The Clear Mind Diet – Food for a Healthy Mood

by Dr. Corey Schuler, MS, DC, CNS, LN

living in a good mood

Bipolar disorder is sometimes referred to by its older, more familiar name: manic depression. This is highly descriptive but also a very isolating term for those who suffer from the condition. When it comes to mood, these individuals have higher than average highs and lower lows.

While more than 6 million people in the US are diagnosed with bipolar disorder, there are likely many more who are undiagnosed. These people go through each day not realizing that their lack of sleep at night, their need for naps during the day, the tendency to crave drugs or alcohol, and the angry outbursts and irritability followed by sadness, are more than simply character flaws.

Lots of people have bad moods. However, because bipolar has a strong genetic component, mood changes are often brushed aside as familial traits. Stress and tiredness are often inappropriately blamed for classic signs of bipolar. Especially when unrecognized, this condition can ruin relationships. Friends, family, and even children and spouses grow weary of not knowing what to expect, fearing both the depressive cycle and manic cycle which is characterized by fast talking, high levels of productivity and creativity, and the occasional break from reality in the form of hallucinations or delusions.

However, not everyone with bipolar disorder spectrum suffers from delusions or hallucinations. Bipolar disorder Type II never includes such breaks. Instead it involves a less severe version of mania (referred to as hypomania) and more mild depression is often not diagnosed until an adult is in their mid- to late 30’s, if ever, with many never seeking treatment for their mood swings. Hypomania is actually a very pleasant state for the bipolar individual and these people never have hallucinations or delusions.

Those with Type II during a hypomanic cycle are joyful, perhaps overly so. And they are dedicated to their work, again, perhaps overly so. They also do not feel the need to be medicated in this euphoric state. While some people seek help during a depressive cycle, often follow-up visits to doctors or psychologists during the hypomanic cycle usually result in, “There’s nothing wrong with me. I’m happy, creative, productive, and sane.” Unfortunately, this cycle is matched by depression, anxiety, fear, irritability, and loss of focus and drive. How often someone bounces between highs and lows is referred to as cycling. The more rapid the cycling, the harder it is to control.

The following dietary information is not only useful for those suffering from bipolar disorder but also for those who have intense cravings, significant mood changes, and even those who tend to have trouble controlling their emotions. Officially, food cravings are not a part of the bipolar disorder spectrum (BDS), nor would we hope them to be. We wouldn’t want potentially toxic medications used for such seemingly trivial behavior.

This diet is used without modification for the entire range of BDS including Type I bipolar disorder down to common mood swings. In fact, sometimes the only indication we have for using this diet is the poor outcomes of other food plans. I’m going to violate the diagnostic criteria of BDS and instead refer to the entire spectrum from Type I, hallucinations and delusions all the way down to non-pathologic mood swings and cravings.

So, for the purposes of this article, whenever you see “bipolar” or “BDS” think to yourself “mood swings, behavior changes, and cravings. Those with BDS do extremely well with routine, though oftentimes an accountability partner or coach is helpful in compliance to this new practice.

Individuals with BDS as well as those with conditions that are less severe yet fall into this same spectrum, tend to have challenges sticking with a diet or even a supplement plan. The reason is two-fold. First, if they do not get the nutrients they need, their brain overcompensates with hunger signals. Have you ever been riding in a car with someone who says, almost out of the blue, “I need to eat something; I’m starving and if I don’t eat, I’ll die.”? The brain is screaming for fuel. In this case, it is likely a hypoglycemic episode.

Many times, those with BDS will have a great diet planned out for the day or week, but then end up in a drive-through secretly chomping on something fried and fatty. This is likely due to a fat deficiency. The below plan does not lack fat. In fact, it is a “fat first” diet…a healthy fat diet. Fat is what makes up the brain and acts as radiator fluid for the overheating mind. Carbohydrates, except for vegetables and some fruits, are minimized due to a link between inflammatory oils found in processed foods and bipolar disorder.

The second reason those with BDS have trouble with staying on plan is that the manic or hypomanic phase gives them a false sense of confidence in health as well as other aspects of life. The long time difficulty of medical care of bipolar disorder is maintaining drug compliance during manic and hypomanic states.

Below represents a one-day example of a diet plan I have suggested to stabilize the up and down cycle. It is not intended to treat bipolar disorder nor is it meant to replace psychiatric medications. I’m not a psychiatrist and therefore I refer all bipolar disorder patients to be co-managed and monitored by a psychiatrist.

