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managing bipolar and depression without medication

(boy)friend currently takes prozac for bipolar but has more depressive and anxious leanings than manic ones. in my opinion it really doesn't work for him and he agrees. I think it is going to be time to try something different. anyone had success in managing moods and brain chemicals with diet, exercise, acupuncture, talk therapy, etc. etc. ?
thank you!

I don't have any suggestions but I believe diet can cure many many forms of dis-ease
I know baypuppy has commented specifically on bi-polar issues in the past... baypuppy are you out there??

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I'm diagnosed with bipolar disorder, and don't take any medication.  Mine usually leads to the depressed end of things, too.  The only thing that works incredibly well is exercise!  Social exercise is really great, stuff like group yoga, dance classes, etc.  Outdoor exercise is the best, tough, but then again I just loooove being outside.

Volunteering is really helpful too.  Makes you feel better about yourself, and usually those you help are SOO greatful.  Try the Special Olympics!

And as silly as this may sound, pretending you're happy really improves mood.  It doesn't really work when super depressed and hopeless, though.  Just for little sadness.

So far I havent found anything which helps mania--medication or otherwise.

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Seconding yoga and exercise.

Additionally, if you are interested in nutritional supplements try GABA and a good B Complex.  Saint John's Wart is good for depression, but reduces the effectiveness of birth control pills (not an issue for your bf) and can cause photosensitivity.

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I'm not bipolar, but I had two roommates who were.  They both ate healthy food, exercised a lot, and had a strong social network.

One roommate was on the manic side.  She did things like what AshleyKimball described and it worked for her - she didn't take any medication.

My other roommate was on the depressed side.  She was already doing the same things as my other roommate and tried to stop taking medication, went into a tailspin, and had to start taking medication again.

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I refuse to take medication and I have had success with exercising regularly and eating well too.  Also, what seems to help me the most is a consistent sleep routine.  My husband first noticed that my mood seemed to escalate to up/down extremes most frequently after I had to stay up late to work something, etc.  I go to bed every night at the same time and get 8-9 hours of sleep, period.  My depression/mania is much more manageable, and when I deviate from my sleep schedule I notice more intense moods. 

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I have friends who suffer from bipolar disorder and emphasize too the importance of sleep and structure.

Like thirteenblackbirds said, go to sleep at the same time every night so you get 8-9 hour of sleep. Exercise 3-5 times a week, yoga, walking and outdoor activities help stabilize you, as these activities physically, emotionally and mentally remove you from environments that cause stress, anxiety and instability.

A support system is also important. That means surrounding yourself with people, places and activities(including volunteer work like ashleykimball said) that provide nourishment.

All these natural forms of treatment, though seemingly simple, are extermely effective.

Lastly, if he is interested in medication, he might want to ask his doctor about a mood stabilizer, such as Lamictal, or anti-anxiety medication, like Buspar, which could be more effective for someone with bipolar disorder. Prozac is an anti-depressant and, from what I understand, is prescribed generally to those who suffer from depression.

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I've been diagnoased with Bipolar disorder as well. as a teenager i was put on several medications and slowly weened myself off of them. i've found that exercising is the best method for me, as i've only mild bipolar symptoms

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dude, all i can say is you don't put bipolar people on antidepressants. it usually will manage the depression but kick up the manic episodes.

i have more depressed/pychotic problems. cutting out dairy really helped a lot for me. the other stuff people noted are good too. i'm really stressed out these days (end of semester) and can feel the depression/disorganization in the head kicking in. i should eat more produce. that helps also.

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yeah, i've been down lately too. I just picked up a ton of red kale (my favorite) and some spinach. I'll eat one full bunch of it at every meal until it's gone. always helps me feel better :)

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thanks for all the suggestions! and i am miffed about the prozac as i was just reading today that anti-depressants are bad news for people with bipolar. so no wonder it doesn't seem to help!

