Bipolar disorder natural treatment

Integrative Treatment of Bipolar Disorder: A Review of the Evidence and Recommendations

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PMC

Discussion

This review examined case report evidence regarding HM-associated mania. Those included were: St John’s wort (Hypericum perforatum); Ginseng (Panax Ginseng); Brindleberry (Garcinia cambogia); ma-huang (Ephedra sinica); “herbal slimming pills”; Herbalife products; Hydroxycut; horny goat weed (Epimedium grandiflorum); “herbal body tonic”; celery root (Apium graveolans), and “herbal mixture.” Where possible the candidate pathophysiological mechanisms are discussed in turn, as are other factors which may have contributed to the onset of mania in the individuals included in the study. There is an inherent difficulty in making attributions regarding the causality of HM on mania as the course of bipolar disorder is unpredictable.

Of the 35 case reports included in this review, 5 were isolated reports of one HM and two cases (both “herbal slimming pills”) were attributed to a contaminant. The remaining 28 cases were accounted for by five HM, all of which were the subject of two or more case reports of mania. Over a publication period of 38 years (1980–2017) this is a small yield of reported concurrence of HM usage and mania. The small numbers and unreliability of discerning and reporting a link between mania and HM preclude any definitive statement as to whether any association is causal or coincidental.

With respect to St John’s wort, there is a high specificity of the stated reason for taking the HM to be for treatment of depression (11 of 14 St John’s wort cases compared to 0 of 21 other HM). There was also greater morbidity in the psychiatric history of the St John’s wort cases (13 of 14 cases compared to 11 of 21 for other HM), in the family history of mood disorder (6 of 14 compared to 2 of 21) and concurrent antidepressant prescribing was more common (4 of 14 compared to 4 of 21). Competing explanations for these patterns include an increased diathesis toward bipolar disorder, fluctuations of established affective illness, antidepressant-associated mania and HM-associated mania. These factors are not mutually exclusive, for instance according to Craddock and Sklar, a family history of bipolar disorder is an important clinical predictor of a likely bipolar course in a patient who presents with one or more episodes of depression even before their first personal episode of mood elevation (55).

The mechanism by which St John’s wort may alter susceptibility to mania is not well understood. As with antidepressants, it is difficult to distinguish spontaneous episodes of mania from St John’s wort-associated switching (56). Angst et al. analyzed the time course and risk factors for a diagnostic change from major depression to bipolar disorders over an average of 20 years from onset. Diagnostic change from depression to bipolar type I occurred in approximately 1% and bipolar type II 0.5% of patients per year (57). In patients with major depressive disorder treated with antidepressants, it has been found that antidepressant-associated mania or hypomania occurs at an average frequency of 3.42% of cases per year, but it is unclear to what extent switching represents undiagnosed bipolar disorder or a direct pharmacological effect of antidepressants (58).

Depression is one of the most commonly cited reasons for using CAM (59). The prevalence of depression in the United States has been reported to have increased between 2005 and 2015 (60). For many patients with depression, HM which are in many countries, predominantly available over-the-counter, may be an attractive alternative to conventional medicines. There is a substantial evidence base from randomized controlled trials supporting the use of St John’s wort in mild-to-moderate depression. In a systematic review and meta-analysis comprising 23 randomized trials of St John’s wort in outpatients with mild-to-moderate depression (N = 1757), it was found that Hypericum perforatum extracts were significantly more effective than placebo (61).

St John’s wort has a variety of actions that may contribute to its therapeutic effects. In vitro, it acts on neurotransmitter regulation, including beta adrenergic and glutamate receptors, and ion channel conductance. Hypericin (an active constituent of St John’s wort) inhibits serotonin reuptake, and 5-HT1A and 5-HT1B receptor changes are associated with prolonged use (62). According to Fahmi et al, in animals, hypericum is effective in three major biochemical systems relevant for antidepressant activity including inhibition of synaptic reuptake of serotonin, noradrenaline and dopamine (26). In the human case reported by Barbenel of concurrent prescribing of St John’s wort and sertraline in a patient following surgery for crypto-orchidism, alteration of testosterone and gonadotrophin levels and interactions of antidepressant and St John’s wort were further considerations.

With five case reports of Ginseng associated mania it was the second most commonly reported HM after St John’s wort. Based on the belief that it is a panacea and promotes longevity, Ginseng root has been used for over 2000 years (63). There are a number of plants that share the common name Ginseng however only three of these are from the genus Panax (Panax ginseng, P. notoginseng and P. quinquefolius). Other “ginsengs” include Siberian (Eleutherococcus senticosus), Indian (Withania somnifera), and Brazilian (Pfaffia paniculata) (64, 65). The most important constituents of Panax ginseng are the ginsenosides, of which 15 different types have been identified (35).

In a systematic review of RCTs examining the efficacy of Panax ginseng root extracts for a number of indications, it was concluded that there is contradictory evidence that Ginseng improves physical performance and immunological measures. It may have beneficial effects on psychomotor performance and cognitive behavior. No trial has confirmed the alleged age-delaying properties of Ginseng. Results suggesting a reduction of blood glucose levels in type-II diabetic patients require further investigation (64, 65). With Panax ginseng, two mechanisms of action in depression have been advocated, firstly, an activating effect of ginsenosides on the HPA-axis resulting in elevated corticotropin and corticosteroid levels (33). Secondly, monoamine signaling could also be affected by ginsenosides (66, 67).

Thirteen of 35 case reports in our study sample involved adverse psychiatric effects of weight loss products including brindleberry (Garcinia cambogia), ma-huang (Ephedra sinica), “herbal slimming pills,” Herbalife products and Hydroxycut. The social stigma of obesity, a desire to lose weight without making drastic lifestyle changes, and frustration at previous failed attempts are commonly reported reasons for using dietary supplements which are readily available and advertised as being “natural” and safe (68).

In one 12-week randomized placebo-controlled trial, Garcinia cambogia failed to produce significant weight loss and fat loss beyond that observed with a placebo (69). In contrast, another double-blind placebo RCT found that Garcinia cambogia reduced abdominal fat accumulation in participants (70). Other human research has confirmed the potential of Garcinia cambogia/HCA in stimulating fat oxidation, increasing serotonin release in brain cortex and normalizing lipid profiles (71). The main active ingredient of Garcinia cambogia is hydrocitric acid which has serotonergic effects and has been implicated in serotonin syndrome (38). Hydrocitric acid is the putative mediator of this HM weight loss effect; it is thought to promote the release and synaptic availability of serotonin thus influencing appetite (41). The effects of Hydroxycut were attributed to the inclusion of Garcinia cambogia in the preparation (49).

Partin and Pushkin, who reported a case of hypomania associated with horny goat weed (Epimedium grandiflorum) proposed that this may have been due to the addition of other unidentified herbs and pharmaceuticals (50). However, these were not explicitly tested for.

