Alternative Treatments for Bipolar Disorder: Holistic and Natural Options

From acupuncture to key supplements, explore holistic strategies to support traditional bipolar disorder treatment safely.

Key Takeaways

• Complementary approaches should support — not replace — prescribed medication, therapy, or other medical treatment.
• Emerging research suggests gut health and metabolic strategies, such as the ketogenic diet under medical supervision, may support mood stability.
• Mind-body practices can help reduce stress and anxiety, but responses vary, and certain techniques may worsen mood symptoms for some people.
• Talk with a healthcare provider before taking supplements, as they can interact with medications or potentially trigger mood shifts.

For someone with bipolar disorder, finding the “right” treatment plan can be a challenge. Bipolar is different for everyone, so there’s no one-size-fits-all approach.

One way you can tailor your treatment to your unique needs is by adding complementary and integrative therapies to the mainstays of medication and therapy. 

But there are caveats. Complementary approaches are not risk-free, and they should never replace standard treatment. 

What Are Holistic and Alternative Treatments for Bipolar Disorder?

The term “complementary and integrative therapies” refers to any healthcare practices that fall outside of conventional medicine, according to Mayo Clinic. Formerly known as complementary and alternative medicine (CAM), this approach is now often described as complementary and integrative medicine, integrative health, or integrative medicine.

By any name, research suggests that complementary and integrative therapy may offer many benefits for people managing a range of mental health diagnoses. However, it’s important to stress that these approaches are generally used alongside medication and therapy, not as replacements for them.

Do Natural Treatments Help Bipolar Disorder?

Some complementary approaches may well support areas such as stress, sleep, anxiety, depressive symptoms, or overall well-being, but evidence varies by therapy type, and more research is necessary.

Helen Lavretsky, MD, an integrative psychiatrist at UCLA Health in Los Angeles, says that complementary and integrative therapies can indeed be useful for people with bipolar — because most of these mind-body therapies target whole-person health, you can use them to improve your overall health, brain health, and reduce stress, she explains.

Meaningfully, integrative therapies can help reduce triggers for new manic or depressive episodes thanks to improved sleep and self-regulation during stressful times, Dr. Lavretsky adds. Increased awareness and control of triggers, moods, and other vulnerabilities — like inadequate sleep or diet — can further help with mood swing management.

But these therapies don’t offer a miracle cure. It takes time and dedication to see results, Lavretsky says. Plus, while some complementary and integrative therapies may work well for some people with bipolar disorder, not every method will produce the same result for everyone; someone may respond well to acupuncture, while another may benefit more from mindfulness-based interventions. More research is needed to better understand how these therapies can support people with severe mental illness, including bipolar, she says.

Here are some complementary and integrative therapies you may wish to consider adding to your treatment regimen for bipolar disorder. Of course, your healthcare provider should be consulted before you try any of them.

Mind-Body Therapies for Bipolar Disorder

Mind-body approaches to treating bipolar focus on the connection between a person’s mental well-being and their physical wellness. They often include practices that help you relax, become more physically and emotionally aware, and better manage your stress. 

For people with bipolar disorder, techniques such as meditation, mindfulness, yoga, and breathing exercises may offer some benefits, but the evidence is still developing. 

Meditation and Mindfulness

According to the National Center for Complementary and Integrative Health (NCCIH), mindfulness is a form of meditation. Many practices fall under the mindfulness umbrella, including sitting in stillness, breathing exercises, reciting mantras, yoga, and more. 

Many modern talk therapies also have a mindfulness twist, including mindfulness-based cognitive therapy (MBCT), which combines mindfulness with cognitive behavioral therapy (CBT). All of these approaches are united in the way they encourage awareness of the present moment without judgment.

You’ve probably heard the buzz about mindfulness-based interventions and their many potential health benefits. These include increased self-control and objectivity, better concentration, and mental clarity.

But this generally rosy picture turns fuzzier for individuals with bipolar disorder. Research into mindfulness-based interventions and bipolar disorder is scarce, and existing results are murky.

“Not much is known about the use of mindfulness and bipolar,” says Lavretsky. Some reviews of the research suggest that mindfulness-based interventions, in general, may not have much of an impact on bipolar’s core symptoms of depression and mania. Still, they may be helpful for treating the anxiety that people with bipolar often experience, she notes. 

