Question:
Alternative Approaches to the Treatment of Manic-Depression?
Answer:
My doctor just sent me this site thought you might find it useful.
http://www.pendulum.org/alternatives/lisa_alternative.htm It is an interesting -- if speculative article. I have a printer-friendly copy of this article if anyone is interested. Warning
it is long -- about 500 lines (approximately 10 pages). I could email it to you
or even post it if there is sufficient general interest in alternative treatment
options for BP.
The following interesting and informative information was taken from:
http://www.pendulum.org/alternatives/lisa_alternative.htm
IMO I do not believe that anyone should rely solely upon these alternative means
to treat their BP condition. I view them as adjuncts and NOT as replacements for
traditional psychoaffective meds. All additives, nutritional supplements, etc.
should be first thoroughly discussed with a knowledgeable psychopharmacologist
or psychiatrist.
INTRODUCTION
------------
Most doctors who treat patients suffering from bipolar depression, as well as
the patients themselves, would probably agree that it is a condition that is
challenging to treat in a fully effective manner. Although an increasing number
of pharmaceutical compounds to address depressions and to stabilize moods are
becoming available, these are not always fully satisfactory for many patients.
Many bipolars, for example, find that medications that are available can lead to
significant side effects, and therefore find themselves having to choose between
living with these unpleasant effects or discontinuing medications (or decreasing
dosages) and somehow learning to manage despite severe mood swings. Others find
that despite an exhaustive trial-and-error process involving different
combinations of drugs, their mood swings continue to present major problems for
them. Finally, many bipolar women who want to have children face the option of
either undergoing extremely difficult mood swings while pregnant or taking a
risk that their children will suffer birth defects, since all of the available
mood stabilizers are known or suspected to be harmful to developing fetuses in
human populations.
This summary of information about alternative medicine is designed to help to
address these problems by giving bipolars an additional tool they can use to
control their illness. In some cases such alternative methods may work in a
complementary way to the use of conventional medications, helping them to work
better or, in some cases, to lower necessary dosages. In other cases,
alternative treatments may be effective on their own, allowing some people to
gradually taper off of their existing medications or (in cases where current
mood stabilizers are deemed unacceptable by the patient and doctor because of
health complications) may help to lessen mood swings to the point where patients
can lead more normal and satisfying lives.
Alternative methods to the management of bipolar disorder tend to work in one or
more of three different ways.
First, some therapies seem to work in a similar fashion to pharmaceuticals, but
with fewer side effects in the direct management of moods. For example,
acupuncture seems to be fairly effective at controlling mania for many people
over the short-term, while the herb St. Johns Wort seems to have activity as an
anti-depressant.
Second, some alternative methods look for alternate explanations for what
psychiatrists may have labeled as manic-depression. For example, food allergies
may cause severe mood swings in some people, and untreated endocrine problems of
all sorts are widely recognized as causing mood difficulties.
Third, some treatments attempt to improve the overall health of the individual,
under the theory that this will allow the body to more effectively fight off
mood problems (especially depressions). Such theories suggest that when an
individual's health becomes taxed, the "weakest link" is the one that is likely
to snap. For some people this means that high blood pressure or heart problems
will occur; for others, that cancer will form; and for still others, that mood
problems will result. It is generally recognized that periods of emotional or
physical stress tend to worsen mood disorders (especially depressions) in many
manic-depressives, for example, and that learning to deal better with stress
(perhaps through psychotherapy) and proper nutritional and exercise habits may
to some extent help to keep the disease under control. Many alternative
practitioners recommend going a step farther, however, and suggest that some
other kinds of more active methods (such as those described below) may provide
additional help.