Ma-huang (Ephedra sinica) is native to China and Mongolia and contains sympathomimetic compounds known as Ephedra alkaloids. Traditionally used to treat asthma and hay fever symptoms, more recently it has been combined with caffeine or botanical sources of caffeine (for example Guarana) for weight loss purposes (68). In a 6–month RCT of herbal Ephedra/ caffeine for weight loss, it was found that 90/192 mg/day of herbal ephedra/caffeine promoted weight and body fat reduction (72). In another randomized double-blind trial of a herbal supplement containing ma-huang-guarana for weight loss, it was found that the active treatment produced significant effects (73). Ma-huang contains variable amounts of ephedrine congeners which enhance norepinephrine release in central noradrenergic neurons. Ephedrine also has direct agonist activity at alpha and beta-adrenergic receptors (44).

Sibutramine is an appetite-suppressing agent that is a norepinephrine and serotonin reuptake inhibitor, initially developed as an antidepressant (48) its use has been associated with mania (74, 75) and hypomania (76). In a recent analytical study of 447 weight loss products, 119 were found to be adulterated with one or more weight loss compounds including sibutramine, its metabolites benzyl sibutramine and desmethyl sibutramine; phenolphthalein; bisacodyl; furosemide; liothyronine (T3); and thyroxine (T4) (77). This demonstrates the importance of having regulatory bodies oversee CAM manufacturing practices and to regularly assess certain classes of CAM products for adulterants (such as weight loss products). These incidences of mania associated with HM weight-loss products highlight the fact that they may be considered safe and harmless by consumers when they have the propensity to trigger adverse events in vulnerable individuals (78).

Khalid et al. reported a case of mania associated with celery root (Apium graveolans), St John’s wort (Hypericum Perforatum) and venlafaxine. Mania ensued shortly after the ingestion of celery root, which belongs to a group of plants classified as the umbelliferous family, which contain phytoestrogens that are structurally similar to estrogen. In this case the patient developed elevated serum venlafaxine levels after taking celery root for menopausal symptoms, suggesting pharmacokinetic potentiation of the venlafaxine level by the celery root as a likely mechanism of induction of mania (52).

Thirteen of the patients were concurrently taking conventional medicines (as shown in Table S1) as well as HM which may have led to herb-drug interactions resulting in mania. This might result from alterations of absorption, distribution, metabolism or elimination of a conventional drug by a herbal product, that is pharmacokinetic effects (79). Alternatively, there may be synergistic effects of a HM and a conventional medicine reflecting common mechanisms of action such as neurotransmitter regulation. Drug dosage is one important factor in such herb-drug interactions as well as in interactions with underlying biological diatheses (80). In approximately one third of the cases reviewed the dosage of the HM was unknown. This limits the ability to make causal inferences regarding the dose of the HM associated with a manic switch in vulnerable individuals.

For the whole sample the time to onset of manic symptoms from commencing the HM (treatment-emergence interval) ranged between 2 days and 2 years with a median of 4 weeks. None of the HM reported associated with mania diverged notably from this median time to onset of manic symptoms. A treatment-emergence interval of 8–12 weeks is deemed to implicate causality; however, a much shorter interval may be necessary to definitively link cause and effect (81). The manic episodes reported in the cases were mostly treated with conventional anti-manic agents, only two reports indicate the outcome of cessation of the HM alone on the course of mania, one indicating remission in 2 days, the other no improvement following a switch into depression. Thus, no general statement can be made with respect to mania resolution on ceasing the implicated HM.

In addition to the systematic review of HM-associated mania, we also assessed the quality of reporting (Table S2) on the modified Quality Assessment Scale by Agbabiaka, in each of the 26 published case report papers. The case report quality assessment score ratings were low quality (0), lower-medium quality (9), upper-medium quality (10) and high quality (7). There are two algorithm-based rating instruments to assign the probability that an adverse event (in this case mania or hypomania) is related to a given exogenous substance, the Naranjo and the WHO-UMC. Of the cases reviewed only one used the Naranjo scale, none used the WHO-UMC. One study compared the two rating scales and found that the WHO-UMC method was more simple and less time consuming compared to the Naranjo probability scale (82). On the 7 additional quality criteria, the quality of reporting was satisfactory only for the inclusion of botanical name of HM (26 of 35 cases) and to a lesser extent HM dosage (18 of 35 cases). On the remaining 5 criteria less than 10% of papers were compliant. It is noted that many of the reports were published before the advent of defined quality criteria ratings, for example 19 of the 26 papers preceded the publication of the modified Quality Assessment Scale by Agbabiaka in 2008. Future published case reports of adverse events should adhere to such criteria in order to improve their overall quality and inferences which may be made from these articles.

The current review of case reports is subject to a number of limitations. Substance/medication-induced bipolar and related disorder may reflect a switch in a previously unexpressed bipolar diathesis. It is possible that the reports in the scientific literature are subject to a confirmation bias in that clinicians are looking for links between mania and recent use of HM. There is also a possible effect of researcher/ publication bias, which has led to the publication of the included studies. Ethically, it is difficult to replicate studies which suggest a potentially harmful effect of various HM.

The compilation of case histories presents a different sample to that commonly seen in a randomized controlled trial setting where fixed inclusion and exclusion criteria apply. This sample of putative HM induced mania includes a number of patients (n = 7) with a stated past history of a diagnosis of BD and a further 7 patients without a BD diagnosis taking antidepressants. This increases the likelihood that the observed manic episode was attributable to extant bipolar disorder or antidepressant induced switching rather than the HM per se, although interactions of these variables cannot be excluded.

Despite these limitations, however, there are a number of strengths associated with the inclusion of case reports including that the patients, episodes of mania, time course of symptoms and aetiological factors are described in detail, as reflected in Table S1. The authors are generally circumspect in their judgements regarding causality, documenting an observed association, summarizing knowledge regarding possible mechanisms of action, and allowing for the multiplicity of explanations that attend a disorder of unclear etiology and pathogenesis and with a typically fluctuating course.

Concepts of exogenous and endogenous causation of psychoses have been debated over the past century. In 1910, Bonhoeffer proposed that the brain only manifested a few stereotyped mental reactions, whether from exogenous or endogenous origins. He recognized delirium in particular as a presentation that could follow diverse exogenous causes. The typical features in delerium of clouding of consciousness and disorientation form the rationale for categorizing it separately to the psychoses (83). Similarly, in the concept of unitary psychosis, as elaborated by Conrad in 1959, there is no fixed relationship between symptom picture and exogenous factors, the latter potentially triggering a range of symptom pictures (84). Relating these propositions to the current study on case reports of mania associated with herbal medicines, the results are inconclusive because it is restricted to one diagnostic category, mania, and one class of aetiological factors, herbal medicines. Comparisons of reports of herbal medicines associated with the onset of a variety of mental disorders would yield information as to whether the relationship indicates specific aetiologies of a disease (e.g., mania) or a broader relationship whereby a diversity of diagnostic categories (e.g., mania, psychotic depression and schizophrenia) are attributable to a common aetiological factor, the unitarian view.

