Diet Tips to Help Manage Bipolar Disorder

by Carmen Roberts, M.S., R.D., L.D.N. Health Professional, Medical Reviewer

It is estimated that 4.4 percent of Americans will suffer from bipolar disorder (also known as manic depression) at some point in their lives. This very serious illness involves significant changes in mood, energy, and behavior. It can be very disruptive to the lives of the people who suffer from this illness as well as their close friends and family members. Bipolar disorder typically begins in adolescence and continues throughout adulthood.

Deciding what to eat, big sandwich or an apple.

Diet is an important part of treatment

While it cannot be cured, people with bipolar disorder who are treated can lead normal, productive lives. It is not a condition that has direct nutritional considerations, like diabetes or heart disease. But if you are living with bipolar disorder, the foods that you eat every day can impact the effectiveness of your medication and symptoms. HealthCentral compiled a list of important tips to help you create a diet that can help to make your medication most effective.

Omega 3 fatty acid foods.

Consume a diet rich in omega-3 fatty acids

Research has shown that omega-3 fatty acid supplementation lessens the symptoms of bipolar disorder, particularly manic episodes. This research suggests that including foods rich in omega-3 fatty acids in your diet such as salmon, flaxseed, chia seeds, and walnuts may help manage symptoms.

Woman weighing herself, concerned about weight gain.

Weight gain can be a side effect of your medication

Weight gain is a potential side effect of nearly all antidepressant medications, though it is not clear whether the weight gain is a direct effect of the drug or of the state of depression. It is important to maintain a healthy weight to avoid the health risks associated with being overweight, including heart disease, hypertension, and diabetes. If you are not at a healthy weight or begin to gain weight during treatment, seek the advice of your healthcare provider or registered dietitian.

Prescription pills.

Be aware that other medications can cause weight gain

“Many more patients are taking ‘atypical antipsychotics’ such as Latuda® (which is now approved as monotherapy for bipolar depression), or Seroquel®,” says Traci Speed, M.D., Ph.D., an assistant professor in the department of psychiatry and behavioral sciences at Johns Hopkins Bayview Medical Center in Baltimore. “These medications may be used as monotherapy or as adjunct therapy with mood stabilizers, and they are known to cause weight gain.”

Doctor holding up prescription pad and pills.

MAOIs can have side effects that are impacted by your diet

MAOIs (monoamine oxidase inhibitors) are a class of drugs used to treat depression and may be prescribed to someone who suffers from bipolar disorder. Side effects of MAOIs include dizziness and low blood pressure. Foods high in tyramine, such as aged cheeses, can make these side effects worse.

“In general, if you are prescribed an MAOI, it is best to avoid all aged products and to discuss dietary restrictions with a medical professional,” Dr. Speed advises.

Aged cheeses at farmers market.

Foods to avoid: aged cheeses

Since the amount of tyramine in foods increases with the aging process, people taking MAOIs should avoid any aged or mature foods including cheeses and wines. Avoid aged cheeses such as Camembert, cheddar, Gouda, Gruyere, mozzarella, Parmesan, provolone, Roquefort, and Stilton. It is important to note that you can still consume other cheeses, such as cottage cheese, ricotta cheese, farmers’ cheese, cream cheese, and American (or other processed cheeses).

mug of beer.

Foods to avoid: alcohol

All beers and certain red wines including Chianti, Burgundy, and Sherry should be avoided while taking MAOIs. However, white wine and clear spirits can be consumed in moderation since they have a lower tyramine.

Salamis hanging in store room.

Foods to avoid: meats

Fermented or dried meats such as salami should be avoided, though fresh sausage and pepperoni can be consumed in moderation. Chicken liver or beef liver should also be avoided.

Miso in a jar.

Foods to avoid: fermented foods

Fermented soybean foods including foods with miso, monosodium glutamate (MSG), and some tofu products should be avoided. Soy sauce can be consumed in moderation.

Small white sack of dried fava beans.

Other foods to avoid: fruits, yeast, beans, and chocolate

Overripe or spoiled fruits should be avoided, as well as fava beans, broad beans, or foods that contain these legumes. Any foods that contain yeast extracts; brewer's yeast; or fresh, homemade, yeast-leavened breads should also be avoided while taking MAOIs. Imported chocolates should also be avoided.

Variety of salts.

Other considerations: lithium and sodium

If you are taking lithium (a mood stabilizer), you should maintain a consistent sodium intake. Sodium stabilizes lithium levels in the body, so too little or too much sodium can impact the medication’s effect. Too little salt in your diet can cause side effects such as fluid retention, mental confusion, and kidney problems. Too much salt can prevent lithium from working properly.

Out to lunch with friends.

The bottom line

It was previously thought that people living with bipolar who were taking MAOIs as part of their treatment should follow a very restrictive MAOI diet. It is now known that this diet can be liberalized while still maintaining safe, effective treatment. If you have questions about how to achieve a balanced diet while avoiding foods that can affect your medication, contact your healthcare provider.

Carmen Roberts, M.S., R.D., L.D.N.
Meet Our Writer
Carmen Roberts, M.S., R.D., L.D.N.

Carmen is a Registered Dietitian. In addition to writing for HealthCentral, she has spent her career working at Johns Hopkins and is also an adjunct faculty instructor for Excelsior College. Carmen has over 20 years of experience in nutritional counseling, education, writing, and program management and is a certified specialist in adult weight management. She enjoys educating her students and clients about how nutrition affects the body and its role in overall health and wellness.