Bipolar Depression

Question 1

Bipolar

Answer 1

Characterised by periods of major depression alternating with elevated mood.
* Manic episodes are more intense, longer in
duration and frequently require hospitalisation.

Question 2

Bipolar: Signs and symptoms

Answer 2

• Depressive symptoms include lethargy and worthlessness.
• Psychosis symptoms (in a severe episode) e.g., hallucinations.
• Excessive self esteem; Extreme talkativeness, rapid thoughts,
  inability to concentrate, easily distracted, reduced need for sleep.
• Increase in social or work oriented activities (e.g., ↑ working hours).
• Poor impulse control

Question 3

Bipolar: Nutritional support

Answer 3

• Reducing food sensitivities within the diet.
• Mediterranean / low GL foods with high omega 3 and folate.
• Adequate protein consumption for NT synthesis.
• Remove excessive stimulants (e.g., caffeine; use alternatives, i.e., turmeric latte) and refined sugars.
• Healthy fats (with some evidence supporting the benefits of a ketogenic in bipolar depression), e.g., coconut oil, oily fish, nuts, seeds, avocado.

Question 4

Bipolar supplementation

Answer 4

Vitamin C
Vitamin B6 (P5P)
Folate and B12
5-HTP
Rhodiola rosaea
Magnesium taurate

Question 5

Anxiety

Answer 5

• Anxiety due to a general medical condition.
• Substance induced anxiety.
• Generalised anxiety.
• Panic.
• Acute stress.
• Social phobia; specific phobias.
• Post traumatic stress.

Question 6

Anxiety: Signs and symptoms

Answer 6

• Palpitations , or accelerated heart
• Shortness of breath.
• Sensation of choking, chest pain or discomfort, nausea or abdominal distress.
• Sweating, trembling or shaking.
• Feeling dizzy, unsteady, lightheaded.
• Fear of losing control or going crazy, fear of dying.
• Specific phobias; paresthesia; chills or hot flushes.
• Somatic symptoms: IBS; fibromyalgia or chronic, persistent
  muscle pain; excessive blushing; chronic fatigue.

Question 7

Anxiety: Causes and risk factors

Answer 7

• Stressful, negative life experiences in early childhood or adulthood.
• Chronic stress
• Genetic SNPs
• Nutrient deficiencies
• Inflammation
• Poor gut health
• Sugar and processed foods
• Caffeine
• Alcohol
• Poor sleep

Question 8

Natural approach to anxiety

Answer 8

• CNM Naturopathic Diet with a ‘Neuro Nutrition’ approach:
• Increase antioxidant rich and anti inflammatory foods
• Fresh fruit and vegetables
• Curcumin decreases anxiety through antioxidant and anti inflammatory mechanisms.
• Ensure quality protein to provide amino acids for NT formation and blood glucose balance.
• Optimise omega 6:3 ratio (1:1-1:3)
• Avoid: Caffeine, alcohol, sweeteners, refined carbohydrates and processed foods. Certain additives can trigger anxiety in some individuals.
• Regular exercise; address stress ; diaphragmatic breathing
• Optimise GI health
• Probiotics to support GBA containing
  Bifidobacterium strains, or prebiotics such as
  GOS that feed Bifido . GABA is f ound in fermented
  foods (e.g., tempeh) and germinated brown rice.

Question 9

Anxiety: Supplements

Answer 9

B-complex vitamins
Vitamin C
Theanine
Lemon Balm
Passionflower

Question 10

Anxiety: B-complex vitamins

Answer 10

• As a group are essential for healthy NS function supporting NT production via methylation and decarboxylation processes.
• B6 is especially important for the conversion of glutamate (excitatory) to GABA (inhibitory)
• Shown to reduce anxiety and improve mood.

50-150mg/day

Question 11

Anxiety: Vitamin C

Answer 11

• A co-factor in glucocorticoid synthesis (anxiety increases adrenal output).
• Concentrates in neuron rich areas of the CNS and reduces anxiety by ↓ oxidative stress.

500mg x 3 daily

Question 12

Anxiety: Theanine

Answer 12

• Inhibits glutamate reuptake (competitive receptor binding) and GABA anxiolytic
• Increases alpha brain waves, anxiety and improves mood without sedative effects.
• Longer term intake increases BDNF providing neuroprotective effects.

50-200mg/day

Question 13

Lemon Balm

Answer 13

• Used traditionally for insomnia, anxiety, irritability, depression, colic, nervous dyspepsia.
• Effect thought to be by inhibition of GABA transaminase system, raising levels of GABA.

300-600mg/day

Question 14

Passionflower

Answer 14

• Modulates GABA pathways; appears to bind to benzodiazepine site of GABA receptors.
• Benefits seen for GAD and anticipatory anxiety.
• The constituent chrysin is neuroprotective.