In summary, the reported co-occurrence of HM usage and mania, whilst inconclusive, provides a plausible signal as to brain mechanisms relevant to the pathogenesis of mania. With the increasing storage of health information in electronic health records and evolving techniques of data mining there are prospects for the widespread application of case report level information to the elucidation of associations and causal links between usage of HM and the occurrence and varied course of mental disorders including BD.

Do Natural Remedies For Bipolar Disorder Exist?

By Sarah Fader

Updated December 06, 2019

Reviewer Aaron Horn

Bipolar disorder is a mood disorder which is characterized by extreme highs and lows. Those highs and lows are called mania and depression. When a person is in a manic state, they might engage in risky sexual behavior, compulsive spending, and make impulsive decisions that could be dangerous. They might sleep very little or not at all during this time, and they may encounter grandiose thinking. When someone is manic or hypomanic, they may become increasingly irritable and on-edge, or they may feel rather euphoric. Their energy levels are increased, and they might experience a heightened sense of creativity.

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The other side of the coin is depression. When a person is in a depressed state, they’ll experience low mood and low energy levels. For some people, this results in possible suicidal ideation or actively trying to harm themselves or end their life. During a depressive episode, one may experience feelings of worthlessness, hopelessness, and loss of enjoyment in activities that they once found pleasure in.

Depression is Real

That said, mental health is complex, and these are only some of the potential symptoms of depression. You can learn more by taking the Beck Depression Inventory or the PHQ9.

If you see these symptoms in yourself, it’s important that you see a mental health professional.

Bipolar disorder is highly treatable with medication and therapy, which are the two main lines of treatment for the condition. If you have Bipolar disorder, it’s important to see a medical doctor and to have a treatment team that can help you with your condition. Having people (including professionals) that you can come to for support regarding your illness is vital. If you’re currently only seeing a medical doctor, it’s important that you see a therapist and psychiatrist as well to make sure that you’re leading a healthy life and managing your illness. You might be wondering if there’s anything else that you can do. Perhaps you’re thinking “what else is out there? Are there natural remedies for Bipolar disorder?”

In addition to medication and therapy, natural remedies can help you manage your Bipolar disorder. Different things work for different people, and for most people, it takes some time to figure out what works for them as an individual. Here are some of the things that you can add to your regimen in addition to medication and therapy:

Lifestyle Changes in Bipolar Disorder

Sleep

Sleep hygiene is extremely important for those living with bipolar disorder. If you do not sleep or sleep too little, it can trigger mania for a person living with the condition. Some people don’t sleep for days and don’t just experience mania, but experience psychosis as well, which can include delusions, hallucinations (both auditory and visual), and more. Sleep is extremely important because it can mitigate how severe a manic episode is. Make sure that you’re doing everything that you can to get a good night of sleep. If you don’t sleep, you might not experience psychosis, but you will experience increased severity of other symptoms such as mood shifts, mood swings, and it can also trigger suicidal thoughts.

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Here Are Some Tips to Help You Get a Good Night of Sleep

Make sure that you have a routine and go to bed and wake up at the same time daily if possible.

Make sure that where you sleep is comfortable and that it’s a place that makes you feel relaxed.

Don’t work or do anything stimulating where you sleep; it’s recommended to cut off screen time a couple of hours before going to sleep. This includes your phone as well as your laptop and television.

  • Make sure that your bed is for sleeping and sex only.
  • Don’t eat a heavy meal too close to bedtime if you find that eating too close to bed impacts your ability to fall or stay asleep.
  • Avoid drinking alcohol to self-medicate; don’t use it as a “nightcap” to try to go to sleep. Alcohol is a depressant, and while it may appear to help you fall asleep, it will actually disturb your sleep patterns and will likely make you feel more depressed in the morning.

Nutrition

Getting adequate nutrition is important. If you’re eating foods that make you feel satisfied, energized, and well-nourished, that is optimal. Many people find that eating sugary or acidic foods at night can really impact their sleeping habits. Getting fresh fruits and vegetables and eating a balanced, nutritious diet is advantageous for physical and mental health. Some medications for Bipolar disorder can raise your blood sugar or cause diabetes, so it is important that you get tested to ensure that you stay healthy. Check the side effect list of your medication and make sure that you’re keeping any potential side effects (such as increased blood sugar or blood pressure) in mind. If you have any concerns about the medication that you’re taking, don’t stop it abruptly. Make sure to check in with your doctor and tell them about your concerns.

Going along with the element of routine, creating a meal plan, or preparing meals for the week may be helpful and decrease stress for some. Make sure that you eat consistent, adequate meals throughout the day. If you struggle with food insecurity, look for resources in your local area such as supplemental nutrition programs and food banks. Engaging in exercise or enjoyable movement regularly is often very helpful for those with the ability to do so.

Exercise

It’s important to make sure that you’re getting out of the house and moving your body. The best way to do this is to go for a walk. Being in nature can be incredibly soothing and refreshing; it’s highly freeing to smell the fresh air and get outside. There was a 2015 study conducted which showed that exercise can greatly help individuals with Bipolar disorder manage their depression. Many people find that it’s an extremely important part of managing their condition and overall wellbeing, so make sure to engage in movement on a regular basis. You might also try something like yoga, swimming, or even a team sport. Find an activity is enjoyable and stress-relieving for you. You don’t need to force yourself to engage in a form of exercise that you don’t like; if you open yourself up to new forms of physical activity, you’ll find something that suits your needs and feels like a good fit for you and your body. We’re all different, so don’t be afraid to try new things.

Living in Moderation

People with Bipolar disorder are at an increased risk for substance abuse. A study indicated that 56% of those living with Bipolar disorder also had problems with drugs or alcohol, so it’s integral to remember the importance of moderation. Many people with Bipolar disorder, especially during mania or hypomania, struggle with impulsivity. The urge to self-medicate can be high, so make sure to reach out for help if you struggle with any of these issues.

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Even if it’s not a matter of substance use, the need to live in moderation can display in a variety of ways. You may notice excessive caffeine intake or compulsive spending behaviors, for example. It’s important to keep all of these behaviors in check and to be honest with yourself because they all play a part in your overall mental and physical wellbeing. If you struggle with comorbid substance use disorder or another mental health condition in addition to Bipolar disorder, be sure to bring up these concerns with a mental health professional as well.

Supplements and Herbs

There are some supplements and herbs that are scientifically proven to help with Bipolar disorder.

