Bipolar Disorder and the Gut Microbiome: Are They Related?

The short answer is yes — lifestyle changes that improve your gut health could in turn improve your mood, early research suggests.

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More and more research shows that the brain and gut are intertwined, and that mental health conditions like bipolar disorder may be associated in part with the gut.

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You may be familiar with the?gut microbiome — the trillions of beneficial bacteria and other microorganisms in your digestive tract that support your overall health. But did you know that those bacteria are not only good for your gut, but for your mental health, too?

All hail the gut-brain-microbiota axis, a network through which the gut and the brain constantly exchange information, according to a?review published in April 2021 in the International Journal of Molecular Sciences. Given how closely the gut and brain interact, it’s not surprising that the bacteria in the gut could have a direct effect on brain functions like mood and behavior.

“We are learning that other physiological systems can be affected by what’s happening inside the gut, and this includes what happens in the brain,” says Richard Day, MBBS, the vice president of medical affairs and clinical development at ADM Protexin, a company that produces probiotic and live bacteria health products. Dr. Day has conducted research related to the gut microbiome.

Ongoing research indicates a connection between the gut microbiome and several mental health conditions, including?bipolar disorder. For example, a?review published in February 2020 in the journal Neuropsychobiology?found that people with bipolar disorder tend to have differences in the composition of their microbiome and more gastrointestinal illnesses than people without the disorder.

Many patients with bipolar disorder have gastrointestinal illnesses such as irritable bowel syndrome (IBS), and research suggests this may be linked to dysfunction within the gut microbiome,” says?Raphael Kellman, MD, an integrative and functional medicine physician at Kellman Wellness Center in New York City, and author of?The Microbiome Diet.

Scientists are studying this relationship in part because it could lead to other treatments for bipolar disorder, alongside standard therapies like medication, to help improve the lives of people with this condition, according to the authors of the previously mentioned review in the International Journal of Molecular Sciences.

Although scientific research on the gut microbiome–bipolar disorder connection is still new, researchers have already made some fascinating discoveries about how the two influence each other.

Bipolar Disorder and the Gut Microbiome: What Research Has Revealed So Far

A?systematic review and meta-analysis published in the August 2016 issue of Medicine?found that people with IBS were twice as likely to have bipolar disorder than people without IBS.

And while everyone’s gut composition is unique, people with mental health conditions like bipolar disorder appear to have fewer healthy microorganisms and more unhealthy ones in their stomach and intestines. Specifically, people with bipolar disorder may have decreased levels Faecalibacterium, one of the most important kinds of bacteria in the human gut microbiome, according to a small?study published in the April 2017?Journal of Psychiatric Research.

Further, reduced levels of this particular beneficial bacteria were associated with more severe bipolar symptoms,” says Dr. Kellman, who was not affiliated with the study.

What Unanswered Questions Remain?

“There is currently no consensus about what a ‘healthy’ microbiome even is,” Day notes. “And so, the next question is whether modulating the microbiome to meet health-associated patterns might predict or result in positive clinical outcomes.”

And while preliminary research has addressed the gut microbiome’s relationship with bipolar disorder overall, experts do not yet know if microbiome issues vary by the?type of bipolar disorder an individual has — bipolar 1, bipolar 2, cyclothymia, or other specified and unspecified bipolar and related disorders.

What’s more, people with bipolar disorder often have additional mental health conditions, such as psychosis and anxiety disorders. This makes it harder for researchers to find out whether bipolar disorder itself, a coexisting mental health condition, or a combination of the two are influencing the gut microbiome, Day explains.

3 Ways to Improve Your Gut Health ASAP

Scientists have identified several lifestyle changes that could enhance your gut health and help keep bipolar symptoms in check. With your doctor’s approval, consider trying the following.

1. Fill Up on Fruits, Vegetables, Healthy Fats, and Probiotics

“Eating a diet that is focused on balancing the gut microbiome is a crucial addition to standard treatments for people dealing with not only bipolar disorder, but anxiety and depression, as well as other mood and psychiatric disorders,” says Kellman.

Trouble is, the diets of people with bipolar disorder commonly are high in fats, sugar, and carbohydrates — foods that can spell trouble for their mood and other bipolar symptoms — a preview article published in March 2016 in Psychiatric Clinics of North America found.

Consider adopting a?Mediterranean diet focused on fresh fruits, vegetables, nuts, beans, herbs, spices, and olive oil. Per the 2016 review, these foods are rich in nutrients that boost mental health in general and may be beneficial for managing bipolar symptoms, too.

Specifically, Kellman suggests filling your plate with:

  • Fresh fruits and vegetables, which are high in phytonutrients and antioxidants.
  • Foods loaded with omega-3 fatty acids, such as wild salmon and tuna.
  • Foods with vitamin B, such as poultry, eggs, legumes, and leafy greens.
  • Healthy fats, such as extra-virgin olive oil and grass-fed butter.
  • Seeds and beans, which are rich in protein
  • Herbs and spices like turmeric, ginger, oregano, and cinnamon, which are beneficial to the gut, according to Kellman.
  • Natural probiotic foods, such as fermented dairy, like yogurt and kefir, which help repopulate the gut with “good” bacteria.

RELATED: 5 Foods to Avoid if You Have Bipolar Disorder

2. Include More Physical Activity in Your Daily Routine

Regular?exercise is known to help people with bipolar disorder keep their moods stable, and it has many other mental health benefits. But did you know that it also promotes a healthy gut?

It’s true: Moderate endurance exercise — things like jogging, cycling, or swimming laps — is associated with a more diverse gut microbiome, per a?review article published in June 2021 in Frontiers in Nutrition.

So, how much should you exercise if you have bipolar disorder? Experts at the?Anxiety and Depression Association of America (ADAA) recommend 30 minutes of exercise a day, three to five times a week.

3. Make a Good Night’s Sleep a Priority

Getting enough shut-eye is vital for anyone’s mental health, but especially for people with bipolar disorder. Not only does a consistent?sleep routine help keep your mood stable, but it also promotes good gut health. In fact, sleep may help foster a diverse array of healthy bacteria and other microorganisms in your gut, according to a?research article published in October 2019 in PLoS One.

Do you have trouble getting and staying asleep? To help regulate your sleep patterns, experts at the?Centers for Disease Control and Prevention (CDC) advise:

  • Going to bed and waking up at the same times each day.
  • Sleeping in a quiet, dark room at a comfortable temperature, ideally 65 degrees Fahrenheit, according to the?Sleep Foundation
  • Placing electronics out of sight when going to bed to prevent distraction
  • Nixing caffeine and alcohol before bedtime
  • Exercising during the day rather than in the evening

If you’re still struggling to sleep well, let your doctor know. A lack of sleep is a?common trigger for bipolar mood episodes.

RELATED:?Bipolar Disorder: Why a Good Night’s Sleep Is Essential