Bipolar Disorder (BD) is a relatively new diagnostic category, derived from a rare psychiatric condition, Manic-Depressive Disorder. BD is characterized by mood swings. Its definition has been controversially expanding, incorporating milder conditions (1). The conventional approach to treatment emphasizes life-long medications management with the goal of reducing inevitable relapses (2,3), while accepting side effects, high treatment costs and disability rates.
We developed an individualized holistic approach with a goal to achieve long term recovery (4). The initial stage usually lasting several weeks is focused on searching for etiological factors, reducing general toxicity, addressing life-style and behavioral patterns, digestive issues and energetic instabilities. It is accomplished with behavioral modification, acupuncture and orthomolecular supplementation with vitamins, minerals and amino-acids (5,6,7). The goal is to reduce symptoms while treating the underlying causes of imbalance.

During the medication titration and emotional stabilization phase that can last several months to years, the etiologies which caused and support BD are addressed. Medications are slowly titrated and the process is supported by orthomolecular supplementation and multiple other modalities. Emotional traumas are resolved by using EMDR, energy work and positive psychology, guided imagery and Systemic Family Constellation therapy, homeopathy and five element acupuncture. Endocrine issues are resolved using bio-identical hormone supplementation, herbal, homeopathic protocols and neural therapy. Digestive issues, like SIBO are resolved using elimination protocols (8), dietary modification, digestive enzymes, neural therapy, probiotics, herbal antibiotics and anti-parasitic supplements. Patients are trained in self-regulation and empowered through keeping a diary, and practicing meditation and yoga. Toxicity is addressed by removing amalgam fillings and herbal chelation.
The healing of BD is a life-long process. Initially patients require our support and counsel as they learn to live a medication free, holistic life-style and resume a normal life by practicing resilience and self-regulation. In time, supplements and required clinic visits are reduced as the patient becomes more self-reliant. The role of the practitioner is to guide the patient through self-discovery on their path to wellness to embrace this holistic approach, practitioners need to be well versed in multiple healing modalities, well-aligned as a team, and practice what they preach.

1. Frances A, editor. Saving normal: an insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, Big Pharma, and the medicalization of ordinary life. New York, NY: William Morrow Paperbacks; 2012.
2. Hirschfeld RMA, Bowden CL, Gitlin MJ, et al. Practice guideline for the treatment of patients with bipolar disorder. In: American Psychiatric Association, editor. American Psychiatric Association practice guidelines for the treatment of psychiatric disorders. Washington, DC: American Psychiatric Association; 2002:547-634.
3. Suppes T, Baldessarini RJ, Faedda GL, Tondo L, Tohen M. Discontinuation of maintenance treatment in bipolar disorder: risks and implications. Harv Rev Psychiatry. 1993;1(3):131–44
4. Michael I. Gurevich, MD; Cassandra L. Robinson, MS, LPN Medication Free Alternatives for Long-Term Maintenance of Bipolar Disorder: A Case Series. Accepted for publication by Global Advances in Health and Medicine Akhondzadeh S, Gerbarg PL, Brown RP. Nutrients for prevention and treatment of mental health disorders. Psychiatr Clin North Am. 2013;36(1):25–36.
5. Sylvia LG, Peters AT, Deckersbach T, Nierenberg AA. Nutrient-based therapies for bipolar disorder: a systematic review. Psychother Psychosom. 2013;82(1):10–9
6. Rucklidge JJ, Kaplan BJ. Broad-spectrum micronutrient formulas for the treatment of psychiatric symptoms: a systematic review. Expert Rev Neurother. 2013;13(1):49-73.
7. Sarris J, Lake J, Hoenders R. Bipolar disorder and complementary medicine: current evidence, safety issues, and clinical considerations. The Journal of Alternative and Complementary Medicine. 2011;17(10): 881-90.
8. Gottschall EG, editor. Breaking the vicious cycle: intestinal health through diet. Baltimore, ON: Kirkton Press; 1994.

Michael I. Gurevich, M.D., C.Ac.
Tia Trivisonno, N.D., LAc.

997 Glen Cove Avenue, Glen head, NY 11545
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WWW.HolisticMD.org [email protected]
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