Omega 3s

Fish oil is helpful for those living with Bipolar disorder and can decrease the severity of episodes of depression. Omega-3 fatty acids have many benefits and can be an excellent addition to your treatment plan

Magnesium

Magnesium is shown to aid in the treatment of mania, depression, and anxiety, so a magnesium supplement may be especially valuable for you to take if you have bipolar disorder and comorbid anxiety.

Vitamins

Vitamin C and folic acid have been known to help those with Bipolar disorder in a variety of ways, and there’s evidence to show that folic acid helps to improve cognitive function in adults living with Bipolar disorder.

As with anything, it’s important to confirm any additions to your treatment plan, including supplements, with your doctor.

Getting Help

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Most importantly, if you’re living with Bipolar disorder, therapy is the number one thing to start with. Having a point person to discuss your mood disorder with is invaluable. Whether you work with an online therapist or someone in your local area, you deserve to get the help that you need. Here at BetterHelp, we have many mental health professionals that specialize in mood disorders and know about how to treat your condition. Bipolar disorder is highly treatable, so reach out to the counselors at BetterHelp today and let us help you.

9 Natural Therapies for Bipolar Depression

2. SAMe

SAMe, or S-adenosylmethionine, is a coenzyme found naturally in the body that has been extensively researched and shown to reduce symptoms in people with major depressive disorder, according to a review of research published in 2015 in CNS & Neurological Disorders – Drug Targets. But SAMe should be used with caution in people with bipolar disorder who are suffering from depression because it can actually provoke mania, according to the National Center for Complementary and Integrative Health (NCCIH). It should be used only under the direct supervision of a physician.

RELATED: Are You Depressed, Bipolar, or Just Human?

“Anything that is a real antidepressant can cause mania in bipolar people,” Muskin says, “so there is some risk that a patient taking SAMe might become manic.” Several clinical trials are now underway to determine the best way to use SAMe in people with depression-related disorders as well as bipolar disorder.

3. St. John’s Wort

This herb, which is often used in Europe for mood management, is one of the better-known natural mood enhancers. Even so, evidence is mixed on whether St. John’s wort actually has a positive effect on major depression or bipolar disorder. The NCCIH states that St. John’s wort may help with depression but can also cause psychosis, and the agency warns that it could interact with many other medications people with bipolar disorder may be taking. St John’s wort has been shown to have similar side effects to some antidepressant medications because it appears to affect the body in a similar way, according to 2015 research published in the journal Clinical and Experimental Pharmacology and Physiology.

4. Meditation

People who meditate using a supervised mindfulness-based cognitive therapy approach may see a reduction in depression that directly correlates to how many days they meditate. The more they meditated, the fewer symptoms they had, according to a study published in 2013 in Behaviour Research and Therapy.

5. Omega-3 Fatty Acids

People with bipolar disorder may have extra motivation to start eating more fish that are heavy in omega-3s, such as salmon, mackerel, and sardines, or they may want to consider taking omega-3 supplements. That’s because the anti-inflammatory effects of omega-3 fatty acids could help regulate mood, according to research published in 2015 in the Journal of the American College of Nutrition. Adding about 300 milligrams of omega-3s each day to a depression treatment plan can enhance results, according to research published in 2012 in the journal Polish Psychiatry. “If you look at countries where they eat a lot of fish, they have a relatively low incidence of bipolar disorder,” Muskin says. “In the brain, we think omega-3s might help with moving neurotransmitters in and out, which may help stabilize moods.”

6. Light Therapy

People with bipolar disorder may have interrupted circadian rhythms, which means their daily biological clock isn’t working well. A number of strategies may help to reset this internal clock and improve bipolar management, according to a 2012 research review published in Dialogues in Clinical Neuroscience. These include timed exposure to periods of light and darkness and a forced change in sleep times. Be sure to discuss these or other similar strategies with your doctor before you try them on your own.

7. Traditional Chinese Medicine

This approach relies on certain herbal combinations and comprehensive changes in diet and daily habits. There is not enough evidence yet to support or rule out Chinese herbal preparations, concludes a review published in 2013 in Evidence-Based Complementary and Alternative Medicine. But some combinations may benefit mood disorders. Work with a practitioner trained in the field in collaboration with your doctors.

8. Interpersonal and Social Rhythm Therapy

This technique teaches people with bipolar disorder to maintain a more regular schedule in all aspects of life, including sleeping, waking, eating, and exercise. It has been shown to improve daily functioning, according to a study published in 2015 in Bipolar Disorders.

9. Eye Movement Desensitization and Reprocessing Therapy

EMDR uses a supervised program of eye movements, combined with actively remembering traumatic experiences, to improve symptoms. This approach can be helpful to people who have bipolar disorder and a history of trauma, according to research published in 2014 in the journal Psychiatry Research.

Complementary Bipolar Treatments: A Few Words of Caution

“The reality is that there is not a lot of data on complementary therapies for bipolar disorder,” Muskin says. “That doesn’t mean these products shouldn’t be used, but when patients try to find out about them, they shouldn’t expect to be able to go to like The New England Journal of Medicine and download a lot of articles.”

Muskin recommends ConsumerLab as a reputable site where people can go to research complementary therapies. “You can find out whether or not the product you’re buying really contains the product you think it does, as well as what it’s indicated for and whether it has contaminants,” he says. The National Institutes of Health Office of Dietary Supplements also provides an extensive online database of dietary supplements that includes detailed product and manufacturer information.

Most of these therapies are safe, and there is limited evidence of negative interactions with prescription medications. Regardless, patients and their family members should actively research these products and discuss options with a psychiatrist before taking them, especially because complementary therapies do not undergo the same strict review process as pharmaceutical medications.

Additional Reporting by Madeline Vann, MPH.

Natural Herbs, Supplements for Bipolar Disorder

While most stick with conventional, medical treatment for bipolar disorder, others look for natural herbs and supplements for bipolar disorder. While some supplements have shown promise in bipolar treatment when taken alongside pharmacological treatments, no natural herbs for bipolar disorder have been found. That said, herbs for some bipolar disorder symptoms may also show promise.

Natural Supplements for Bipolar Disorder

There are two supplements that have shown usefulness in treating bipolar disorder – specifically in dealing with bipolar depression.

  • Omega-3 fatty acids – The research on this natural supplement for bipolar disorder is “clear” according to Jim Phelps, MD: “This stuff works. Not very powerfully, and it takes a while to get in there.” Omega-3 fatty acids need to be taken in supplement form in order to obtain a therapeutic dosage to help with bipolar depression. Also, you need a highly concentrated version so you can get to 1,000 mg of eicosapentaenoic (EPA) in two or three pills per day and the pills need to contain at least 60% EPA. Note the only studies that support their use add this supplement to traditional treatment; there is no evidence that omega-3 fatty acids are effective when used alone.
  • N-acetylcysteine (NAC) – This is, essentially, an amino acid. The research best supports the use of NAC for bipolar depression in addition to traditional treatment and not for use alone. NAC may also work to treat those with obsessive behaviors.

