in several key brain neurotransmitters, including norepinephrine, serotonin, and dopamine. Medications help balance these neurotransmitter levels in the brain.
Also, bipolar disorder is a severe and persistent condition. Bipolar episodes recur for around 90 percent of people diagnosed with the disorder. These episodes occur out of the blue. Sometimes its possible to recognize triggers, but not always. You could be doing everything right — not drinking, going to therapy, and exercising and BOOM you have an episode.
Also, bipolar is associated with structural changes in the brain. So, repeated manic episodes damage the brain. Even though the amount of damage is tiny, it adds up with each occurrence. Going off medications increases the risk of manic episodes.
How to pick up the pieces after a manic episode.
What About Homeopathic Remedies for Bipolar Disorder?
You may have seen supplements like fish oil, choline, and St. John’s Wort being touted as being helpful for bipolar disorder. Could these work? The scientific answer is….no.
St. John’s Wort has been found to help mainly with depression, not bipolar disorder. Studies have shown that it may actually increase psychotic episodes in people with bipolar disorder. It can also interfere with the effectiveness of some bipolar mood stabilizer medications.
Fish oil is unlikely to cause harm if you want to supplement with it. However, it’s been shown in studies to not affect bipolar. Some people believe that s-adenosylmethionine may be helpful for bipolar disorder. But studies have shown that it can actually trigger mania. Rhodiola rosea is another homeopathic remedy people claim helps with bipolar. However, looking at the research, it can trigger manic episodes, as well.
What about lithium orotate? It is available over the counter and some people with bipolar disorder claim that it helps with their mood. Lithium orotate is different from lithium carbonate, a prescription mood stabilizer that is used to treat and prevent bipolar mania. Lithium carbonate has been proven to manage bipolar symptoms.
According to the research, there is potential for certain applications of lithium orotate (such as in preventing dementia), but more studies are needed to determine if lithium orotate can help bipolar. Most of the current studies are with animal subjects.
Things That May Help Bipolar Disorder (Besides Meds)
While medications are important in the treatment of this disorder, they are not the only thing that can help you manage the condition. Other strategies may be able to help you reduce medication usage. Therapies backed by research include:
Psychotherapy - Therapy is an important part of the treatment of bipolar disorder. It can help you come to terms with the challenges of living with bipolar. Therapy can also help you learn coping skills to manage symptoms.
Keto diet - Keto diet alone can’t control the symptoms of bipolar disorder. But, it has been studied as a potential treatment. A small clinical trial led by Stanford Medicine researchers found that the metabolic effects of a ketogenic diet improved symptoms of both bipolar and schizoaffective disorder. It is hypothesized that this diet may help stabilize brain chemicals. While the study was small, it is promising.
Lifestyle changes - Home remedies for bipolar disorder include eating healthy, exercising, and following a sleep routine. These interventions are especially helpful for depressive symptoms.
More lifestyle changes to help you thrive.
Working With Your Doctor
If you’re set on managing bipolar without medication and decide to go off mood stabilizers, don’t do so cold turkey. Many psych medications have to be slowly discontinued. This is where you will work closely with your psychiatrist.
If you and your doctor agree that it is safe for you to stop taking your medications, make sure you are connected with a therapist who you trust. A therapist can help you identify warning signs and stay safe while going off medications.
