Diary of a bodacious dietitian, Mental health

Probiotics for mania in bipolar

Can we help reduce mania naturally?

I have a special interest in bipolar disorder.

Specifically, I’m curious if  there are any natural or nutritional adjunctive approaches to helping treat it. 

My grandmother was bipolar, back when it was called “manic depression”  in hushed whispers at dinner parties.

She was subjected to repeated electroshock therapy and a lifetime of high dose antipsychotics and antidepressants. Manic episodes led her to run through the woods naked fueled by fears of end times.  

The aftereffects of her mania and the drugs to squelch it came with a slew of undesirable consequences- both for her and our family. When I was younger, all I knew was that my grandmother “was crazy” and her hands shook profusely.

Today, I know that she didn’t choose to shake. And she wasn’t crazy (I really don’t like this word). She had a chemical imbalance, and it was not her fault. She was also not her diagnosis. Nor is anyone. 

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She was a painter. She painted the most realistic birds, beautiful and alluring images with abstract backgrounds and bright colors. As with many bipolar sufferers, she was strikingly artistic. She had a collection of poems seemingly 1,000 pages long.

I wish the hushed whispers were about her talents instead of her struggles.

So I was pretty amped when I read the Johns Hopkins School of Medicine study published in print in Bipolar Disorder last month.

Basically, it gives us evidence that manic episodes requiring hospitalization could be decreased with the use of probiotics.

This is HUGE news, guys. Probiotics are live bacteria, and when we take them, they contribute to our almost 3 lbs of live gut bacteria (collectiely called our microbiome). We are discovering more and more that our microbiome has a profound effect on our brain and immune function.

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Bipolar disorder and mania are worsened when we have systemic and neural inflammation, and the Hopkins researchers were testing whether probiotics can help decrease mania by decreasing our inflammation.

They measured inflammatory markers in the 66 study participants- 33 of which were given the probiotics and 33 were given a placebo while they continued with their medication regimens for the 24-week study period.

Results were alarming:

  • In the placebo group, 51.1% (24 of the 33) were rehospitalized compared to 24.2% (only 8 of the 33) in the group who took probiotics.
  • On average, there was a 74% reduction in admission rates in the group taking probiotics vs the group taking the placebo.
  • If hospitalized, those taking placebo only stayed an average of 2.8 days compared to 8.3 days in the placebo group indicating more manageable manic episodes.
  • Those with the highest levels of inflammation as measured by blood markers showed the most profound positive change due to taking the probiotic- there was a 90% reduction in hospitalizations in this group! Amazing.

The study used the probiotics Lactobacillus rhamnosus strain GG and Bifidobacterium animalis subsp. lactis strain Bb12.

Researchers think the probiotics may decrease inflammation thereby decreasing mania; but probiotics also have an impact on stress response, neurotransmitter production, and endocrine pathways.

We are just starting to crack the surface.

Researchers also stress that this is a small study and we need to be careful jumping to conclusions as we don’t yet understand everything that probiotics can influence.

Less severe forms of bipolar and depression have also not always responded to probiotics in studies, but I still think this is a win for the world of mental health.

I’m sure my grandmother would have liked to try a gentle addition to her treatment regimen if it meant she would have less hospital admissions to contend with. 

And in this study, two probiotic strains decreased the number and severity of manic episodes. I hope more studies like this will come out soon- and on a larger scale. 

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