Both of these are available over the counter and there is a pharmaceutical version of an omega-3 fatty acid as well. Note that you should always check with your doctor before starting a natural supplement for bipolar disorder.

Natural Herbs for Bipolar Disorder Symptoms

As stated above, no studied herbs have shown promise in the treatment of bipolar disorder. However, some herbs have been found to treat the symptoms of anxiety and depression. These herbs may be “natural” but they may also interact with bipolar medications or even make some bipolar symptoms worse for some people so it’s critical to check with a doctor before use.

Natural herbs for the bipolar symptom of depression:

  • St. John’s wort – This has been studied extensively for mild-to-moderate depression and shows effectiveness like traditional antidepressants. It can take four to six weeks for it to work and it interacts with many medications including birth control pills. St. John’s wort should not be used to treat severe depression (St. John’s Wort and the Treatment of Depression).
  • Ginkgo – Preliminary research suggests this may treat depression but possibly only in older adults. Ginkgo can increase the risk of bleeding, especially if taking blood thinners.

Note that anything that acts as an antidepressant such as the herbs above, runs the risk of inducing mania, hypomania or rapid cycling for those with bipolar disorder.

Natural herbs for anxiety:

  • Valerian – This is often used to treat insomnia but sometimes is used to treat anxiety as well although research on its use is mixed. Valerian may be combined with lemon balm or St. John’s wort to treat mild-to-moderate anxiety. Valerian may interact with other drugs that cause a sedating effect such as benzodiazepines, antihistamines and others.
  • Passionflower – A few studies have shown passionflower to have antianxiety effects but more research is needed. As with valerian, this herb can interact with other substances that have a sedating effect.

According to the University of Maryland Medical Center, other herbs that are sometimes recommended for anxiety include ginger, chamomile and licorice. The risks include the following:

“Ginger can increase the risk of bleeding, especially if you also take blood-thinners, such as clopidogrel (Plavix), warfarin (Coumadin), or aspirin. Ginger may also interact with some drugs used to treat high blood pressure. Avoid licorice if you have heart failure, heart disease, kidney or liver disease, or high blood pressure. DO NOT take licorice if you take a diuretic (water pills), anticoagulant (blood thinner), or antidepressant such as Prozac. Chamomile may interact with a number of medications, including blood thinners. People who have or are at risk for hormone-sensitive cancers such as breast, uterine, ovarian, or prostate cancer should avoid taking chamomile. Some people may be allergic to chamomile.”

Additionally, while kava kava has been sometimes suggested for mild-to-moderate anxiety, the Food and Drug Administration has issued a warning concerning dangerous effects on the liver in rare cases.

For more on alternative treatments for bipolar disorder see Can You Manage Bipolar Disorder Without Medication?

Natural treatments for bipolar disorder

Are there any effective natural treatments for bipolar disorder? No natural therapy has been proven as a viable alternative to medication for genuine cases of clinical bipolar disorder.

HOWEVER,there ARE many powerful natural treatments with good evidence to support their use. These natural alternatives are valuable add-ons to medication and should be part of your bipolar treatment
plan.1

Diet is the foundation of physical health. It may also play a much larger role in mental health than we ever realized. The Bipolar Diet helps to both balance moods and fight medication related weight gain.

Other lifestyle factors are also critical in effectively managing bipolar.

Two of the top tips from the Mayo Clinic are:

Reminder

Two other natural antidotes to bipolar disorder are exercise and sleep.

1. NO substance abuse.

2. NO toxic relationships.

Substance abuse and bipolar disorder frequently go hand in hand. However, this kind of self-medication only worsens episodes of both bipolar mania and bipolar depression, and leads to a much worse long-term prognosis.

Unhealthy relationships are a huge negative that can trigger more mood episodes, increase the risk self-destructive behavior and adverse consequences, and contribute to the attitudinal problems that undermine stability and wellness. Of course quitting alcohol, recreational drugs and toxic people are difficult tasks but if you want to treat your bipolar disorder naturally, you will need to develop the discipline to drop certain bad habits and cultivate certain positive habits.

Two other natural antidotes to bipolar disorder are exercise and sleep.

Taking part in regular exercise sessions has long known to deliver profound mental and physical transformation. Exercise has been shown in clinical research to obtain the same benefits in combating bipolar depression as popular antidepressant medications like Zoloft.

Exercise also aids in improving cardiovascular conditioning – important given that people with bipolar
disorder are three times more likely to die prematurely from heart disease, stroke, diabetes and other”lifestyle” diseases.

NEVER underestimate value of strength, resilience, and all-around “wellness” that derives from proper exercise. A “strong body” is more resistant to depression, mania, and the stress that often triggers depression or mania.

Another foundation of physical health that also has profound mental health consequences is SLEEP. YOU MUST maintain good sleep habits and come to terms with the bipolar sleep connection.

Although the lifestyle modifications described above can be very effective in controlling your condition and maximizing your health and happiness, NO natural treatments for bipolar disorder should ever be considered as a
substitute for traditional psychiatric care, including medication.2

In other words, if you really have bipolar disorder, discontinuing medication and counseling is NEVER recommended.

What IS recommended is that these natural treatments for bipolar disorder are integrated into an overall wellness program.

Positive results are almost always fast and obvious.

Natural antidepressants for treating bipolar

Natural treatments for bipolar disorder include natural antidepressants that are proven to be effective in fighting bipolar symptoms.

What are the most effective natural antidepressants for symptoms of bipolar depression?

1. Omega-3 fatty acids

2. Choline

3. Folic acid

4. B vitamins

5. Vitamin C

6. Magnesium

7. Zinc

8. The amino acids taurine and tyrosine.

These dietary supplements can have a significant impact on mood and brain function, and protect people with bipolar disorder from early death due to heart attack, stroke and diabetes. (Bipolar disorder is tied to dramatically elevated risk of early death from from these diseases.)

Omega 3 Fatty Acids, for example, have great potential as mood stabilizers and natural antidepressants. These fatty acids are found in food sources such as cold water fish. Extracted forms of Omega 3 Fatty acid are available in capsule supplements. Regardless of how the Omega 3 Fatty Acids are ingested, they have the potential to reduce anxiety and depression.

Overall, it is important to eat a proper diet when seeking to keep bipolar disorder in check. And this does not mean an exotic diet plan is needed. Simple dietary changes such as increasing protein intake can have a tremendously positive impact since protein will increase the production of norepinephrine and dopamine. These are neurotransmitters that reduce negative bipolar disorder symptoms.

Similarly, a diet of leafy green vegetables can also be quite helpful since they contain folic acid. Folic acid has been shown to help reduce both mania and depression.

