Interest in complementary and alternative medicine (CAM) for bipolar disorder—acupuncture, omega-3 fatty acids, N-acetylcysteine (NAC), massage, homeopathy, naturopathy, hypnosis, etc.—has exploded on social media. But does any of it actually work? If you know me, you know that I look for medical evidence. Someone once attempted to insult me by saying that I would try heroin if it had clinical evidence. Um, yeah. Clinical evidence is what says something is safe and effective, so, yes, I would try it. (Of course, I don’t think heroin is going to pass that bar any time soon.) Here’s what the evidence says about CAM for bipolar disorder (spoiler: some adjuncts help depressive symptoms; others are all hype).
(Jump to evidence at-a-glance.)
Acupuncture for Bipolar Disorder: RCT Evidence
When evaluating alternative treatments for bipolar disorder, acupuncture shows the following:
- A pooled analysis of two randomized controlled trials (RCT; 20–26 patients) examined acupuncture as an adjunct to standard medication for bipolar depression and hypomania. Both real and sham acupuncture produced improvement—but no significant difference between them. This suggests benefits likely stem from non-specific effects like attention and ritual.
- A case series of acupuncture for bipolar disorder showed various results from useful to no effect at all—but lacked a control group, limiting conclusions.
Bottom line: Acupuncture seems generally safe, but evidence does not support specific benefits over placebo (a placebo is a substance that does nothing).
Omega-3 Fatty Acids (Fish-Oil) and Bipolar Depression
Omega-3 has almost moved out of the alternative treatment for bipolar disorder category, but not quite.
- A 2012 meta-analysis of bipolar trials (double-blind, placebo-controlled) found that omega‑3 supplements improved depressive symptoms but not mania.
- A 2021 systematic review (five trials) confirmed effectiveness for residual depressive symptoms.
- A 2023 randomized trial with 31 patients showed lower relapse rates over six months and reduced depressive severity.
- Despite promising signals, a 2018 American Psychiatric Association (APA) review emphasized strong publication bias and trial heterogeneity, urging caution.
Bottom line: Omega‑3s may help with bipolar depressive symptoms and relapse prevention, but findings are modest and inconsistent. (More on diet in bipolar disorder, here.)
N-Acetylcysteine (NAC): Antioxidant Adjunct
This alternative treatment for bipolar disorder has some evidence behind it.
- A 2008 double-blind RCT (n = 75, 24 weeks) reported significant improvement in depressive symptoms for those taking NAC (1 g twice daily) adjunctively; benefits were lost after washout.
- A 2020 meta-analysis of six double-blind RCTs (248 patients) found a moderate effect favoring NAC vs. placebo, but noted high heterogeneity.
- However, a 2021 meta-analysis failed to show a statistically significant benefit for NAC add‑on therapy.
Bottom line: NAC shows mixed evidence—some trials are promising, but recent reviews are inconclusive. More large, high-quality studies are needed. (More on N-acetylcysteine in bipolar disorder can be found here.)
Massage and Hypnosis: Stress Relief, Not Symptom Control
These alternative treatments for bipolar disorder are not supported.
- There are no direct RCTs of massage or hypnosis in bipolar disorder.
- However, these methods have documented benefits for stress and anxiety relief in other psychiatric conditions (here and here).
Bottom line: While probably safe, their role is supportive—not therapeutic—for anxiety in bipolar disorder.
Homeopathy and Naturopathy: No Benefit, Real Risks
I do not like these alternative treatments for bipolar disorder at all.
- No rigorous trials (RCTs or meta-analyses) support homeopathy or naturopathy for bipolar disorder.
- Naturopathy often includes unsubstantiated herbal mixes, and many use them to replace evidence-based treatment—posing a real risk of treatment delay, side effects, or drug interactions.
- The overall medical consensus is that homeopathy does not work, ever. It is no better than a placebo in all conditions studied.
Bottom line: Strongly not recommended as a primary or adjunct treatment for bipolar disorder.
Bipolar Alternative Medicine Evidence at a Glance
Treatment | Evidence Summary |
---|---|
Acupuncture | RCTs show improvement in symptoms but no specific benefit over placebo |
Omega‑3 fatty acids | Meta-analyses suggest benefit for bipolar depressive symptoms and relapse prevention, but not mania |
N‑Acetylcysteine (NAC) | The evidence is mixed: early RCTs positive, later meta-analyses inconclusive |
Massage / Hypnosis | No bipolar-specific RCTs; may help stress/anxiety |
Homeopathy / Naturopathy | No evidence; potential harm |
Risks, Interactions, and Money Pits
Here are some of the risks alternative medicine offers to those using it for bipolar disorder treatment.
- Delay to effective care: Using unproven alternatives may lead to poorer outcomes if medications are postponed.
- Interactions and safety: Even natural supplements can affect drug metabolism and have side effects.
- Waste of resources: Time and money spent on ineffective methods could be better spent on evidence-based treatments..
