Bipolar Depression

Question 1

Bipolar depression

Answer 1

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

Question 2

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

Nutritional therapy support

Answer 3

The approach is as for depression, with a particular focus on:

• 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

Vitamin C 500–2000 mg / day

Answer 4

• Lower serum levels associated with nervous system disorders. Could help to reduce heavy metals.

Question 5

Vitamin B6 (P5P) 20–150 mg / day

Answer 5

Increases 5-HT neurotransmission

Question 6

Folate and B12 Folate: 400 mcg+ B12: 500 mcg+

Answer 6

A deficiency in folate and B12 not only causes elevated homocysteine levels and increased inflammation in the brain, but also reduces the amount of available SAMe.

Question 7

5-HTP 50–100 mg

Answer 7

Support 5-HT synthesis

Question 8

Rhodiola rosaea 100–400 mg / day

Answer 8

• Adaptogen. Increases BBB permeability to precursors of dopamine and 5-HT (increasing them)