A good diet is not just about what you eat. It is also about what you need to stay away from. Those seeking natural treatments for bipolar disorder may wish to stay away from processed sugars, saturated fats, and other unhealthy dietary items. Such poor diet choices are notorious for their ability to depress mood. Refined sugar is known to boost mania and then set the stage for a mood crash. Needless to say, this would not be helpful to anyone wishing to reduce the negative traits of bipolar disorder.

CAUTION: No matter what you may have heard, DO NOT use St Johns Wort or SAMe. Although these may be effective for people with “ordinary” or unipolar depression, they are very dangerous for folks with bipolar disorder as they are known to trigger mania.

See this Mayo Clinic summary on alternative treatments for bipolar disorder.

TMS for naturally treating bipolar depression

For a while TMS (Transcranial Magnetic Stimulation) has seemed like it could be the next big thing.

TMS for depression and bipolar disorder caused particular interest.

The problem is that so far the studies are inconclusive. Some research has shown positive benefits but others have not.

The Mayo Clinic summarizes the existing scientific evidence like this:

“Some research showed that transcranial magnetic stimulation improved depression symptoms, while in other studies it didn’t seem to help. If transcranial magnetic stimulation works for you, your depression symptoms may improve or go away completely. Symptom relief may take a few weeks of treatment.”

However, in 2008 the FDA did ok one TMS device, the NeuroStar TMS brain-stimulating device. This was a clearance, as opposed to a formal approval.

According to the FDA:

“Because the NeuroStar device is not implanted and carries only “moderate” risk, the FDA needed to only “clear” the device and not formally “approve” it.”

The approval was very hard one and followed an initial rejection by the FDA. The FDA’s reluctance stemmed from their perception that clinical trials have not conclusively proven the efficacy of TMS treated. The FDA did recognize studies showing that TMS-treated individuals were twice as likely as those who received a sham treatment to show clinical benefit. However, some of the FDA reviewers expressed concerns that TMS for depression benefits appeared “small,” “borderline,” “marginal,” and “of questionable clinical significance.”

In terms of natural treatments for bipolar disorder, TMS for depression may be worth investigating, but it is not without side effects (and is unsafe for folks with epilepsy or seizure disorders), and does not always deliver measurable results.

Also, it is most likely to NOT work in some of the circumstances where folks may need it most – those who have experienced psychotic breaks and seek to be less heavily medicated, and those who have suffered extended depression (over 4 years in duration) and show a pattern of treatment resistance.

On the up side, it is offered by the Mayo Clinic and some other highly reputable treatment centers.

Conclusion

In terms of natural treatments for bipolar disorder, it seems that depression is more easily treated than mania, with many more natural antidepressants than natural anti-manic agents being available.

The full spectrum of bipolar symptoms are challenging to treat and it is arguable that some traditional treatments, such as lithium (a natural mineral salt) are both “natural” and effective, despite side effects.3Sometimes I am asked about my personal favorite natural treatments for bipolar disorder.

My own experience is that there are some powerful tools that offer extraordinary power for the self management of bipolar symptoms. These are all clinically proven, practical, hands-on and completely natural. Best of all, they are all about self determination! They allow the person with bipolar to manage their own care instead of being a drugged out “zombie”, “child” or “victim”. For example, Mood Charts, Treatment Contracts and Wellness Plans.

We know bipolar disorder requires medication and talk therapy for effective management, but this not the whole story.

Many “natural”, “lifestyle”, or “alternative” treatments provide significant benefit, and should be included in any regime seeking to effectively manage bipolar symptoms and control mood swings.

10 Of The Most Effective Natural Sleep Aids

If you’re a regular reader here, you know I am deeply interested in how to employ natural therapies to help sleep. I’m not alone in that interest: I’m asked all the time about how to treat sleep with supplements and natural remedies.

Over the years, I’ve written in-depth about some of the best-studied, most effective natural sleep aids. As we head into the new year with a focus on prioritizing sleep, I thought I’d share a quick review of some of my top suggestions for natural sleep therapies. These are the supplements that I most often discuss with my patients, and in some cases use for myself and my family.

Below, I’ve shared highlights and key information about some of the top sleep supplements. You can also find links to more in-depth articles for each supplement, which include information about dosing, side effects and interactions with medications and other supplements.

Always consult your doctor before you begin taking a supplement or make any changes to your existing medication and supplement routine. This is not medical advice, but it is information you can use as a conversation-starter with your physician at your next appointment.

CBD: a calming sleep-promoter

People often ask me about whether, and how, to use cannabis for sleep. (I wrote about some dos and don’ts for using cannabis as a sleep tool—you can check it out here.) One of the easiest, most effective ways to harness the relaxing, sleep promoting effects of cannabis? Try using CBD. You’ve probably heard of CBD. It’s showing up everywhere as a therapy to reduce anxiety and improve mental focus. It’s also a natural sleep booster.

How CBD works: CBD, or cannabidiol, is what’s known as a cannabinoid, a group of chemical compounds found in cannabis. CBD is one of the most calming and stress reducing of the cannabinoids—and one of the most helpful to sleep. Unlike THC, another well-known cannabinoid, CBD has no “high” associated with it.

How CBD helps sleep: Research shows CBD can significantly reduce insomnia symptoms. It also can increase overall sleep amounts, according to studies. In particular, CBD has been shown to reduce insomnia in people who suffer from chronic pain. In smaller doses, CBD stimulates alertness and reduces daytime sleepiness, which is important for daytime performance and for the strength and consistency of the sleep-wake cycle. One thing I really like about CBD? New research shows it relieves anxiety without causing changes to healthy sleep-wake cycles.

I’ve been so impressed with the research on the benefits of CBD for sleep, I’ve used it as a key ingredient in my own sleep supplement, the Aktive Sleep Booster.

Other potential health benefits: CBD can be effective in easing symptoms of depression and anxiety. With anti-inflammatory and antioxidant properties, CBD may offer protection for the brain, and against neurodegenerative diseases such as Alzheimer’s.

Read more about how CBD can improve sleep and health.

Melatonin: a key sleep hormone

You’re probably not surprised to see melatonin make my list. This hormone, produced naturally by the body in response to darkness, is essential for sleep. As a supplement, melatonin is one of the most-used and best-researched sleep supplements.

How melatonin works: It often surprises people to hear it, but melatonin does not work as a sedative. Melatonin production is triggered by exposure to darkness, and is a powerful bio time regulator. It improves sleep by helping to strengthen the body’s sleep-wake cycles. Stronger sleep-wake cycles translate into a more consistent sleep routine. When your bio clock is in sync, it can help improve your mood, daytime performance, energy levels and your overall health, including immune function, and regulation of metabolism, digestion, and appetite.

How melatonin helps sleep: Melatonin can shorten the time it takes to fall asleep and increase overall sleep amounts, according to research. It’s been shown to improve quality of sleep and reduce daytime sleepiness and fatigue. Studies also show melatonin may increase REM sleep. It’s during REM sleep that we consolidate and process memory, and prime the regions of the brain associated with learning.

