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Can fish oil supplements boost mood with bipolar disorder?

Fish oil contains the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are crucial for the production of hormones and nerve tissue. Results from one study showed positive effects of omega-3 fatty acids in treating depression but not for mania. Supplementing the diet with fish oil is less understood with bipolar disorder, because conflicting study results exist on whether or not it has value for treating or preventing episodes of mania or depression.  If you are using fish oils, you must use a product that contains both EPA and DHA for this to be an effective addition to your medications.

Because there is evidence that omega-3 fatty acids can benefit cardiovascular health, some experts believe taking 1 gram per day of omega-3 fatty acid supplements may be beneficial.

Omega-3 Fatty acids may help, when used with your other medications, in treating your bipolar disorder.

What about St. John’s wort and bipolar disorder?

St. John's wort (Hypericum perforatum), an herbal therapy that’s been shown in studies to lift symptoms of minor to moderate depression, has been used in Europe for centuries. Minor to moderate depression is a common disorder that's underdiagnosed and undertreated. Not only can minor to moderate depression affect your daily functioning and quality of life, it’s also a serious risk factor for major depression.

Studies show that St. John’s wort may affect various brain chemicals (neurotransmitters), including serotonin, epinephrine, and dopamine. One of these neurotransmitters (serotonin) is the same chemical affected by the prescription drug Prozac, a selective serotonin reuptake inhibitor (SSRI). St. John’s wort may also improve sleep because hypericum extract increases the brain's output of melatonin at night. Melatonin is a hormone produced by the body that influences the circadian rhythm and sleep.

But St. John’s wort is not recommended for the treatment of bipolar disorder. Drugs such as quetiapine or olanzapine-fluoxetine are the only FDA-approved treatments for bipolar depression, while mood stabilizers such as lithium, divalproex, or lamotrigine may also have value. Because of the risk of triggering a manic episode, doctors advise caution and monitoring when using any antidepressant, including St. John’s wort, for treatment of bipolar depression. In addition, St. John’s wort may cause serious herb-drug reactions if taken with other SSRI medications such as Prozac.

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