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Harvard Health Blog
Probiotics for bipolar disorder mania
- By Marcelo Campos, MD, Contributor
Bipolar disorder can be a debilitating disease. Dealing with this illness is quite difficult for patients, family, and friends. The manic phases can profoundly disrupt people’s quality of life. The cost is another reason for concern, as patients can be hospitalized for days until their symptoms are well controlled. After discharge there is a high risk of relapse, so careful observation is important to prevent rehospitalizations. But what if a simple supplement could help manage these serious flare-ups?
Bipolar disorder and gut health
There is growing evidence that mood disorders may be related to overall inflammation and to changes in the microbiome, the bacteria that live in our digestive tract. We have learned that probiotics may help improve a variety of health conditions, in part due to an anti-inflammatory effect.
Researchers from Johns Hopkins University School of Medicine designed an interesting study to determine if probiotics could help people discharged from the hospital after a manic flare-up avoid rehospitalization. The study randomized 66 patients with bipolar disorder who were hospitalized for mania and divided them into two groups of 33 patients. They gave a probiotic combination of Lactobacillus and Bifidobacterium species to one group and a placebo to the second group. They asked all patients to continue taking their regular medications for bipolar disorder and followed them for a total of 24 weeks. Before the start of the study, the researchers identified which patients had higher markers of inflammation (that is, people with more overall inflammation in the body).
What this study on probiotics and mania showed
The results were striking. The rates of rehospitalization were 51.1% in the placebo group and 24.2% in the group who took probiotics. On average, the reduction in readmission was 74% lower in the probiotic combination compared with the placebo arm of the study. The most significant finding was an almost 90% reduction of hospitalization in the group with the highest inflammation score who took probiotics. Additionally, patients who took probiotics and were rehospitalized stayed in the hospital on average 2.8 days, compared with 8.3 days for those taking placebo.
The microbiome and mood disorders beyond bipolar
This study adds to the data that suggest gut flora has an effect on psychiatric diseases. We still do not know if an intestinal microbiome disarray is the cause of mania and bipolar disorder. However, this research supports an assertion that overall inflammation is associated with gut inflammation, which in turn can modulate mood disorders, or at least severe cases of mania for bipolar patients. The evidence of a “gut-brain axis principle” is more robust, especially after some studies showing that the type of bacteria that live in our bowels could cause brain inflammation. This most recent research indicates that we could potentially manage the symptoms of severe cases of bipolar disorder merely by changing the makeup of our microbiome.
What now?
A few words of caution before you buy probiotics to address mood changes. The study was small, and the selected patient population had a more severe form of bipolar disorder. Similar studies for patients with milder symptoms of depression and schizophrenia found little to no effect when comparing probiotics to standard treatment. We need a lot more data from high-quality research to change what we currently recommend for the treatment of other psychiatric illnesses.
Yet, this research still has the potential to change practice after patients with bipolar disorder get discharged from the hospital for mania. Adding probiotics to the regular medication regimen is simple, cheap, has no side effects, and appears to be highly effective.
About the Author
Marcelo Campos, MD, Contributor
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Comments
“We still do not know if an intestinal microbiome disarray is the cause of mania and bipolar disorder.” But we do know the antidepressants and ADHD drugs can create the symptoms of bipolar, including mania. And this iatrogenic pathway to a bipolar diagnosis has resulted in millions of people, including over a million children, being misdiagnosed as “bipolar.”
https://www.alternet.org/story/146659/are_prozac_and_other_psychiatric_drugs_causing_the_astonishing_rise_of_mental_illness_in_america
https://www.amazon.com/Your-Child-Does-Bipolar-Disorder/dp/0313381348?SubscriptionId=AKIAIRKJRCRZW3TANMSA&tag=psychologytod-20&linkCode=xm2&camp=2025&creative=165953&creativeASIN=0313381348
From the DSM-IV-TR: “Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.”
