Medications and psychotherapy are the gold standard treatments for bipolar disorder — a mental health condition characterized by episodes of highs (mania) and lows (depression). But if you have bipolar disorder, you may wonder if taking vitamins or other supplements can improve your mood and boost your health, too.
“There can be a role for vitamins and supplements in treating bipolar disorder, but as a complement to the first-line treatment, not as substitutes,” explains Jeffrey J. Rakofsky, MD, a psychiatrist at the mood and anxiety disorders program at Emory University School of Medicine in Atlanta.
Dr. Rakofsky says food sources are the best way to get the vitamins your body needs. “Food is the best way to obtain these vitamins, as supplements don’t always contain the ingredients they claim or are not always fully absorbable once they move through the digestive tract,” he explains.
But if you’re interested in trying supplements, there are some things you should consider first.
- The U.S. Food and Drug Administration (FDA) doesn’t have the authority to regulate the safety or effectiveness of vitamins and supplements, which means it’s hard to know whether a product is high-quality.
- Some vitamins and supplements can interact negatively with medicines you’re already taking, says Rakofsky.
- There’s not a lot of rigorous research on the effectiveness of vitamins and minerals for bipolar disorder, says Vanika Chawla, MD, a psychiatrist at Stanford Lifestyle Medicine in Palo Alto, California. “Many of the studies have small sample sizes and short follow-up, and results have not been replicated in multiple trials,” says Dr. Chawla.
Some vitamins and supplements have more evidence of their effectiveness for bipolar disorder than others. Here are seven options that may be worth considering, according to experts. Be sure to talk to your doctor before adding any supplement to your treatment plan.
1. Omega-3 Fatty Acids
What it is Omega-3 fatty acids are healthy fats that your body needs to function at its best. They’re very beneficial for heart and brain health, according to the National Institutes of Health (NIH) Office of Dietary Supplements.
“Omega-3 fatty acids have been studied extensively for their potential neuroprotective effects,” says Chawla. There are three types, she says:
- Alpha-linolenic acid (ALA), found mainly in plant oils
- Eicosapentaenoic acid (EPA), found mainly in seafood and seaweed
- Docosahexaenoic acid (DHA), found mainly in seafood and seaweed
The evidence Foods or supplements containing omega-3 fatty acids appear to improve bipolar symptoms, according to a systematic review of 33 studies related to nutrition and bipolar disorder, published in May 2022 in Nutritional Neuroscience.
EPA and DHA may be the most beneficial omega-3 fatty acids for people with mood disorders, say experts at Harvard Medical School in Boston. But some research suggests omega-3s may be helpful only for the depressed phase of bipolar disorder, Harvard experts add.
The bottom line Omega-3 supplements have more robust evidence of benefit for mood disorders like bipolar disorder than other vitamins and supplements.
2. Folate (Vitamin B9)
What it is Folate (aka vitamin B9) helps your cells grow and stay healthy, according to the Mayo Clinic. The synthetic form of folate, called folic acid, is used in supplements.
The evidence Overall, there’s limited research related to B vitamins like folate and bipolar disorder.
Research published in BMC Psychiatry in 2019 found an association between low levels of folic acid and bipolar disorder. In a review published in a 2022 issue of Biomedicine & Pharmacotherapy, investigators reported that 3 milligram (mg) folate supplements were effective and safe when used with the medicine sodium valproate to treat acute mania among people with bipolar I disorder. More research with longer follow-up is needed to confirm these findings.
Additionally, folate supplements alongside traditional bipolar disorder treatment appears to be significantly better than placebo for depressive symptoms among people with either bipolar or unipolar depression, according to a systematic review of studies on folate for mental health conditions, published in the April 2020 Journal of Affective Disorders.
The bottom line Folate supplements may be helpful for certain bipolar symptoms when added to your existing treatment regimen, but more research is needed to confirm their effectiveness.
3. N-Acetyl Cysteine (NAC)
What it is N-acetyl cysteine (NAC) is an antioxidant that may help prevent cancer and is often used to treat acetaminophen poisoning, according to MedlinePlus.
Some studies have shown no benefits of NAC supplements for bipolar disorder. But a review of six clinical trials published in November 2021 in Bipolar Disorders suggested NAC supplements alongside standard treatments for bipolar depression was better than placebo. Larger studies are needed to confirm these results, the researchers wrote.