Although mindfulness-based interventions could help some people with bipolar alleviate anxiety and depressive symptoms, more research is needed.

Yoga and Breathing Techniques

For people with bipolar disorder, benefits may depend a great deal on the specific mindfulness intervention you select. For instance, a systematic review found MBCT may help with bipolar’s depressive symptoms, says Lavretsky. Likewise, a research review found that yoga may also help you manage bipolar symptoms, including depression. 

However, Lavretsky says earlier research also showed that yoga had the potential to worsen manic and depressive symptoms; paying attention to how a given mindfulness intervention affects your symptoms is recommended.

Breathing techniques can also go a long way in regulating stress, improving focus, and supporting better sleep, according to the Depression and Bipolar Support Alliance (DBSA). Deep breathing techniques like breathing into your diaphragm (belly breathing), box breathing, or 4-7-8 breathing can calm the mind by lowering levels of the stress hormone cortisol. A clinical trial published in 2018 found that deep breathing effectively reduced anxiety in patients with bipolar disorder without any negative side effects.

Supplements and Nutritional Approaches for Bipolar

Researchers are also exploring whether diet, gut health, and certain supplements may help support the management of bipolar. Some of the potential pathways currently being studied include probiotics, ketogenic therapy, and supplements such as vitamins, minerals, and plant-based compounds. As with other complementary therapies, some findings are promising, but overall evidence remains fairly limited, and these strategies are at best possible additions to standard treatment rather than alternatives.

Probiotics

Probiotics are live microorganisms that may be beneficial to your health, according to the NCCIH. You can find them in fermented foods (think kombucha or sauerkraut), supplements, and beauty products. When you think of probiotics, you probably think of gut health first, but they may also offer a path to better management of bipolar disorder.

The idea hinges on a growing understanding that the gut and brain are connected, quite literally, according to Harvard Health Publishing.

“The thought is that if there’s a relationship between the gut and the brain, then balancing the gut microbes could potentially aid in the treatment of mental illness,” says Crystal Obi-Azuike, MD, MPH, a psychiatry resident at Tulane School of Medicine in New Orleans. “This is where probiotic supplements come into play.”

Already, Dr. Obi-Azuike and her colleagues have found differences in gut microbiota composition in people with bipolar disorder versus those without the condition.

Even more excitingly, this same research suggests that changing gut microbiota with probiotics was linked with lower patient rehospitalizations, as well as reduced depressive symptoms and cognitive impairments among those with bipolar disorder, explains Obi-Azuike.

However, don’t expect your doctor to prescribe probiotics to you just yet. While Obi-Azuike and her team concluded that probiotic supplements and other gut-balancing therapies could be effective adjunctive methods for treating bipolar, they also noted that more research is needed.

The gut-brain relationship is complex and not yet completely understood. Stress, genetics, and diet all impact your gut microbiome. It’s also not clear which aspects of the gut microbiome imbalance are specific to bipolar disorder, Obi-Azuike says. 

Probiotics are unlikely to ever be a replacement for core bipolar therapies. “I want to emphasize probiotic use is being studied as a possible adjunct to therapy because taking psychopharmacology consistently is also key to preventing relapse,” she says.

Although research is ongoing, some studies suggest that probiotics can help brain health. You should know that the effectiveness of bipolar disorder medications may also be impacted by changes to your gut health, so consult your doctor before making dietary changes or adding new probiotics to the mix.

Metabolic Ketogenic Diet

If you’re living with bipolar disorder, consuming a ketogenic therapy diet may be good for your brain. For those counting macros, on a keto diet, you’ll aim for around 55 to 60 percent fat, 30 to 35 percent protein, and 5 to 10 percent carbohydrates, according to a detailed breakdown in StatPearls.

Unlike traditional diets that use glucose for energy, ketogenic diets rely on ketones. This shift can provide a different kind of fuel for your body, which might be beneficial, especially considering the metabolic challenges associated with bipolar disorder, per a research-focused summary.

Some research suggests that bipolar disorder may be linked to a metabolic dysfunction — when something goes awry within the body’s process of converting food to energy. This may explain why conditions like metabolic syndrome and insulin resistance occur at twice the rate in those with bipolar disorder compared with the general population, underscoring the complex link between metabolic health and bipolar.