With a few exceptions, most of the alternative methods described below tend to
address depressions or the short-term mood fluctuations suffered by
"rapid-cyclers" (and generally treated by most knowledgeable doctors with
anticonvulsants) rather than the more "classic" longer-term highs and lows that
are usually treated with lithium. Many alternative practitioners, in fact, state
that despite their best efforts, lithium is still a necessity for some patients,
although they may tend to attempt to minimize the necessary dosage through a
variety of other means. Most alternative practitioners, however, seem to believe
that the need for the long-term use of antidepressants by bipolar or unipolar
depressives can usually be eliminated through the use of alternative treatments,
although it may take a substantial amount of work before this can be
accomplished. The use of anticonvulsants such as Depakote and Tegretol seems to
fall somewhere in the middle of the two extremes: although the use of
alternative methods may help many patients to taper off of these medications,
some need to continue to use at least small dosages in order to remain stable.
(It should be noted that since most antidepressants increase rapid-cycling in
many patients, the elimination of the antidepressants may make these drugs less
necessary.) In many cases, however, decreasing the dosage of anti-manic agents
is almost as desirable as eliminating the need for medications entirely, since
side effects tend to be substantially less at smaller dosages for most patients.
Most of the therapies listed below tend to be relatively safe and have few side
effects for most people. Nevertheless, a few points should be kept in mind.
First, the patient's doctor should be kept aware of the types of alternative
treatments that are being used, and should closely monitor any positive or
negative effects that might occur as well as any attempts to decrease the
dosages of any medications that are being used. Manic-depression is a serious
illness that may have fatal consequences if inadequately treated, and
psychiatric medications may have severe side effects if they are discontinued
too abruptly or not kept in balance with one another. In general most
psychiatrists (especially ones that specialize in medications, who are
preferable for bipolars since their medications are often difficult to manage)
are not very well-versed in alternative methods of treating bipolar disorder and
may put up some resistance or need to be supplied with relevant information
before they will render an opinion. In general if a practitioner strongly
objects to a particular treatment for a particular reason, then it may make
sense to look into other methods instead. On the other hand if a doctor objects
to all non-drug approaches, then the patient may have to take a stand that he or
she wants to try some of these approaches anyway, or may need to find another
doctor if alternative methods are to be pursued.
Let me reiterate that I am not a medical practitioner myself; however, I have
done extensive reading on the topic and have attempted to summarize the
information on a variety of alternative treatments that is widely available or
that has been published in medical journals. However, I strongly encourage you
to use this information only as a starting point, and to read more about the
methods that you are interested in pursuing and/or to seek out appropriate
specialists.
In general although alternative therapies can be helpful, they do seem to
require a substantial commitment on the part of the individual -- they are not
nearly as convenient as simply taking a few pills every day. In addition, using
alternative techniques can be quite expensive, since most insurance companies do
not cover such treatments as acupuncture, nutritional supplements, or even food
allergy testing. Still, for people who find conventional medications to be
insufficient or unacceptable for one reason or another, the availability of
alternative medications can be potentially useful and therefore worth pursuing.
GENERAL BOOKS
-------------
Following are some books that discuss a variety of natural approaches to
treating mood disorders. References of more specific books dealing with
particular types of treatments are listed under the appropriate sections.
"Optimal Wellness", Ralph Golan, M.D., Ballantine Books, New York, 1995.
A wonderful book that discusses a variety of conditions (including most of
those discussed below) that can lead to suboptimal health. For those who want
just one book on the topic of alternative approaches to health (including
mental health), this would be a good choice.
"The Good News About Depression", Mark S. Gold, M.D., Bantam Books, New York,
1993.
Not a "holistic medicine" book per se, but discusses a variety of alternative
diagnoses to depression and manic-depression (including hormonal problems,
nutritional deficiencies, and environmental toxicity) that the author believes
should be ruled out before proceeding with pharmaceutical treatment.
The next four books deal specifically with issues related to alternative
treatments of depression and manic-depression, and provide roughly the same
kinds of information. Any of them would be a good choice.
"Beyond Prozac" by Michael J. Norden, M.D., HarperCollins, New York, 1995.
"Dealing with Depression Naturally" by Syd Baumel, Keats Publishing, New
Canaan, CT, 1995.
"Depression and Natural Medicine" by Rita Elkins, Woodland Publishing,
Pleasant Grove, Utah, 1995.
"Natural Alternatives to Prozac" by Michael T. Murray, N.D.,