“NAC is also helpful for treating obsessive-compulsive disorder (OCD) and skin picking disorders, which sometimes occur in patients with bipolar disorder,” says Rakofsky.
The bottom line NAC may be helpful for treating some symptoms of bipolar disorder, but more studies are needed to confirm its effectiveness. In most of the trials, doses of NAC ranged between 1 and 3 grams (g) per day, says Chawla.
4. Vitamin D
What it is Vitamin D helps your gut absorb calcium and maintain appropriate calcium levels for bone health, according to the NIH Office of Dietary Supplements. It’s found naturally in foods such as trout and salmon, added to foods like milk, and produced naturally in the body when your skin is exposed to the sun’s rays, NIH experts add.
The evidence A study published in the Journal of Clinical Psychopharmacology found that vitamin D deficiencies were nearly five times more common in people with bipolar disorder, schizophrenia, or schizoaffective disorder than in the general population.
While there seems to be a connection between low levels of vitamin D and bipolar disorder, vitamin D supplementation did not appear to improve bipolar depression among participants with low levels of vitamin D, according to a study published in December 2017 in the Journal of Psychiatric Research.
Chawla points out that many participants in the study remained vitamin D deficient until the end of the trial period. This could mean that there was more benefit if participants’ vitamin D deficiency was properly treated.
Additionally, a meta-analysis published in the journal Nutrition found vitamin D provided no significant benefit for depression. It’s not clear whether the findings apply to bipolar depression as well as unipolar depression.
The bottom line Although there’s not enough evidence to show that vitamin D supplementation can improve bipolar symptoms, many individuals with bipolar disorder have a vitamin D deficiency. You can make sure you’re getting enough vitamin D by spending a few minutes outside in the sun each day, eating more vitamin D–rich foods (such as salmon, tuna, mushrooms, and egg yolks), or taking a dietary supplement with your doctor’s guidance.
5. Coenzyme Q10 (CoQ10)
What it is Coenzyme Q10 (CoQ10) is an antioxidant that helps keep the cells in your body healthy, according to the Mayo Clinic.
The evidence Two hundred mg of CoQ10 per day, taken alongside standard mood stabilizers and antidepressant medication, was better than placebo at reducing bipolar depression over eight weeks, according to a study published in the October 2018 Journal of Clinical Psychopharmacology.
The study authors theorized that CoQ10 may benefit bipolar depression because of its antioxidant and anti-inflammatory properties. Previous research has shown that inflammation may play a role in the development of bipolar depression, they noted.
The bottom line While this study had positive results, future and larger studies are still needed to confirm whether CoQ10 is effective for bipolar symptoms.
What it is Magnesium is a mineral that the body needs to keep your muscles, bones, nerves, blood pressure, and blood sugar levels healthy, according to the NIH Office of Dietary Supplements.
The evidence Limited research has suggested that magnesium levels in the body may play a role in regulating mood. Magnesium supplementation may improve symptoms among people with depression, according to a systematic review of 32 studies of magnesium and mental health conditions, published in June 2020 in the journal Nutrients.
But it’s not clear whether magnesium supplements could be as helpful for bipolar depression as they could be for unipolar depression.
The bottom line There’s no strong evidence to show that magnesium improves bipolar symptoms. On the other hand, Rakofsky says magnesium may be helpful for insomnia, which can precipitate mania or signal the start of a manic episode.
What it is Melatonin is a hormone the brain makes in response to darkness, according to the NIH.
The evidence While melatonin may not target bipolar symptoms directly, the supplement is known to help with sleep, which is important for preventing mood episodes among people with bipolar disorder. Approximately 80 percent of individuals whose bipolar disorder is in remission still have sleep problems, according to a review published in August 2017 in Encéphale.
“Patients with bipolar disorder have been shown to have a later release of their own melatonin, so taking a supplement may help bring on tiredness earlier in the evening,” says Rakofsky.
Melatonin supplements in conjunction with the usual treatments for bipolar disorder appear to be helpful for managing sleep issues among people with the condition, a review published in Current Pharmaceutical Design found. Additional research is needed to confirm their effectiveness for this purpose.
The bottom line Melatonin may help some people with bipolar disorder sleep better, which in turn promotes mood stability and helps prevent future mood episodes. If you’re interested in taking a melatonin supplement, talk to your doctor to find out the right dose for you.