A small pilot study by Stanford Medicine, published in the May 2024 issue of Psychiatry Research, found that a ketogenic diet could improve both metabolic and psychiatric symptoms in individuals with bipolar disorder or schizophrenia.

While the ketogenic diet shows promise as a helpful tool for managing bipolar, it’s crucial to consult your clinician before making any dietary changes, as it could potentially trigger hypomania or mania in some individuals.

Another reason it’s essential to consult a nutritionist or medical professional is to identify which fats are healthy and can contribute to cardiovascular well-being and which may be harmful to heart health. For example, research suggests that omega-3 fatty acids, unlike the omega-6s found in vegetable oils, can be beneficial. Eating fats from sources such as olive oil, avocados, nuts, and oily fish can aid in weight loss and enhance cardiovascular health.

Currently, the wider psychiatric community does not recommend the ketogenic diet as a standard treatment for bipolar without further extensive research to verify its effectiveness and safety. However, ongoing research is exploring its potential, pointing toward possible new treatment avenues in the future.

Nutraceuticals and Phytoceuticals

Nutraceuticals and phytoceuticals may both help lessen bipolar disorder symptoms, especially those associated with mood. Nutraceuticals are nutrient-dense foods or ingredients extracted from those foods, such as omega-3 fatty acids, vitamin D, and zinc. Phytoceuticals, on the other hand, come directly from plants and include supplements like St. John’s wort, saffron, and lavender.

While many nutraceuticals and phytoceuticals have been used for generations to support wellness, researchers are only just beginning to assess them scientifically. They face an uphill battle, as the U.S. Food and Drug Administration (FDA) doesn’t have the authority to regulate the safety or effectiveness of vitamins and supplements, making it difficult to determine the quality of one versus another. Even with these barriers, high-quality research exists, and experts are using these findings to develop clinical guidelines for the use of nutraceuticals and phytoceuticals to address symptoms of brain-based health conditions.

Bipolar disorder may be one of the diagnoses helped by a focus on nutrition and supplements, according to the results of a systematic review of 60 studies. Promising nutraceuticals and phytoceuticals for bipolar include omega-3, folic acid, zinc, coenzyme Q10 (Coq10), and probiotics.

Vitamins and supplements may be a helpful add-on for individuals with bipolar disorder, research suggests. But before adding any to your treatment plan, consult with your healthcare provider, for there may be medication interactions or side effects — like mania or rapid cycling. For example, although St. John’s wort has shown some potential for reducing depression, reports have shown a worsening of psychotic symptoms in some people.

Lifestyle Changes That Support Bipolar Stability

Lifestyle habits are an important pillar of managing bipolar disorder in addition to standard treatment. Consistent sleep, stress reduction, and mood stability, combined with a balanced diet and strategies that support self-regulation, may all contribute to overall well-being and mood stability. 

Physical Activity

It’s common knowledge that physical activity benefits your body. But fewer people are aware of how much being active boosts brain health, including for those with bipolar disorder.

Although not traditionally classified as integrative medicine, the importance of physical activity is well recognized in conventional medicine, with numerous health organizations providing guidelines for minimum activity levels. Its role in preventing and managing bipolar disorder is increasingly being explored.

While experts know that physical activity is good for mental health, the science isn’t settled on why that might be, according to the American Psychological Association (APA). Exercise may boost mood by increasing “feel-good” neurotransmitters such as dopamine and serotonin, as well as brain-derived neurotrophic factor (BDNF), which can promote brain cell growth. Additionally, exercise enhances psychological factors such as self-efficacy while also improving cardiovascular health, reducing inflammation, and improving sleep quality.

Research suggests these benefits may apply to individuals with bipolar disorder as well as the general population. In one small study, people with bipolar 1 or 2 did aerobic and strength training three times a week. After 12 weeks, the majority said their depressive symptoms improved.

As for how much exercise to get, the U.S. Department of Health and Human Services recommends 150 minutes of moderate aerobic activity per week, or 75 minutes of more vigorous activity, for general health. The type of exercise doesn’t matter as much as doing it consistently — going to the gym, running, or biking are all great.

Getting regular physical exercise is beneficial for both body and mind and holds promise for alleviating the depressive symptoms of bipolar. Additionally, because individuals with bipolar disorder are more susceptible to cardiometabolic issues, exercise helps prevent these health complications while its psychological impacts continue to be studied.