- False reassurance: Feeling better due to placebo effects, not actual symptom remission, can be dangerous.
Bottom Line: What to Try—What to Skip
I understand why people want to try alternative treatments for bipolar disorder. They can seem seductive. They promise improvements without side effects. They’re outside the medical system, which is often a selling feature for those who have had previous bad experiences with the system. Some people offering these alternatives are very convincing salespeople. All of this can make putting your money and time into them seem to make sense.
But please believe me when I tell you that by and large, these alternatives do not work. They will not help you, no matter what a salesperson says.
Remember this:
What do you call alternative medicine that works? Medicine.
In other words, if it worked, it would be part of the medical system.
In short:
- Core treatments remain medications (e.g., mood stabilizers, atypical antipsychotics, etc.) as prescribed by psychiatrists.
- If you’d like to try alternative therapies, consider:
- Omega‑3 supplements (EPA-rich) or NAC—only as adjuncts, not replacements
- Acupuncture, massage, hypnosis—for stress relief, not symptom control
- Avoid homeopathy and naturopathy unless integrated with medical care.
- Always consult your prescriber before starting supplements or any alternative treatment to monitor for interactions and ensure continuity of evidence-based care.
Have you tried any alternative treatments for bipolar disorder? Share your experience below—evidence counts, but anecdotes help others feel less alone.
(To check out more possible options, click here for a great resource.)
Hi Natasha,
I am the guardian to my 42-yr-old daughter who has bi-polar schizophrenia, anxiety, and deals with depression, and it has been a constant challenge getting her to take the right medication for treatment.
I really would prefer her to use an alternative treatment instead of having to experience the side effects of what’s being prescribed.
Thank you for the heads up on what alternatives may or may not work.
Hi Fay,
I’m sorry your daughter deals with so many challenges. That must be difficult for you and for her.
Please understand that any alternative treatment would need to be used in conjunction with traditional psychiatric treatment. Anyone with the illnesses you describe would need medication (and therapy), I’m afraid. That doesn’t mean you shouldn’t look to minimize side effects, because of course you should. You may be able to do this by lowering dosages or switching medications. I hope she has a psychiatrist that can work with both of you on those issues. No one should have to undergo more side effects than is necessary.
Also, please see the resource I linked to at the end of the article. It has some alternatives that may address certain side effects.
I hope that helps.
— Natasha Tracy
Hi Natasha, By the way I love your name!
Thank you so much for your reply to my concern, it was very helpful, and I really appreciate it.
This information is vital for the proper treatment to those that are dealing with Bi-Polar Depression, as well as their friend or family member(s) who’s really concerned about their mental health.
Sincerely,
Fay
There is a woman who has schizophrenia with psychosis. Hospitalized many times in psych wards. Finally she went on something called Medical Keto. She worked with a keto doctor and with her psychiatrist. The more she followed it the more she was able to slowly taper off her meds. I normally think Keto diets are stupid and misleading but she was doing medical keto. She is off all meds for 6 months or more and seems to be doing well with her family.
Lauren Kennedy West is her name and youtube channel. I think she has over 400 vids. She did get flack from some of her viewers about what she was doing but at the end of the day it worked. Go figure.
Hi Robert,
Yes, _medical_ keto is being trialed in certain areas of mental health such as in cases of schizophrenia and bipolar disorder.
As you said, this is very different from just keto as you would see it online. It is much more rigorous and involved. It is so rigorous and involved, in fact, that I suspect most people couldn’t even come close to sticking to it. (Everyone hates diets and diets that are this strict are not for most people.) People with these illnesses often forget or refuse to take a medication. Thinking that they are going to stick to a diet where every single thing you put in your mouth has to be correct is probably not very realistic.
It’s an interesting area of study, however. Right now there isn’t the data to tell people to adopt such a practice, but there may come a time when there is.
— Natasha Tracy
I did not even know that existed. She went at it really focused with a husband and several kiddies. Hopefully it sticks and she never has to go back on her various meds. Im guessing a Keto Dr is not free so if thats the case many would not be able to access it. Nothing healing is coming down the road for me. Thanks for the reply Natasha Cheers
IMNSHO, the value of evidence in mental health is far trickier to interpret than in other areas of medicine. Not to say it isn’t relevant, but that the existence of evidence (for) is less a predictor of sucess. The lack of evidence (for, against) is (slightly) less a predictor of failure, depending on the type of product. Lack of evidence for a medication (backed by a company that can afford to run real studies) is more significant (in the real-world sense) than lack of evidence for something that you can grow in your backyard. The combinatorial explosion that is any mental health diagnosis makes the relevance of a treatment in any individual circumstance much harder to predict, evidence or no. People get victimized on both sides—clinicians who blame the patient when an “evidence-based” treatment fails and predatory companies who can make outrageous claims on the most questionable basis. Thanks so much for cautioning about CAM side effects and interactions.