Melatonin can be helpful in reducing the impact of jet lag. (Before I started using the Aktive Sleep Booster to help with jet lag, I used to take melatonin about 90 minutes before bedtime in my new time zone, and made sure to get a dose of bright light exposure first thing the next morning.)

Other potential health benefits: Melatonin may help to guard against cognitive impairment and neurodegenerative disease. It’s also being investigated as a therapy for some cancers. Supplemental melatonin may be effective at improving sleep quality and sleep quantity in people with ASD, and also may help improve daytime behavior. Melatonin has shown promise as a natural treatment for a range of conditions, including fibromyalgia, menopause, and irritable bowel syndrome.

Want to know more about melatonin? I wrote about it here.

Magnesium: a deep-sleep mineral

Magnesium is an important macro-mineral for overall health. A lot of us don’t get enough magnesium in our diets: about half of adults in the United States have a magnesium deficiency.

How magnesium works: Magnesium plays a widespread role in the human body, helping regulate and many essential functions. One of magnesium’s most important roles is to enable healthy enzyme function. Magnesium is involved in more than 300 different enzyme-related reactions in the body’s cells. This mineral helps regulate blood pressure, cholesterol and blood sugar, and helps to control the body’s stress response. Getting sufficient magnesium helps the body maintain healthy levels of GABA, a neurotransmitter that promotes sleep, as well as elevating and stabilizing mood.

How magnesium helps sleep: This mineral has a range of scientifically-backed connections to sleep. Magnesium helps to regulate the body’s bio clock and melatonin. Low levels of magnesium are linked to low levels of melatonin. Research indicates supplemental magnesium can improve sleep quality, especially in people who sleep poorly. Magnesium can also help insomnia that’s linked to the sleep disorder restless-leg syndrome. This mineral can help with symptoms both mild-to-moderate anxiety and mild-to-moderate depression, which in turn can help you rest better.

For my patients who want to add magnesium, I recommend Jigsaw MagSoothe, it is the magnesium I use for myself.

Other potential health benefits: Magnesium helps with stress reduction, contributes to bone health, supports cardiovascular function. Maintaining sufficient magnesium can help to reduce pain, and maintain healthy muscle function.

Interested in learning more about magnesium? I wrote about its healthful, sleep-promoting benefits here.

Valerian and hops: a relaxing, sedating herbal pair

This duo are well-studied, well known herbal supplements for sleep and stress relief. The root of the valerian plant has an ancient history as a sleep aid and a natural remedy for nervousness and anxiety. Hops has been used for centuries to treat sleep and anxiety as well.

How valerian and hops work: Both valerian and hops help to boost production of GABA, a calming brain chemical that promotes sleep. Valerian appears to function primarily as an anxiolytic—an anxiety reducer. Hops also has sedative properties—therapeutic doses of this plant lower body temperature, which contributes to drowsiness.

How valerian and hops help sleep: You can use valerian and hops separately to treat sleep problems. Valerian has been shown to help people fall asleep more quickly, reduce restless sleep, increase sleep amounts, and improve symptoms of insomnia. Research also shows valerian is effective in treating sleep problems linked to menopause. Hops itself can increase sleep time. Studies show these herbal supplements pair well together: according to research, hops may be more effective for sleep when in combination with valerian.

Other potential health benefits: Valerian and hops have both been shown to reduce stress and anxiety. A flavonoid in hops has also been found to help reduce weight gain, lower elevated cholesterol and reduce high blood sugar.

Read more about the sleep and health benefits of valerian and hops, here.

Magnolia bark – a gentle sedative

The bark of the magnolia tree has long been used in traditional medicine to treat sleep issues, protect memory, reduce stress, and help with digestive problems and weight loss. Despite its long history, this natural sleep remedy sometimes gets overlooked.

How magnolia bark works: Magnolia bark is packed with potent natural compounds that have been shown to reduce inflammation and lower anxiety, as well as improve symptoms of depression. Improving these conditions can help sleep. Magnolia bark also acts as a sedative, providing direct benefits for sleep.

How magnolia bark helps sleep: Bioactive compounds in magnolia bark appear to help increase time in both slow wave sleep and REM sleep. Other compounds in magnolia bark lower levels of stimulating hormones adrenaline and cortisol.

Other potential health benefits: Research indicates that magnolia on its own and in combination with ginger can help with depression. It also can ease stress and anxiety. Bioactive compounds in magnolia bark have been shown to protect health of brain cells and support memory and learning.

Here’s a full rundown on the health and sleep benefits of magnolia bark.

Jujube – a nutrient-rich sleep booster

Remember the candy we used to eat at the movies? It was one of my favorites! The jujube fruit is actually a nutritional and therapeutic powerhouse. It’s packed with vitamins, minerals and fatty acids, and has been used for centuries to treat insomnia, as well as pain, stress, and stomach upset.

How jujube works: Compounds in jujube also relax the body and the mind, boosting levels of calming neurotransmitters GABA and serotonin. It also acts as a sedative.

How jujube helps sleep: Studies show jujube can lengthen sleep time and increase time spent in deep, restorative slow-wave sleep and REM sleep.

Other potential health benefits: Jujube contains bioactive compounds that work to reduce inflammation, strengthen the immune system, and lower blood sugar, as well as supporting heart and brain health. Jujube can improve digestive function, and treat constipation.

Wondering if jujube is the right sleep aid for you? Learn more here.

L-theanine – a wakeful relaxer

Are you a tea drinker? If so, you’re getting a dietary dose of L-theanine. This amino acid found in tea leaves.

How L-theanine works: L-theanine elevates levels of GABA, as well as serotonin and dopamine, neurochemicals that regulate emotions, mood, concentration, alertness, and sleep, as well as appetite, energy, and other cognitive skills. At the same time, L-theanine also reduces levels of chemicals in the brain that are linked to stress and anxiety. L-theanine boosts production of alpha waves in the brain, which enhance relaxation, focus, and even creativity. That can make L-theanine a good choice for people who are looking to enhance their daytime relaxation without worrying about becoming sleepy and fatigued during the day.

How L-theanine helps sleep: With its ability to increase relaxation and lower stress, L-theanine can help people fall asleep more quickly and easily at bedtime. Research also shows L-theanine can improve the quality of sleep.

There’s evidence that L-theanine may help improve sleep quality in children with attention deficit hyperactivity disorder (ADHD). A study examined the effects of L-theanine on the sleep of boys with ADHD ages 8-12, and found that the supplement worked safely and effectively to help them to sleep more soundly.

Other potential health benefits: L-theanine has been shown to boost cognitive skills, including attention and focus, memory and learning. It also may help protect against obesity.

There’s more to know about L-theanine, here.

