Unlock Stable Moods: Top Diet and Exercise Tips for Managing Bipolar Disorder

Bipolar disorder is a complex mental health condition characterized by unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks. These mood episodes can range from extreme highs (mania) to severe lows (depression). Managing these episodes effectively often involves a combination of medication and lifestyle adjustments. Diet and exercise play a crucial role in supporting overall well-being and potentially mitigating some of the symptoms of bipolar disorder.

Understanding Bipolar Disorder

Bipolar disorder is marked by dramatic mood swings that can significantly impact a person's life. These episodes can manifest gradually or suddenly, affecting not only mood but also sleep, energy, thinking, and behavior. To be considered an episode, these symptoms must persist for several days and represent a noticeable change from the individual's usual state.

While it was once believed that bipolar disorder affected about 1% of the population, some experts now estimate that it may affect 3% to 4%. Due to the lack of specific laboratory tests and the overlap of symptoms with other psychiatric disorders, bipolar disorder is often misdiagnosed and undertreated.

The Importance of Diet in Managing Bipolar Disorder

While there is no specific "bipolar diet," making informed dietary choices is essential for maintaining a healthy weight and overall well-being. These choices can complement medication and other therapies in managing the condition.

Dietary Recommendations

Avoid the "Western" Style Diet: This dietary pattern, characterized by high consumption of red meats, saturated and trans fats, and simple carbohydrates, is linked to an increased risk of obesity, type 2 diabetes, and heart disease. Reducing the intake of these unhealthy components can contribute to overall health but may not directly impact bipolar disorder symptoms.
Embrace a Balanced Diet of Nutrient-Dense Foods: Prioritize fresh fruits, vegetables, legumes, whole grains, lean meats, cold-water fish, eggs, low-fat dairy, soy products, and nuts and seeds. These foods provide essential nutrients necessary for maintaining good health and preventing disease.
Monitor Caloric Intake and Exercise Regularly: Maintaining a healthy weight is crucial, as individuals with bipolar disorder may be at a greater risk of being overweight or obese. Consult a doctor about strategies to avoid weight gain while taking bipolar medications.

Specific Food Recommendations

Omega-3 Fatty Acids: The American Heart Association (AHA) recommends consuming non-fried fatty fish at least twice a week. Good sources include albacore tuna, anchovies, herring, mackerel, salmon, sardines, and trout. If fish is not a preferred food, consider taking an over-the-counter fish oil supplement. Some experts believe that omega-3 fatty acids may play a role in brain function and behavior and may be helpful for individuals with bipolar disorder, especially those at higher risk of cardiovascular disease or high triglycerides. Some research suggests that omega-3 fatty acids are linked to greater volume in brain areas related to mood and behavior. Walnuts, flaxseed, and canola oil contain alpha-linolenic acid (ALA), which the body converts into omega-3 fatty acids.
Whole Grains: Whole grains are thought to help increase the production of serotonin, a brain chemical that helps regulate mood and behavior. They are also rich in fiber, which helps control weight.
Mangos: Mangos are rich in folic acid, which may help stabilize mood, fiber, which has many health benefits, and potassium, which may help reduce drug side effects.
Citrus Fruits: Lemons, oranges, and other citrus fruits contain folic acid, a nutrient that plays a key role in the development of neurotransmitters. Citrus fruits are also rich in vitamin C, which has a positive impact on mood.
Nuts and Seeds: Several types of nuts and seeds, including walnuts, Brazil nuts, and sunflower seeds, contain the brain-friendly nutrients folate and selenium. Optimal selenium levels in the body are linked to improved mood and fewer depressive symptoms. Nuts and seeds are also packed with fiber.
Root Vegetables: Many root vegetables, including beets, squash, carrots, and sweet potatoes, deliver a host of nutrients, including vitamin C, potassium, fiber, and niacin. The nutrients found in many root vegetables are especially good at improving blood flow to the brain.
Avocado: Avocados are packed with fiber and healthy, unsaturated fats, a combination that can suppress hunger for hours. They also provide niacin and omega-3 fatty acids, nutrients that help the brain function at its best.