This is not a lip-service disclaimer. Bipolar disorder is a serious psychiatric condition and only a psychiatrist should taper or discontinue medications. Please heed this warning as inappropriate weaning from psychoactive medications can have serious consequences. Similarly, not seeking appropriate medical care is equally dangerous.

This meal plan is designed to feed and nourish the brain tissue itself, provide the raw materials for development of neurotransmitters, avoid common food allergens, and balance and regulate blood glucose metabolism.

Not everyone with BDS needs to have such a hypoallergenic diet. This example is consistent with common food intolerances as outlined in The Virgin Diet and other popular elimination diets. Gluten , dairy , soy, corn , , peanuts, added sugar and artificial sweeteners, and eggs should be avoided until proven safe for each individual. This is only an example and approved foods should be rotated on a daily basis to prevent further development of food sensitivities, intolerances, reactions, or allergies.

All of the recipes for the meals can be found in the reference section. The dietary supplement dosages have been omitted as these should be determined by a qualified practitioner. Further supplements may be suggested to support whole body function. While this diet supports whole body function, some people with BDS can have individualized needs over and above this. Not all symptoms or signs can be ascribed to the diagnosis of BDS. Additionally, those who are intensely training, which I recommend for those with BDS, will have higher nutrient demands.

First thing in the morning
Sole therapy using Original Himalayan Crystal Salt
Tyrosine supplement
NAC (N-acetylcysteine) supplement

7:00 am
Vegan protein shake
3 tbsps first press extra virgin olive oil
Inositol powder supplement
Methylation supplement with vitamins B6, B12, and folate ,
Zinc supplement ,
Vitamin C supplement
Vitamin D supplement ,
Phosphatidylcholine supplement
Multivitamin/ multimineral supplement

7:30 am
“Bulletproof” coffee with
1 tbsp organic grass-fed butter
1 tbsp MCT (medium-chain triglyceride) oil

The first meal of the day is incredibly important as many times someone with BDS won’t stop during the day to eat until they have lost all willpower and end up gorging on unhealthy, easily accessible foods. Those with BDS have a tendency toward blood sugar highs and lows. A mix of protein and fat keeps this pattern more even throughout the day. , After breakfast is the longest stretch of the day in this plan and it’s important to begin the day well nourished.

We start the day with a salt therapy as well which wards off cravings and supports adrenal and digestive function. The rest of this meal plan is relatively low in salt as it is devoid of highly processed foods, yet salt is important, especially for those with mood and craving challenges.

Sole therapy is made from premium salt only, preferably large granules or stones. Salt stones are placed in a container with pure, fresh water and allowed to saturate so that some stones remain at the bottom. This creates a fully saturated solution. A teaspoon of this super saturated solution is added to a large glass of water (12-16 ounces). Drink up. If it is too salty, next time add the teaspoon to a larger glass of water. Most people acclimate to the taste of mildly salty water and buttery coffee quite surprisingly quickly. Give it at least a week, but preferably three weeks.

The recommendation for those with BDS to avoid coffee is largely speculative. BDS coffee intolerance likely mimics the general population. If coffee makes you wired all day or if you could drink a cup at 10:00 pm and fall fast asleep, you should avoid it. If you cannot have coffee, a dark tea works as well. Otherwise, consider adding the butter and oil to your morning shake.

You need the fat but watch for greasy stools and/ or discomfort on the right side of your ribcage as these are signs of exceeding bowel or gall bladder tolerance of fat. If anyone has trouble with the amount of fat this early in the morning, I suggest a pancreatic digestive enzyme with lipase and the amino acid taurine to support the gall bladder. If greasy stools persist, reduce all oils and fats temporarily and remain on the enzyme and taurine until your body adapts to using fat for fuel.

11:30 am
Healthy Caesar Salad
• Use an oil dressing instead of a creamy one. A house salad is usually sufficient but be sure to get your greens in. A Caesar salad alone will be insufficient for those with BDS. Additional phytonutrients (plant nutrients beyond vitamins and minerals) and proteins should be included in this mid-day meal.

And

Salmon, Cucumber, Dill
• 6 ounce salmon filet
• 1/4 cucumber
• 1/4 tomato
• 1/4-1/3 avocado

2:30 pm
1 cup raspberries
Vegan protein shake
Fish oil liquid supplement
Methylation supplement – a combination of vitamins B6, B12, and folate
Zinc supplement
Vitamin C supplement
Multivitamin/ multimineral supplement

The focus of lunch is on fresh foods. The above examples and similar dishes can often be found in casual dining establishments if necessary. Antioxidants and phytonutrients are the name of the game as we shift from a fatty breakfast to a more balanced lunch and afternoon snack. Ideally, eating a variety of at least nine different plants each day is a good way to go.