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Yes, there have been numerous news stories that have reported that anti-depressants have triggered mood swings, increased suicidal behaviors, and subsequently have prompted more labeling on packaging, as is reported in this Bloomberg newslink.

http://www.bloomberg.com/apps/news?pid=10000085&sid=aPUuBLjesrR4&refer=europe

Also, forgot to add in my earlier post that in addition to 8-9 hours sleep each night, exercise, healthy diet and support system, ... weekly therapy might help. A therapist might be able to help monitor the effectiveness of your boyfriend's Prozac prescription, as well as identify those factors in his life that trigger manic episodes so he can make adjustments in his lifestyle to prevent them from recurring or destabilizing him.

Cashafrass, I think that's great that your boyfriend has someone as sensitive and caring as you to try and find ways to help him manage his mental health.  

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Go to the chiropractor.

One side effect of depression is physical aches and pains.  If he can afford it, he should go to a chiropractor/masseuse.  It's pretty much amazing...shoot it's good even if the masseuse has no idea what they're doing (like a friend or something).

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I think the first thing he would need to do is to understand what triggers his depression if he doesn't already know.

Cognative behavioural therapy is really good for this.

Also I would recommend the book Undoing Depression by Richard O'Connor

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It's a common misconception that when BP symptoms are mild and manic episodes are "hypomanic"--i.e., you feel happy, energetic, creative, as though you are at your best--it's ok to avoid medication.  In fact, many mistakenly enjoy hypomania.  HOWEVER, if left untreated, the symptoms become progressively worse (and more difficult to manage with medication).  The interepisodic period shrinks over time; mood changes become more pronounced; hypomania becomes full-fledged, out-of-control mania and causes tremendous impairment in functioning.  *There is a very fine line betw. hypomania and mania.

BP has a STRONG genetic component; that's why medication is so effective.  Proper outpatient care, minimizing interpersonal stressors and making positive environmental changes (avoiding substances, including caffeine; maintaining a regular sleep/wake cycle; exercising year-round; stabilizing the amount of bright light exposure) are all important, but MEDS ARE A MUST!!!  The mood stabilizer lithium is the most common treatment, but it only works for about 20% of patients, usually people with a family history of BP and long stretches of good functioning, plus it has a LOT of side effects.  Combinations of drugs--anticonvulsants, antipsychotics/sedatives--work for a larger number of patients...it's just a matter of trying out different combos until you find the one that works.  

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thanks for all the suggestions! and i am miffed about the prozac as i was just reading today that anti-depressants are bad news for people with bipolar. so no wonder it doesn't seem to help!

There is a new subtype of bipolar disorder (to be listed in DSM V) called Bipolar III.  Bipolar III starts out as severe unipolar depression (early onset in childhood), but, once the patient is treated with certain medications (antidepressants and/or steroids), he/she starts to experience bipolar disorder.

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BP has a STRONG genetic component; that's why medication is so effective. but MEDS ARE A MUST!!!

Out of the 100+ people I know with severe-mild bipolar disorder, medication has helped 0.  You're very right that it takes a proper balance of drugs to be effective.  An exact mg of this, some mg of that, blah blah blah.  It's physically exhausting, and down right dangerous, to be pumped full of different drugs all the time.  If/when my disorder becomes un-manageable, maybe I will be forced to ingest medication.  But until then, the natural methods and cognitive behavorial therapy work loads better than experimenting with disgusting drug cocktails.

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I agree. I don't think EVERYONE needs medication to manage if other strategies are working for them. It has been very frustrating and counterproductive for my bf to be trying different medications to no avail.  I think lifestyle changes and and therapy should always be the first line of defense in these situations.  plus neither he nor I are enticed by the negative effects of pharmaceuticals on the body. from the all the reading that i have done about bipolar disorder i have seen that there is  a distinct camp of people who say that medication is an absolute must.  In most any situation that is not usually advice that i buy into.

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This is something I know about, both personally and from school (grad school, counseling degree).  I have been diagnosed with Bipolar II disorder.

There are now considered to be two types of bipolar, I and II.  BPI is what we used to call "manic depression."  It is the stereotypical high flying mania, high spending and/or addictive, seductive extremely manic behavior punctuated by extreme depression.

