Anyone living with bipolar disorder (BPD) will admit it: they’ll try anything that might weaken their symptoms and improve brain health. Who could blame them? With episodes of hypomania, mania, depression, and psychosis, life with BPD is difficult and unpredictable. What’s more, studies from recent decades show that BPD damages cognitive function, even during stable periods. This inspires people with BPD to always ask what else they can do.
Perhaps the most overlooked tool at their disposal is nootropics. Nootropics isn’t a word most people have heard. If they have, many think of pill-popping millionaires in Silicon Valley trying to achieve superhuman intelligence, imitating Bradley Cooper in the movie “Limitless.”
In reality, nootropics don’t create superhuman intelligence. They’re tools for improving the brain’s health and function. This makes nootropics a no-brainer when it comes to managing BPD.
What Are Nootropics?
Dr. Corneliu E. Giurgea, who coined the word “nootropic,” described nootropics as substances with the following properties:
- protects the brain from harm
- improves memory and learning
- has minimal side effects
- is neither a stimulant nor a sedative
- helps brain function in spite of disruptive conditions
- improves neuronal function in the brain’s cortical and subcortical regions
Meeting those criteria is a pretty tall order. Few true nootropics exist. When people use the word “nootropic,” they usually mean “cognitive enhancer.” Cognitive enhancers improve concentration, memory, or other aspects of cognitive function but it doesn’t necessarily meet all of Dr. Giurgea’s criteria. “Cognitive enhancers,” “nootropics,” and “smart drugs” are used interchangeably.
What Cognitive Problems Does BPD Cause?
What cognitive problems occur in BPD? Cognitive impairment happens during all episodes seen in BPD — mania, hypomania, psychosis, and depression. It occurs during euthymia, the stable period between episodes. It even occurs when BPD is in remission.
Here are some areas where cognitive impairment is seen in BPD.
- verbal memory – remembering words, lists, word associations
- long-term memory
- information processing
- inhibitory control – self control
- cognitive flexibility – ability to think about two or more concepts at once
- problem solving
- social cognition – storing, processing, and using information about people and situations
- psychomotor speed – reaction time while doing a task that includes processing information
In addition to those listed above, certain drugs used to treat BPD may cause cognitive impairment. For example, lithium may slow the processing of information or impede memory.
What To Look For In A Nootropic For BPD
Before getting started, there’s a crucial detail everyone with BPD must know. Some nootropics that are safe for people without BPD can trigger hypomanic, manic, and psychotic episodes in those with the disorder. Others can counteract prescription drugs taken for BPD. For example, high doses of Ginkgo biloba may weaken the effectiveness of anticonvulsant drugs like Depakote and lamotrigine.
What should someone with BPD look for in a nootropic? The nootropic should improve at least one form of cognitive impairment caused by BPD or BPD drugs. It may improve the effectiveness of a prescription drug taken for BPD. It shouldn’t induce bipolar episodes, counteract prescription drugs, or cause major side effects. Whatever the nootropic one chooses, it should help restore the brain’s resilience and function amidst the chaos of BPD.
Three Good Nootropics For BPD
Used for millennia in Indian Ayurveda Medicine, ashwagandha is Withania somnifera, a shrub native to Asia. As a nootropic ashwagandha is best taken in extract form.
Among others, studies suggest ashwagandha may offer these benefits:
- improved reaction time
- better auditory-verbal working memory
- improved social cognition
- could help alleviate insomnia
Note that if you take MAO suppressors (used to treat depression and Parkinson’s disease) or JNK inhibitors, ashwagandha may decrease the effectiveness of your medication.
Eli Lilly and Company created memantine as a treatment for Alzheimer’s disease. Aside from Alzheimer’s and BPD, memantine is used to treat ADHD, anxiety disorders, and OCD. Thus far, studies have shown that those with rapid cycling BPD benefit the most from memantine.
Studies suggest its benefits may include:
- a mood-stabilizing effect
- possible relief from anhedonia
- a boost in the antidepressant effect of lamotrigine when used together (though the boost doesn’t last long-term; researchers are working on this)
- improvements in five types of memory:
- working memory
- verbal memory
- episodic memory
- improved attention
Eleuthero, Aka Siberian Ginseng
Eleutherococcus senticosus (“eleuthero” for short) is an herb from Northwest Asia. Its nickname is Siberian ginseng, though eleuthero isn’t a variety of ginseng. Eleuthero root tea has relaxing effects. For the full nootropic benefits, an extract of the root, stem, or leaf is used.
A study on eleuthero found:
- the combination of lithium and supplemented eleuthero root was as effective as lithium and fluoxetine taken together for depression. Eleuthero with lithium had fewer side effects than fluoxetine with lithium.
Some Nootropics To Avoid
With so many fascinating nootropics out there, it’s a real bummer that with BPD, you can’t use them all. What may be really healthy for people without BPD may have catastrophic consequences for those with BPD. Every nootropic — every supplement, even — must be researched before it’s used. Is it known to induce hypomania, mania, or psychosis? Does it interfere with any prescription drugs you’re using?
Here are some examples of well-known, well-regarded nootropics that can cause trouble.
- John’s Wort – an herb with powerful antidepressant effects. Can cause mania and psychosis in those with BPD.
- Panax ginseng – an herb with stress-relieving, anti-fatigue, and mood-lifting effects. Can cause mania and psychosis in those with BPD.
- Ginkgo biloba – a tree, its extract improves memory and helps fight cognitive decline. Can decrease effectiveness of anticonvulsants, which are used as antidepressants and mood stabilizers in BPD.
People living with BPD will find nootropics have a lot to offer. Nootropics can mitigate the cognitive impairments of BPD and protect the brain against further harm. This can bring an improved quality of life. Before using any nootropic, one should talk to their doctor. Research the nootropic to ensure it’s safe for BPD in general and safe in combination with your medications.