Acupuncture and Other Complementary Therapies

Some limited or preliminary evidence suggests that other complementary therapies, such as acupuncture or art therapy, may hold some benefits for bipolar.

Acupuncture

Acupuncture is a traditional Chinese medicine technique in which very thin steel needles — as thin as human hair — are inserted into your skin at “acupoints,” according to Cleveland Clinic. The needles typically remain in place anywhere from a few to 20 minutes. This process helps rebalance your body’s vital energy, or qi, which may encourage natural healing and help alleviate certain health conditions and symptoms. 

“There are some studies supporting the role of acupuncture for bipolar disorder,” Lavretsky says. In one such study, 36 people with treatment-resistant major depressive disorder or bipolar disorder received weekly acupuncture for 12 weeks. The acupoints used were customized to each person’s particular mood and physical symptoms. By the end of the study, people said their mental health was better (with lower levels of anxiety and depression), and their bodies felt better, too (with less insomnia and pain).

Overall, research suggests that an individualized acupuncture treatment plan may help improve the quality of life for people living with bipolar disorder. Still, these findings are small-scale, and, as with many complementary and integrative therapies, more research is needed to understand how best to apply them to manage bipolar disorder.

Creative Art Therapies

Creative art therapy engages the mind, body, and spirit and can be used to improve cognitive and sensory-motor functions, as well as reduce and resolve conflicts and distress, according to the American Art Therapy Association. When you hear “art therapy,” you might think of visual arts, but creative art therapy is more than that. You can work with a creative art therapist who specializes in dance, music, drama, or poetry.

While medications are a keystone of bipolar care, their use comes with tradeoffs. The appeal of creative art therapies is that they can be added to an existing medication regimen to increase your quality of life without also adding to your list of side effects, according to a review published in Psychiatry Research. 

But are creative art therapies powerful enough to support individuals managing a serious condition like bipolar disorder? The Psychiatry Research review (which analyzed 86 studies) suggests that they can be. The review looked into other diagnoses, including major depression and schizophrenia, and found that many types of art therapy can help you minimize symptoms and maximize functioning. Still, questions remain about how exactly these treatments might be tailored to particular conditions and individuals.

When it comes to how creative art therapies work, the jury is also still out. Some evidence suggests these therapies can help you integrate your body and mind, support your holistic health, and possibly reduce inflammation in your brain, according to the same review.

Creative art therapy can be a beneficial expressive form of therapy for those with mental disorders, including bipolar. However, more studies are needed to understand what formats are most effective for which psychiatric conditions.

Animal-Assisted Therapy (AAT)

AAT aims to help your physical, social, emotional, or cognitive functioning, according to the American Veterinary Medical Association (AVMA). It’s a goal-oriented intervention in which a specific animal is chosen as part of your treatment. Many kinds of animals can be therapy animals, including dogs, horses, and birds.

A service dog or emotional support animal can help you manage bipolar disorder by providing emotional comfort and companionship, according to U.S. Service Animals.

This sentiment might ring true for anyone who has loved an animal, but importantly, it’s also a scientifically supported therapy for individuals with bipolar.

One study looked at the role of pets as a support source among 54 adults with long-term mental health problems, including schizophrenia and bipolar disorder. The pets were found to be a beneficial distraction for participants in managing their feelings and dealing with upsetting experiences. The researchers concluded that “Pets should be considered a main rather than a marginal source of support in the management of long-term mental health problems, and this has implications for the planning and delivery of mental health services.”

If you’re interested in animal-assisted therapy, talk to your doctor to see whether it’s a viable option for you and which animal may be the best fit.

Risks of Natural and Alternative Treatments for Bipolar

Complementary and lifestyle approaches may offer benefits for some people with bipolar disorder, but the evidence is often limited, mixed, or we simply need more of it. 

If you’re thinking of adding some complementary approaches to your standard bipolar treatment, it’s worth bearing in mind the risks: Some complementary therapies or supplements may worsen psychosis or mood episodes. Supplements can interact with medications, and changes to diet, supplements, or complementary treatments may affect your current treatment plan, so it’s important to discuss any changes you’re planning to make with your clinician beforehand.

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UPDATED: Originally posted July 3, 2024