5 Foods to Avoid If You Have Bipolar Disorder

Can an unhealthy diet play a role in triggering bipolar mood swings? According to recent research, the answer is "yes." In fact, certain foods — such as caffeine, alcohol, and fatty foods — could lead to worse outcomes, finds research in the September 2015 issue of the Journal of Psychiatric Research. It’s a good idea to follow national healthy diet guidelines, such as eating more vegetables, fruits, whole grains, and lean meats. But you may also want to pay attention to some of the subtler points raised in this study.

“Evidence of poor diet in people with bipolar disorder is found in the altered metabolism of important healthy fats and is consistent with an imbalance in the ratio of omega-6 to omega-3 intake in diet," says study author Melvin G. McInnis, MD, the Thomas B. and Nancy Upjohn Woodworth professor of bipolar disorder and depression, and director of the Prechter Bipolar Research Program in the department of psychiatry at the University of Michigan Health System in Ann Arbor.

Dr. McInnis explains that this means people with bipolar disorder should rebalance the types of fats in their diets to include more omega-3 fats, and fewer omega-6 fats. You only need a small amount of omega-6 fats each day, which come primarily from vegetable oils. Omega-3 fats come from sources such as salmon and other fatty coldwater fish, flaxseed, nuts, and certain plants, such as basil.
If you choose to eliminate bipolar-offending foods from your diet, you’ll do more than keep mood swings in check and reduce periods of mania: You’ll also improve your heart health. That's important, because with bipolar disorder you’re at a greater risk of obesity and heart and vascular disease, according to the National Institute of Mental Health.

“People with bipolar disorder have, in general, poor diets and are not good at planning healthy diets with appropriate foods,” McInnis explains. One particular problem is fast food, which is a primary food source for a good number of people with bipolar disorder, he says. "It's convenient, cheap, and provides satisfaction — albeit short-term.”
Other factors that could lead to poor dietary choices include medication side effects, inadequate exercise, smoking, and lack of access to care, explains psychiatrist Jess G. Fiedorowicz, MD, PhD, an associate professor in the departments of psychiatry and internal medicine at the University of Iowa Carver College of Medicine in Iowa City.
Your first step? “While there's been some speculation regarding specific diets for bipolar disorder, simply eating a healthy, balanced diet is an important start,” Dr. Fiedorowicz says.

Foods and Drinks You Should Ditch

The fundamentals of a healthy diet include not just what to eat, but also what not to eat. Consider skipping these choices that could worsen your bipolar symptoms:

1. Caffeine

“Stimulants can trigger mania and should be avoided,” Fiedorowicz says. “Caffeine is an underappreciated trigger and can also impair sleep,” and sleep deprivation is a notorious trigger for bipolar mood swings and mania, he says.
The National Sleep Foundation points out that caffeine can increase irritability and anxiety, in addition to affecting sleep, and recommends avoiding caffeine as you approach bedtime. Fiedorowicz adds that some over-the-counter medications — such as pseudoephedrine, which is found in some cough and cold medications — have stimulant properties similar to caffeine and can also trigger bipolar mood swings.

2. Alcohol

Bottom line: Alcohol and bipolar disorder make a bad combination. Alcohol can negatively affect bipolar mood swings and may also interact negatively with medications such as lithium, according to the National Institutes of Health Clinical Center (NIHCC). People with bipolar disorder are also more likely to die prematurely if they use alcohol or other substances, according to an analysis of data that included more than 11,000 people with bipolar disorder published in the September 2015 issue of The Lancet Psychiatry.

3. Sugar

Eating a diet high in sugar can make it harder to control weight, and obesity — including related belly fat — may make some bipolar disorder drug treatments less effective, according to results of a multicenter study published in the June 2015 issue of Acta Psychiatrica Scandinavica. If you need to satisfy a sweet tooth, reach for fruit.

4. Salt

If you’re on lithium, moderating salt intake can be tricky, because a change in salt intake — either a sudden increase or a decrease — can affect lithium levels, according to the NIHCC. Talk with your doctor about how to safely manage the salt in your diet to stay within a healthy range. The American Heart Association recommends consuming less than 1,500 milligrams a day. Equally important when taking lithium is to make sure you drink enough fluids: Dehydration can cause dangerous side effects, Fiedorowicz cautions.

5. Fat

Fiedorowicz suggests following the heart-healthy recommendations from the American Heart Association to limit the amount of saturated fat and trans fat in your diet. That means opting for lean protein and low-fat dairy products when choosing animal products. You might have heard that the fat in foods could alter the way your body uses medications: Generally, your medications will still be effective, but eating a lot of fried, fatty foods just isn’t good for your heart? And remember that the oils used for frying are high in the omega-6 fatty acids you want to avoid.

Healthy Food Swaps to Try

Planning a healthier diet doesn’t have to be drudgery. McInnis advises going to your local farmers' markets, exploring the options, and talking with the farmers themselves about how to enjoy their produce. And for quick stops at the store, he recommends sticking to the periphery, where whole foods, such as produce and fish, are usually found. For more ways to make your diet healthier, McInnis says:

• Instead of potato chips or fries, munch on crispy vegetables with a savory dip, such as hummus.
• Skip the sweet pastry and instead top a slice of whole-grain bread or a few crackers with fruit preserves.
• Instead of a fourth or fifth cup of coffee, choose a decaf latte or an herbal tea.
• Skip the fast-food burger and fries and order a fresh salad instead.
• Swap a fried entrée for steamed or broiled fish.

Building the best diet often takes teamwork, including help from your medical team. If your diet and lifestyle need a complete makeover, reach out to your doctor or dietitian for help.