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The Science & Treatment of Bipolar Disorder

Episode 82 Jul 25, 2022 2h 16m 17 insights
In this episode, I explain the biology, symptoms, causes and types of bipolar disorder (sometimes called bipolar depression). I discuss neuroplasticity and how the brain normally regulates mood, energy, and perceptions; then, I contrast that with the biology of bipolar disorder, which is characterized by extremes of energy and mood, e.g., mania and depression. I outline the mechanisms through which bipolar disorder manifests in the brain, including deficits of interoception and reduced connections between the parietal and limbic systems. I also outline how treatment options (such as lithium) work in part through homeostatic plasticity.’ I discuss not only lithium but also the treatment of bipolar with ketamine, different talk therapies, electroconvulsive therapy, transcranial magnetic stimulation, and nutraceuticals, including Omega-3 and Inositol supplementation. This episode should interest anyone who has or knows someone with bipolar disorder and, more broadly, those interested in how the brain works to create a balance between thoughts, energy levels, focus, and mood. For the full show notes, visit hubermanlab.com.
Actionable Insights

1. Seek Professional Bipolar Diagnosis

If you suspect you or someone you know has bipolar disorder, consult a qualified health professional for accurate diagnosis and treatment, given the condition’s severity and associated risks.

2. Prioritize Prescription Drug Treatment

Do not rely solely on talk therapy or natural approaches for bipolar disorder; instead, prioritize appropriate prescription drug treatments from a board-certified psychiatrist due to the disorder’s severity and suicide risk.

3. Initiate Early Bipolar Treatment

Seek early treatment for bipolar disorder, as interventions like lithium can prevent longer-lasting neural circuit changes and mitigate the disease’s progression.

4. Combine Drug and Talk Therapies

For bipolar disorder, combine drug therapies with talk therapies, as drug treatments are generally necessary, and talk therapies serve as terrific augmentative support, potentially allowing lower drug doses.

5. Monitor Bipolar Symptoms in Others

Be vigilant and increase awareness of bipolar disorder symptoms in yourself and others, especially observing patterns of mania, hypomania, depression, and symptom-free states, as early recognition is crucial.

6. Utilize Family Reports for Diagnosis

For an accurate diagnosis and understanding of bipolar disorder, rely on reports from family members or close acquaintances, as patients often have diminished interoception and may not accurately perceive their own state.

7. Consider High-Dose Omega-3s

Discuss high-dose omega-3 fatty acid supplementation (e.g., 9.6 grams/day) with your doctor, as it shows promise in reducing depressive symptoms and potentially some manic episodes by improving neural membrane fluidity.

8. Engage in Cognitive Behavioral Therapy

Engage in Cognitive Behavioral Therapy (CBT) alongside drug treatments to adjust responses to anxiety-provoking life events, potentially making drug treatments more effective and reducing harm.

9. Explore Family-Focused Therapy

Participate in family-focused therapy to leverage family members’ insights into a patient’s condition and help predict or navigate bipolar episodes, given their unique perspective on the individual’s behavior.

10. Try Interpersonal & Social Rhythm Therapy

Consider Interpersonal and Social Rhythm Therapy (IPSRT) to address social and interpersonal dynamics, which can significantly impact the course and outcomes of bipolar episodes.

11. Implement Supportive Lifestyle Interventions

Incorporate lifestyle interventions such as better sleep, adequate exercise, proper nutrition, healthy social interactions, and regular sunlight exposure to support the nervous system and psyche, but recognize they are supplementary and not a standalone treatment for bipolar disorder.

12. Ensure Daily Hydration & Electrolytes

Drink Element (an electrolyte drink with sodium, magnesium, and potassium, no sugar) first thing in the morning and during physical exercise to ensure proper hydration and electrolyte balance for optimal brain and body function.

13. Cover Nutritional Needs with Greens

Take Athletic Greens once or twice a day to cover basic nutritional needs, address deficiencies, and support microbiome health with probiotics.

14. Supplement Vitamin D3K2

Supplement with Vitamin D3K2, as D3 is essential for brain and body health (even with sun exposure) and K2 supports cardiovascular function and calcium regulation.

15. Drink Non-Smoked Yerba Mate

Drink non-smoked varieties of yerba mate for mild appetite suppression and caffeine, as it stimulates GLP-1 release which causes gut distension and brain satiety.

16. Use Waking Up App for Calm

Use the Waking Up app for meditation, mindfulness, yoga nidra, or NSDR protocols to explore different mental states, improve understanding of consciousness, and restore cognitive and physical energy.

17. Avoid Recreational Drugs for Bipolar

Avoid using cannabis or psilocybin for treating bipolar disorder, as there is currently no significant data supporting their effectiveness for either manic or depressive phases, and they are illegal in many places.