5:30 pm
Chicken curry over spinach
• 4-6 ounces of chicken
• 3 cups of spinach
• Coconut milk

Side of mixed fermented vegetables

Evening meals consists of vegetables and lean protein. Keep it simple. If you choose to be vegetarian or vegan, then think about this as a major protein meal. Nuts, seeds, and tolerated legumes may be good alternatives.

8:30 pm
Branched-chain amino acid (BCAA) supplement (optional)

A BCAA supplement is often an excellent way to ward off the “continuous meal” that occurs in modern American households after work hours. Alcohol, sweets, salty and savory snacks tend to round out the day even despite good choices earlier in the day and those with BDS should protect themselves against this. Poor choices in the evening often result in a lack of appetite the next morning.

Before bed
5-HTP supplement (only under the supervision of a qualified healthcare practitioner trained in nutritional and functional medicine when taking medications for depression)

The Numbers
Often the first concern patients share with me is “this is going to make me fat.” This is when I break down “the numbers.” Some of you may also be in interested in the numbers, so, even though it pains me to do so because I am not a calorie-counter, a gram-counter, or a percentage measurer, here are the details. I haven’t seen patients get fat on this type of plan. In fact, many patients who could stand to lose a few extra pounds do as excess carbohydrates, excess calories, and derogatory fats are typically the culprits in weight gain. If you are gaining weight, reduce food in all categories, not just the fats.

Grams Calories % of diet
Fats 153 1377 66
Protein 127 508 24
Carbohydrates 50 200 10
2085 100%

If after three weeks on a food plan that resembles these macronutrient proportions you are feeling worse from a mental health perspective, stop and work with a holistic nutritionist or nutrition specialist who can modify the plan based on your history as well as your reaction to this experimental diet. Further testing may be helpful at this point as well.

Personalized lifestyle medicine is in fact an art and not all diets are effective despite similar or identical diagnostic criteria. If after three weeks you are feeling great on this type of macronutrient proportion diet, consider remaining on a similar plan and over time replacing fats with additional proteins and minimally refined carbohydrates Continue to refrain from processed carbohydrates and known sensitivities whenever possible. The above meal plan is rich in minerals, vitamins, and phytonutrients in addition to its unique ratio of proteins, fats, and carbohydrates.

Conclusion
Those who fall on the bipolar spectrum are often high-functioning, even high-achieving individuals. It may surprise you that well-known actors, artists, and executives live with bipolar disorder spectrum. Be assured that a BDS diagnosis does not have to be a limiting factor for anyone’s life. Practicing the Clear Mind Diet as part of the protocol can lead to a highly satisfying life filled with deep personal and healthy relationships.

