5 Depression / Bipolar Treatments You Might Not Know About
I’ve been in treatment for over a decade now and in that time I’ve had more than my share of doctors. Some doctors have been awful, but some have been great and at the top of their field. And when a doctor at the top of their field sees a treatment-resistant bipolar, they have some treatment options that your average doctor might not think of.
I don’t need to tell you this but I'm going to: do not undertake any treatment, supplement or change in treatment without talking to your doctor first.
- L-methylfolate (often sold as Deplin) – research suggests that some depression is linked to suboptimal folate levels, or, more specifically, the inability of the depressed individual to convert folate into L-methylfolate. Taking folic acid supplements is not effective in this case as the person can’t convert that folate into the needed metabolite. L-methylfolate is available with a prescription, and, in my opinion is well worth trying as there are very few side-effects.
- Omega-3 (sold as Lovaza) - much fuss has been made over Omega-3 fatty acids of late, but the fact of the matter is, some studies support Omega-3 supplement use in the treatment of depression and others don’t. What you should know is that the amounts used in studies are typically far higher than what you will get in a regular supplement and far more than you will get in your diet. Omega-3 is available by prescription which is superior to a regular supplement as the quality is controlled and the dose is known. Talk to your doctor about appropriate dosages for mood disorders and don’t just start this on your own. Again, the advantage with this is that there are few (but some) side effects, and as an additional upside, omega-3s do good things for other parts of your body too.
- Calcium channel blockers – research here is also mixed, but there is some support for using calcium channel blockers for depression, mood stabilization and even mania. This medication is generally prescribed for high blood pressure, so if you have that, you can hit two birds with one stone.
- Thyroid hormones – there is evidence that those with low thyroid hormone levels get depressed, and some evidence to suggest that boosting the thyroid level can help in bipolar and depression. Also note that there is also evidence now suggesting that standard thyroid testing may not correctly identify if you are low on this hormone. This gets really technical, click the above link for details.
- Light therapy – this is one of my favorites because I actually found it helped me wake up and gave me more energy (although didn’t improve my depression). Even if you do not have a seasonal-effective component to your illness, lack of light may be making you depressed. The vast majority of people don’t get enough light and with a light box you can boost the amount you get. Keep in mind that this therapy must be done with a medical-grade light box capable of producing 10,000 lux of light at 18 inches or more and the light must be at the correct angle to your eye – click the above link for more details. Medical light boxes are not cheap so you should get a recommendation before buying one. Also, do not start this on your own as you run the risk of flipping into mania.
All five get complicated as to the science of how they work so make sure you or your doctor understand the appropriate use of each. Again, none of these are things to handle yourself, but they are possibilities to talk to your doctor about.
Tracy, N. (2010, July 22). 5 Depression / Bipolar Treatments You Might Not Know About, HealthyPlace. Retrieved on 2020, June 6 from https://www.healthyplace.com/blogs/breakingbipolar/2010/07/5-depression-bipolar-treatments-you-might-not-know-about
Author: Natasha Tracy
I have bipolar type 2, NOS (rapid cycling) as well as a traumatic brain injury (TBI). I cycle from depression to mania in about 26 days on a fairly regular schedule. I'm treatment resistant. The TBI has made my bipolar disorder much worse, and I'm down and out for about 20 days a month, fairly depressive as well as having TBI-induced ADHD. I stared blankly at the TV for 20 days a month and it was getting to me, like I was just wasting my life. Not even able to sustain a creative outlet. I was in despair and no meds of course really worked. In desperation, my pdoc decided to try me on a "wakefulness" drug called Nuvigil. He thought it might lift me out of my depression and give me more productive days. Airforce pilots use the drug to stay awake and alert on long flights. Okay. Since I had only 3 to 6 days a month where I could DO anything, I decided to try the drug. I took 150 mg, and spent 3 days hallucinating, as the package information warned me might happen. Bad & Scarey. But since I was desperate, a month later, I cut the dose in half ... and miracle of miracles, I went from dull-witted couch potato to a near-hypomania. Energy, thinking, focus. "Wakefulness" does not mean that, if you are tired, it wakes you up: it means, your brain is active in spite of how tired you are. I can't take the drug while I am in the depression, it doesn't work. But, 4 days after my depression has started it does lift my mood. (On my 26-day schedule, before the TBI, I would "normally" cycle out of my depression after 3-5 days.) Obviously, I can't say that Nuvigil would work in someone who WASN'T rapid-cycling and couldn't predict when their depression should start to lift ... but I thought I would mention this drug. It's been a miracle for me. Also note that it's expensive as he**, I think about $30/pill, 150mg. I've been taking the drug since November 2012, and I'm pretty sure it's experimental. My pdoc didn't even know what dose to prescribe so he did let me figure it out. Since Nov 2012 and my good experience with the drug, he has tried other people on it. I didn't think to ask him WHY or HOW he came up with Nuvigil though, and I did have to tell him what "wakefulness" meant. He seemed to have this idea that Depression tired is the same as didn't-get-enough-sleep tired. I had to tell him that Depression tired means your body is basically shut down FOR you ... it's not really being sleepy. I mean, if depression was just lack of sleep, coffee would help. We'd all be cured like magic. All right, I think I've said everything I needed to.
Thanks for sharing. Interesting areas of research. I always say, if it ain't broke don't fix it. So if it's working for you and you have medical oversight then that's great.
However, for others I must stress there is very little scientific evidence for these substances.
NAC is N-acetyl cysteine which is basically a way of transmitting an amino acid, cysteine. There is extremely limited evidence to suggest it may work for bipolar and a number of other mental disorders. Keep in mind it _may_ pull trace minerals out of the body, but because there is so little research, it's difficult to tell. What few studies have been done mostly use the IV form, which is much, much stronger than taking it orally, so taking it in its currently available form at the drug store might not even get you up to a decent dose, even if it does work.
5-HTP is 5-hydroxytryptophan, a precursor to serotonin. And while this instinctively sounds like a good idea, the research, what little there is, shows little to no benefit. This may be because the compound is broken down in the stomach before it can get to your brain.
Both of these substances have possible side-effects, including mania, and should be discussed with your doctor.
I may include them in an article in the future. Thanks for bringing them up John!
After years of bi-polar I have seemingly cured it with NAC and 5-HTP.
Hi Buzz and Paul,
Actually none of the above really worked for me, except the light gives me more energy, but it's nice when other succeed.
Buzz - glad you found it helpful.
I love this. I've found I have to be involved in my illness (goes without saying,) moreover in it's treatment. I actually moved 2100 mi. to avoid seasonal effective symptoms, started OMEGA 3 and calcium supplements. Does it work for me? Yes. Everybody, I'm guessing not. Keep it coming. Great and thoughtful info.
I can say through my experience that Olive oil caps fortified with Omega 3, theuse of light box during winter months and as much daily exercise and pref as much sunlight as possible certainly helps me through winter months when my mood dips massively compared to the sumer months. I have not taken anti depressives for 3 years now and if I may say, without these tabs I am more able to have a much better love/sex life with my lovely wife