And we do know combining the antipsychotics and the antidepressants, which is part of today’s recommended bipolar treatments, can create psychosis and hallucinations, via the central symptoms of anticholinergic intoxication syndrome, aka anticholinergic toxidrome.
https://en.wikipedia.org/wiki/Toxidrome
And we also know that weaning people off of the “bipolar” drug cocktails can result in a drug withdrawal induced “super sensitivity manic psychosis,” too.
Perhaps a good way to prevent most of the “bipolar,” would be to stop passing out the psychiatric drugs, that create the “bipolar” symptoms, like candy?
Do the Harvard doctors know that the head of the National Institute of Mental Health declared “bipolar,” and all the DSM disorders, to be “invalid” disease entities in 2013?
https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml
I have no doubt that the brain and the gut are connected – as manifested in many ways. Generally speaking, the brain/mind/body connection is well documented – work begun, I believe, by Candice Pert. However, I do wonder if there’s a way to know ‘which came first, the chicken or the egg’ – e.g. do these significant mood disorders come from changes in the brain, or inflammation in the gut? And, then too, does it matter, if they are so intimately connected? Since probiotics are good for many things, I’m not quite sure how their benefit for mood disorders is teased out from many other possible impacts. I’m very interested in learning more about this.
Hi there Bob,
Thanks for sharing your insights; a few questions:
– when you mention ‘its the bacteria that assist..’ what bacteria do you refer to?
– and what deficiencies are we talking about? Could you please share practical/ hand on advices for those to book progress?
Thank you so much!
* and out of curiosity, whats your background/ sources?
What probiotics ? There are many.
Is it possible to receive the article on the benefits of Probiotics ?
Just another way to sell yogurt….now they say coffee is good for you…All about $$…..😤
Thank you, I am using probiotics since long period , I notice it started not to work as it has been.
Hi which probiotic brands do you suggest better.
REPLY TO GLEASON–WHAT IS FODMAP?
We need to maintain a Vitamin D3 level of 40-70 year round Optimize magnesium levels(if you kidneys are good. Probiotics with most meals. We have taken too many antibiotics over our lifetimes and need to replenish our beneficial gut flora. Pain levels and depression will improve. Many take meds that deplete vital nutrients Statins deplete CoQ10 levels and cholesterol and we need cholesterol to synthesize Vit D. Also research Fluoridated water and negative health effects.
https://www.ncbi.nlm.nih.gov/m/pubmed/29693757/
This is worrying reporting. Please note that the people who took the probiotics were on medications. It seems to me that the research points to probiotics helping people better absorb medications- this would not be a correlation with it actually helping mania. This is still a positive finding, but the outcome inferences don’t work overall.
I expect more from a Harvard study. Thank you, Julie Fast
Kudos! It’s been tough not to become cynical. I mean, it sometimes seems that medicine has “just discovered” a connection between diet and health. Now that the one-time saviors of technology and drugs are showing their limitations, maybe we can start to focus on what we eat instead. I recently abandoned all drugs for my digestive problems, and switched to a FODMAP diet, and within a week, problems have vanished. Don’t know if this solution is going to prove successful for treating bipolar, but I give it a thumb’s up for heading in the right direction. We need a lot more research, and a lot more researchers with *new ideas* for health. Hopefully this is a major step in the right direction.
What is the best probiotic to buy?
Now probiotics is also for Bipolar Disorder Mania. Just wow! day by day probiotics keep on improving or new research about it appears. A very good thing because probiotics are cheap but gives so much nutrition or benefit to our body. Thank you for this informative one!
What is your factual basis for this statement? Research reference please. It is so easy to state sensible sounding theories but much more difficult to truely establish a valid cause and effect relationship.
and it is not only about this bacteria, there are mycobacterium vaccae too helping with mental disorders https://www.sciencedirect.com/topics/neuroscience/mycobacterium-vaccae
Dirt is great 🙂 .
It’s not the bacteria, it’s the fact that the bacteria assist in nutrient absorption.
The underlying neurological problems are from mineral and vitamin deficiencies.
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