The role of nutrition in bipolar disorder

Loots et al (2021) note that psychiatric disorders comprise 13% of the total global disease burden, with non-adherence to medication ranging from 63–74% in patients with schizophrenia and some 50% in patients with bipolar disorder (BD). And whereas around one third of those with BD respond to mood stabilisers, almost half of those for whom medication interventions provide relief initially, ‘continue to experience recurrent mood episodes despite continuing treatment’, with Ede (2024) asking whether such patients are failing treatment, or whether treatment is failing them.

In addressing this question, one element worth considering is the role of metabolism in individuals with BD. In a Cochrane Review, Tully et al (2018) reported that, compared with the general population, individuals with BD are more often overweight or obese. Obesity can contribute to diabetes, hypertension, metabolic syndrome, cardiovascular disease and coronary heart disease; and ‘cardiovascular disease is the leading cause of premature death in BD, occurring a decade or more earlier, on average, than in the general population.’