Foods to Limit or Avoid

Caffeine: Consume caffeine in moderation and avoid abruptly stopping caffeine use. While caffeine may temporarily boost energy and mood during depressive episodes, it can disrupt sleep, cause nervousness, heart palpitations, and headaches, worsen high blood pressure, and irritate the stomach or esophagus.
High-Fat Meals: Avoid high-fat meals, as they may delay the absorption of some bipolar medications.
Tyramine-Containing Foods: If taking MAO inhibitors, avoid foods high in tyramine, such as overly ripe bananas, tap beer, fermented cheese, aged meats, and soy sauce in high quantities, as they can cause severe hypertension.
Alcohol: People with bipolar disorder are more likely to develop alcohol misuse and dependence. Alcohol is a leading trigger of depressive episodes.
Grapefruit and Grapefruit Juice: Grapefruit juice may increase the blood levels of many psychiatric medications used in bipolar disorder, potentially leading to excessive drowsiness, mental impairment, and toxicity.

Natural Dietary Supplements

Be cautious with natural dietary supplements, as they can interact with bipolar medications. Discuss any natural dietary supplement with your doctor to ensure its safety.

The Role of Exercise in Managing Bipolar Disorder

Exercise can have a positive effect on mood. When you exercise, your body releases endorphins, also known as the brain’s “feel-good” chemicals. Over time, higher levels of endorphins can help you feel better.

Benefits of Exercise

Improved Mood: Exercise releases endorphins, which can elevate mood and reduce symptoms of depression and anxiety.
Reduced Risk of Physical Health Conditions: Exercise can help manage weight and reduce the risk of obesity, heart disease, type 2 diabetes, and metabolic syndrome, which are more prevalent in individuals with bipolar disorder.
Better Sleep: Regular physical activity can improve sleep quality, which is often disrupted in bipolar disorder.
Reduced Anxiety: Compared to sedentary peers, physically active individuals with bipolar disorder had lower levels of anxiety and experienced fewer mood episodes and hospitalizations.

Exercise Recommendations

Aerobic Exercise: Engage in regular aerobic activity, such as brisk walking, cycling, or swimming, to release mood-boosting endorphins.
Mind-Body Practices: Consider incorporating yoga or other mind-body practices to calm the mind and reduce anxiety.
Establish a Routine: Consistency is key. Aim to exercise regularly, even during mood episodes, to maintain the benefits.

Precautions

Mania: Be mindful that a sudden increase in or excessive physical activity is one of the classic symptoms of mania. For some individuals, working out too much could intensify mania.
Consult Your Doctor: Talk with your doctor before starting a new exercise regimen, especially if you are starting a new exercise regimen.

Lifestyle Interventions

Lifestyle interventions in BD targeting nutrition, exercise, wellbeing alongside beliefs, coping strategies and attitudes towards health show promise in reducing the risk of comorbid ailments in BD.

Studies on Lifestyle Interventions

Gillhoff and colleagues tested the effects of a 5-month multimodal lifestyle intervention on BMI compared with standard care. The intervention included three modules focusing on nutrition, motivation, and physical activity. The primary finding of this study was a significant decrease in BMI in the treatment group compared to the control group.
Kilbourne and colleagues also conducted a RCT in the field of lifestyle management in BD and reported positive effects of an intervention involving patient self-management on physical health called ‘Life Goals Collaborative Care’ (LGCC) compared to treatment as usual. LGCC led to reduced systolic and diastolic blood pressure and decreased severity of manic symptoms, but did not lead to a reduction of primary metabolic parameters of interest such as cholesterol and triglycerides levels, and BMI.
Frank et al. recently published a RCT in a sample of BD-I patients with a BMI above 25. After 6 months IRRI was associated with a decrease in BMI. Three physiological measures related to inflammation and neuroendocrinological functioning (C-reactive protein, total cholesterol, instability of total sleep time) led to a faster decrease in BMI.

The Importance of Routine

The highs and lows of bipolar disorder can make life feel chaotic, but establishing a routine can help bring back a sense of control and stability.

Identifying Triggers

Figuring out what sets off your bipolar symptoms is often a trial-and-error process. Keep a journal, noting when your symptoms appear and what you were doing at the time. Share the journal with your doctor or therapist.

Sleep Schedule

During a manic episode, you might find it harder to sleep. A lack of sleep also can trigger more mood symptoms. Try to go to bed at the same time each night and wake up at the same time each morning to keep yourself on a consistent schedule. Avoid anything stimulating before bedtime, like caffeine, alcohol, or engaging with a digital device.

Read also: Food Choices and Mood

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