Expert: Jurriaan Plesman, Nutritional Psychotherapist - 7/16/2004

Question
I am Bipolar (type 2) and have 3 children and a spose.  My husband has an understandably difficult time dealing with my depression and with various shortcomings that I have.  I tend to be very forgetful and often struggle with everyday tasks.  I have had trouble maintaining jobs for great lenghts of time and am currently looking for work.  I often start things and don't finish them either because my interest level changes or I deprioritize it, sometimes I'm a bit obsessive.  I no longer express much creatively because of my tendency to be absorbed in a subject.  It can be a good thing, when I need to learn something quickly and apply it to a problem, but most of the time it is inconvenient to my family and unhealty.  I really try to stay level and aware of my surroundings.  I am currently taking medication, prozac, wellbutrin, and neurontin.  

My husband has a hard time dealing with me.  We have been together now for ten years.  Through that time I have made many improvements though it seems to be a slow process.  I know my problems are common for people with bipolar, I was looking for information for my husband on what people with bipolar disorder commenly have problems with, a type of profile, and how their support network can or should help.  It would also be helpful if it included a realistic idea of changing/progress for a bipolar person and some suggestions on how to deal with issues and how to work together to make improvements in relationships/environment.  Any reccommendations would be helpful.  I visited the NIMH site but it doesn't really address on how to cope with someone with bipolar disorder or common personality type symptoms.  I need to find something more practical, less clinical.

Answer
Dear Amy B,

Living with a bipolar person is always somewhat difficult because of the mood swings from high to low and the unpredictability of these symptoms.

Significant partners need to realize that these emotional upheavals are mainly determined by an underlying biochemical disorder that prompt these behaviours, and over which neither the person so afflicted nor the partner have little conscious control. It is not a MENTAL disease as such, but mental experiences are more the symptoms of the underlying disorder. The disorder does not affect a person's intelligence, and this could be the more frustrating as there appears no rational explanation for these mood swings.

Bipolar disorder is usually treated with special medications for bipolar disorder such as lithium carbonate. Some of the side effects of this medication can be reduced by the supplementation of certain nutrients. Lithium carbonate may cause a folic acid and vitamin B12 deficiency, that may be responsible for additional mood swings especially depression. Some times bipolar people have been found to be low in calcium levels. Some studies have indicated that the supplementation with omega-6 or omega-3 (fishoil) may reduce symptoms.

What is perhaps more important is that many bipolar people have been found to have insulin resistance (hypoglycemia), which is a sugar handling problem. It means that the body's cells are not responding properly to insulin, which functions to push glucose across cell membranes, including brain cells. Thus initially blood sugar levels go up and more insulin is produced until there is a sudden drop in blood sugar. The brain is entirely dependent on  glucose as its only source of energy, and hence hypoglycemia affect brain chemistry and behaviour.

The sudden drop of sugar levels can cause brain starvation and the body then produces excess stress hormones, such as adrenaline, that is said to be responsible for the many unpredictable symptoms of bipolar disorder. Adrenaline functions to raise blood sugar levels in case of crises.

Fortunately, hypoglycemia can be treated without recourse to drugs by adopting the hypoglycemic diet. This is a diet low in refined carbohydrates (such as sugar) and high in good quality proteins, consumed in frequent small snacks and supplemented with a number of nutrients, such as vitamin C, zinc, chromium picolinate. Glucose production comes mainly from proteins and hence stabilize sugar concentrations.

After some time on this diet, blood sugar levels will stabilize, and the body will reduce the production of stress hormones, and mood swings, depression will be less volatile. It will also regulate energy levels, so as to allow for a longer span of attention in one's activities. Lowered levels of stress hormones will wash away the feelings of obsessions.

Please read:

“What is Hypoglycemia?”

“The Hypoglycemic diet”


at our web site.

After you have familiarized with the principles of nutritional medicine, have your medications adjusted (reduced or otherwise) with the help of your doctor.

Please discuss with your doctor.

Jurriaan Plesman
Free web site
http://www.hypoglycemia.asn.au