Sources:
1 Bazinet RP. Is the brain arachidonic acid cascade a common target of drugs used to manage bipolar disorder? Biochem Soc Trans. 2009 Oct;37(Pt 5):1104-9.
2 Dickerson F, Stallings C, Origoni A, Vaughan C, Khushalani S, Alaedini A, Yolken R.Markers of gluten sensitivity and celiac disease in bipolar disorder. Bipolar Disord. 2011 Feb;13(1):52-8.
3Severance EG, Dupont D, Dickerson FB, Stallings CR, Origoni AE, Krivogorsky B, Yang S, Haasnoot W, Yolken RH.Immune activation by casein dietary antigens in bipolar disorder. Bipolar Disord. 2010 Dec;12(8):834-42.
4Goldberger, J. and G. A. Wheeler (1990). “Experimental pellagra in the human subject brought about by a restricted diet. 1915.” Nutrition 6(5): 357-360; discussion 361-352.
5Goldberger, J. (2006). “The etiology of pellagra. 1914.” Public Health Rep 121 Suppl 1: 77-79; discussion 76.
6http://www.himalayancrystalsalt.com/sole-recipe.html
7Kummer A, Dias FM, Cardoso F, Teixeira AL.Low frequency of bipolar disorder, dopamine dysregulation syndrome, and punding in Brazilian patients with Parkinson’s disease. Rev Bras Psiquiatr. 2010 Mar;32(1):62-5.
8Magalhães PV, Dean OM, Bush AI, Copolov DL, Malhi GS, Kohlmann K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Berk M.A preliminary investigation on the efficacy of N-acetyl cysteine for mania or hypomania. Aust N Z J Psychiatry. 2013 Jun;47(6):564-8
9Chengappa KN, Levine J, Gershon S, Mallinger AG, Hardan A, Vagnucci A, Pollock B, Luther J, Buttenfield J, Verfaille S, Kupfer DJ.Inositol as an add-on treatment for bipolar depression. Bipolar Disord. 2000 Mar;2(1):47-55.
10Baek JH, Bernstein EE, Nierenberg AA.Aust N Z J Psychiatry. 2013 Aug 22. One-carbon metabolism and bipolar disorder.
11Ozbek Z, Kucukali CI, Ozkok E, Orhan N, Aydin M, Kilic G, Sazci A, Kara I. Prog Effect of the methylenetetrahydrofolate reductase gene polymorphisms on homocysteine, folate and vitamin B12 in patients with bipolar disorder and relatives. Neuropsychopharmacol Biol Psychiatry. 2008 Jul 1;32(5):1331-7
12Mizuno T, Omata N, Murata T, Mitsuya H, Maruoka N, Mita K, Kiyono Y, Okazawa H, Ikeda H, Wada Y.Mania: not the opposite of depression, but an extension? Neuronal plasticity and polarity. Med Hypotheses. 2013 Aug;81(2):175-9.
13González-Estecha M, Trasobares EM, Tajima K, Cano S, Fernández C, López JL, Unzeta B, Arroyo M, Fuentenebro F.Trace elements in bipolar disorder. J Trace Elem Med Biol. 2011 Jan;25 Suppl 1:S78-83.
14Naylor GJ. Vanadium and manic depressive psychosis. Nutr Health. 1984;3(1-2):79-85.
15Ahmadi S, Mirzaei K, Hossein-Nezhad A, Shariati G.Vitamin D receptor FokI genotype may modify the susceptibility to schizophrenia and bipolar mood disorder by regulation of dopamine D1 receptor gene expression. Minerva Med. 2012 Oct;103(5):383-91.
16Anglin RE, Samaan Z, Walter SD, McDonald SD. Vitamin D deficiency and depression in adults: systematic review and meta-analysis. Br J Psychiatry. 2013 Feb;202:100-7.
17Jope RS, Tolbert LC, Wright SM, Walter-Ryan W.Biochemical RBC abnormalities in drug-free and lithium-treated manic patients. Am J Psychiatry. 1985 Mar;142(3):356-8.
18http://www.bulletproofexec.com/how-to-make-your-coffee-bulletproof-and-your-morning-too/
19Amsterdam JD, Maislin G.Hormonal responses during insulin-induced hypoglycemia in manic-depressed, unipolar depressed, and healthy control subjects. J Clin Endocrinol Metab. 1991 Sep;73(3):541-8.
20Calkin CV, Gardner DM, Ransom T, Alda M.The relationship between bipolar disorder and type 2 diabetes: more than just co-morbid disorders. Ann Med. 2013 Mar;45(2):171-81.
21http://www.whfoods.com/genpage.php?dbid=23
22http://www.whfoods.com/genpage.php?dbid=130
23Stoll AL, Severus WE, Freeman MP, Rueter S, Zboyan HA, Diamond E, Cress KK, Marangell LB.Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial. Arch Gen Psychiatry. 1999 May;56(5):407-12.
24http://www.whfoods.com/genpage.php?dbid=51
25http://www.dakotasbest.biz/ProductDetails.asp?ProductCode=MJP1276
26Metz JT, Holcomb HH, Meltzer HY. Effect of 5-hydroxytryptophan on H-reflex recovery curves in normal subjects and patients with affective disorders. Biol Psychiatry. 1988 Mar 15;23(6):602-11.

photo credit

About the author...

 is a board-certified nutrition specialist and functional medicine clinician. He is a frequent radio and podcast guest on the topic of connecting the dots between mood, hormones, and metabolism. He has appeared on Underground Wellness, Elevate Your Energy, Five to Thrive Live, Primal Diet Modern Health, Doctor Health Radio, Let’s Get Healthy with Bill Swail, Good News Health Show, Healthy Choices, and The Opening Door. He teaches for the School of Applied Clinical Nutrition and The Institute of Transformational Nutrition, is a frequent speaker at functional medicine and nutrition conferences for practitioners, and consults for nutritional supplement companies. Growing up on a family farm, followed by a stint in research chemistry at NASA, taught Dr. Schuler to combine nature and science in a systems approach to health and healing. He is the creator of the Clear Mind Diet and the author of When Nutrition Doesn't Work: What Went Wrong and How to Find a New Doctor available on Kindle. He is the clinic director for Metabolic Treatment Center which uses food-based, functional medicine approaches to bipolar, depression, and anxiety, PCOS, food sensitivity recovery, and thyroid disorders.

Leave a Reply

Your email address will not be published.