Bipolar II people are hypomanic.  Literally, this is "below mania."  Hypomania is usually what leads a BPII to seek help.  It feels like one's life is totaly out of control.  Where a BPI might enjoy the energy of mania, a BPII feels as though life has gotten out of control. Hypomania can be many things:  Anger, low frustration threshold, not sleeping well or very little, increased energy without the feeling of accomplishing anything, talking too fast and too much, to name a few.  This tends to be what punctuates the longer times of depression because a lot of BPII people live in the depression mood much more of the time than they experience hypomania.

You DO NOT put someone with bipolar on an SSRI, of which Prozac is one of many (Zoloft, Paxil, Lexapro, Celexa, Effexor to name some others).  These can trigger mania and can even trigger deep depression with suicidal ideation, intent and action.  They are sometimes given to those with BPI in CONJUNCTION with other medications, but not alone.  From my personal experience, I have found these drugs can vary in the reactions they trigger, even when taken in very minute doses. 

Of note, you can't give SNRIs to bipolar people either.  These drugs are close to SSRIs and can trigger similar reactions.  Some of the ADHD drugs on the market are SNRIs, Strattera in particular.  It is a black labeled drug at this point.  I took it at the same time I was taking prednisone in 2004 and I nearly died, but survived the stroke that ensued, though it took me a good 6 months to type again (I am an MT and I transcribe for a living) and my balance is still not very good. 

The problem with "mental illness" if I can use that term in relation to depression (I didn't say I agreed with that idea, I don't !) is that people are not being properly treated.  It is widely known that 80% to 90% of the antidepressants prescribed in the USA are prescribed by primary care physicians, who are not trained and not experienced in this particular facet of medicine.  My problems with SSRIs stem from a GP who felt she had simply not found the magic pill to fix my depression and I ended sick in the hospital a fair number of times from her attempts to treat me.  Most health plans either do not pay for a psychiatrist's care or only in very limited amounts, which has lead to the problem with GPs overstepping their bounds and acting in ways that are frankly unethical.

At this point, I do not take any medication for bipolar disorder.  WHen I did, it was not helpful.  The thought right now is that I am not a bipolar person, but rather a lupus patient with a worsening disease course and a poor prognosis.  The only time I experience depression is when I am beginning a lupus flare.  Being a vegan and understanding that I should sleep when I am tired has made  world of difference and I am very rarely, if ever these days, depressed and never ever hypomanic unless I am given the wrong medication.

You need to get an expert opinion and that means a psychiatrist, to properly diagnose what is really going on and to properly treat it.  My psychiatrist was so knowledgeable and good, he is the one who diagnosed my lupus!  They are worth the money.

Life is short and sometimes the way to go IS better living through chemistry.  Some people cannot manage without medications and the goal isn't to be medication free, it is to be as well and as high functioning as possible.  If that means medications, you take them.

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Thanks for all you input ladydragonfly.  Talking about it today he wants to go and be completely reevaluated and also find a psychiatrist or qualified individual he can work with on a regular basis as his first order of business. i think having all this information is going to help him make informed patient decisions which i hope leads to getting the treatment he needs, i whatever form. 

you have all been extremely informative and helpful, thanks  :)

anyone have any tip on finding the "right" therapist/psychiatrist/etc. ?

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Ladydragonfly1, thank you for that very thorough explanation of bipolar disorder I and II and SSRIs. I want to tell people now who don't understand the distinctions in bipolar disorder and treatments to go to Vegweb and look up your posting. I thank you profusely for that information.

Cashafrass, I suggest you get a referral from a friend or relative you know, and can trust, who is happy with his/her psychiatrist, psychologist or psychotherapist. That will save you a lot of psych-shopping which can be really frustrating. Also, make sure the doctor he sees is covered by his insurance or else you will be paying mucho out of pocket bucks.

Before his appointment, he should be prepared to answer questions about the effectiveness of the meds he is taking now and any prior, as well as how long his mood swings last and what triggers them, if he knows.

I would be very careful about docs who are too pushy with the meds. Choose a doctor who carefully monitors the meds and also works with him on natural ways of managing bipolar disorder through exercise, sleep, healthy diet and other nourishing activities.

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