5-HTP – a serotonin booster

5-Hydroxytryptophan—commonly known as 5-HTP—is a compound made naturally in the body. 5-HTP is created as a by-product of the amino acid L-tryptophan. Our bodies don’t make L-tryptophan naturally—we absorb this essential amino acid from the foods we eat. 5-HTP is produced as a supplement from the seeds of a plant, Griffonia simplicfolia.

How 5-HTP works: This compound helps the body to produce more serotonin, a neurotransmitter that regulates mood and sleep-wake cycles. Serotonin is required to make melatonin, a hormone that helps the body’s bio clock stay in sync, and regulates daily sleep-wake cycles.

How 5-HTP helps sleep: Research shows 5-HTP may help shorten the time it takes to fall asleep and increase sleep amounts. 5-HTP can be effective in improving mood, and easing symptoms of stress and anxiousness, which can in turn interfere with sleep. 5-HTP may also be effective in helping to reduce sleep terrors in children.

Other potential health benefits: 5-HTP can help regulate appetite and may make it easier to lose weight. It’s also been shown effective in easing symptoms of depression, anxiety and stress. Research indicates that 5-HTP can help improve fibromyalgia symptoms, including pain, tenderness, daytime fatigue, sleep quality, and anxiety.

Find out more about 5-HTP, here.

Glycine – a sleep-stimulating amino acid

Glycine (also known as 2-Aminoacetic Acid) is an amino acid and a neurotransmitter. The body produces glycine on its own, synthesized from other natural biochemicals. We also consume glycine through food. This amino acid is found in high-protein foods including meat, fish, eggs, dairy and legumes. A daily diet typically includes about 2 grams of glycine.

How glycine works: Glycine is considered among the most important amino acids for the body. It exerts widespread influence over our bodies’ systems, structure, and general health, including cardiovascular, cognitive, and metabolic health. Glycine helps the body make serotonin, a hormone and neurotransmitter that has significant effects on sleep and mood.

How glycine helps sleep: Glycine can improve symptoms of insomnia, and can help you bounce back to healthy sleep cycles after a period of disrupted sleep. A recent study of the effects of glycine as a supplement showed it triggered a drop in body temperature and at the same time helped people both fall asleep more quickly and spend more time in REM sleep. And glycine may help you move more quickly into deep, slow wave sleep.

Other potential health benefits: Glycine has been shown to improve both memory and attention in young adults. Scientists are actively investigating the use of glycine in the treatment of neurodegenerative disorders such as Alzheimer’s disease. Higher levels of glycine have been associated with a lower risk of heart attack, and there’s some evidence that glycine may help protect against high blood pressure. It also may help strengthen bones and joints, and guard against arthritis.

Want to find out more about glycine? I wrote about it, here.

Sweet Dreams,

Michael J. Breus, PhD, DABSM

The Sleep Doctor™

Natural Remedies for Insomnia

Sleep is one of those things that we don’t really think about until it’s gone, and when it’s gone it can feel like the only thing we can think about.

If sleep is a struggle or if you have insomnia while you are in addiction recovery, sleeping pills aren’t really an option. But that doesn’t mean you have to suffer.

The Florida Institute of Technology’s Counseling and Psychological Services emphasize the importance of sleep and describes it as “the body’s way of rejuvenating itself. This process helps replenish the energy stores we have depleted throughout the day, as well as give our organs the opportunity to rest…Lack of sleep can lead to deficiencies in concentration, reaction time and overall alertness.”

Even if you do not have a history of substance abuse, relying on over-the-counter sleeping aids actually hurts more than helps; not only can it lead to a dependence but, as Dr. Buchfuhrer explains, the ‘sleep aid’ in these medications comes from one of the side-effects of antihistamines, which also include “rebound insomnia, anxiety, and dehydration” (Reader’s Digest).

Tonight, try out one or a couple of these natural remedies, tips, and tricks for fighting insomnia:

Certain drinks and foods eaten before bed can help set your body up for a good night’s sleep. Many non-caffeinated, herbal teas can also help, but especially valerian tea: “This herb is found in health food stores, at pharmacies, or from a qualified herbalist, and when brewed into tea, it can reduce the time it takes to fall asleep and produce a deep, satisfying rest” (Reader’s Digest).

In addition to tea, drinking warm milk and honey before bed is a delicious and effective natural remedy for insomnia. Milk increases our brain’s natural sedative, serotonin, and the carbohydrates in honey speed up that process.

Now that you know what you should eat and drink for a good night’s rest, here are some foods and drinks to avoid. FIT recommends that you stop consuming caffeine 3-6 hours before bedtime or else it “can double the time it takes to fall asleep, and quadruple the number of times a person wakes in the night.”

This might sound like a no-brainer, but there are a lot more sources of caffeine than what we typically expect and already avoid around bedtime. For example: decaffeinated coffee, dark chocolate, coffee or chocolate ice cream, energy water, some brands of root beer, Sunkist’s orange soda, cream soda, weight loss pills, and some pain relief medications (Health). Speaking of medication, many prescriptions like “beta-blockers, thyroid medication, decongestants, and certain antidepressants” can also meddle with your sleep cycle, so make sure to talk to your doctor and recovery team about any side effects you are experiencing.

Another natural tip for fighting insomnia is to make sure that your sleeping environment is one that encourages sleep–not just tolerates sleep. According to 6 Things Bedrooms of Good Sleepers Have in Common, a cool dark room is the optimal setting for a good night’s sleep; this would look like simple bedding, pitch-black darkness, and a thermostat set to 65 degrees fahrenheit. Dr. Maas explains that “You want a body temperature where neurons aren’t firing intensely, and that happens when the hypothalamus, the temperature regulator in the brain, is cool.”

Before you go to sleep, turn off the lights and close your curtains, and try to find anything that flashes or shines a small light–clocks, TVs, computers, smoke detectors–and cover them up or turn them away from your bed. Even if you don’t notice them during your sleep, your body might still be sensing them.

Limiting your screen time an hour before bedtime (at the minimum) can also greatly improve your sleep. Dr. Mass emphasizes this point and explains that “these devices put out a lot of blue daylight spectrum light, which blocks the flow of the sleep hormone melatonin and delays sleep onset.” Try switching to a real alarm clock and charging your devices away from your bed or even in another room for just a week to see if you notice a difference.

There are also some tricks you can try when finding the natural remedy that works best for you. Exercising during the day–not too close to bedtime–can decrease the amount of time it takes to fall asleep and improve the sleep itself. And while you’re exercising, try to soak up some sunshine or get exposure to light-therapy, which greatly affects your circadian rhythm (Reader’s Digest).

Finally, developing a routine before bed helps prepare your body for sleep, settle your mind, and get yourself into the habit of getting a good night’s rest. This routine should be tailored to you, but some effective suggestions would be deep breathing, meditation and journaling.

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