"The theme of healthy nutrition is important for all youth, but especially for youth with mood disorders, as they are at increased risk for heart disease and related physical conditions such as diabetes and obesity."

Maintaining a nutrition-balanced diet is a crucial part of disease prevention and living a healthy lifestyle. For adolescents in particular, major biological changes place greater nutritional demands on the body than at any other point in life. If these nutritional needs are overlooked, serious health complications and negative effects on physical and mental growth or maturation could take place.

According to research conducted by Dr. Benjamin Goldstein, director of the Centre for Youth Bipolar Disorder in Toronto, adolescents with bipolar disorder are significantly more likely to have poor nutritional behaviors than those with other/without mood disorders. Dr. Goldstein et al.'s study, published in the Journal of Affective Disorders, examines the relationship between eating behaviors in healthy adolescents and adolescents with bipolar disorder, as well as demographic correlations that might identify individuals who could particularly benefit from treatment and prevention strategies related to nutrition.

Demographic & Clinical Differences in Nutritional Behavior

Past studies have found that unhealthy eating behaviors--including the consumption of processed foods and low consumption of foods with essential nutritional values--can lead to depression, low mood, anxiety, substance abuse and even suicide attempts in adolescents. Dr. Goldstein et al.'s study examined several demographic and clinical factors that may have a significant influence on nutritional behaviors of adolescents and young adults with bipolar disorder.

  • Living with/without Bipolar Disorder: As compared to participants without bipolar disorder, adolescents with bipolar disorder are far more likely to engage in stress-induced eating behaviors such as binge eating and emotional eating.
    • Effects of Medication: "Youth with bipolar disorder are likely to be treated with medications that impact appetite and weight gain, which comprise additional challenges to maintaining healthy nutrition," says Dr. Goldstein.
    • Shared Symptoms: It is important to note that bipolar disorder and eating disorders are both marked by cognitive aspects such as impulsive behaviors, severe mood and cognitive disturbances.
    • BP & Eating Disorders: Bipolar disorder is also associated with food insecurity, poor nutritional variety and dietary excess, which further demonstrate a correlation between bipolar disorder and eating disorders. Binge eating disorders in particular can be seen as a coping strategy associated with emotional irregularities and intense mood swings.
    • Mood & Eating Behaviors: It is also possible that irregular eating behaviors and poor diets can heighten symptoms of bipolar disorder. Mood dysregulation both causes and increases likelihood of poor diet, demonstrating a bi-directional relationship between bipolar disorder and nutrition.
  • Demographic Differences: After examining demographic factors--such as gender, age, race and socioeconomic status--the study found that race was the only variable that differed significantly among the groups tested, reflecting a higher sample of Caucasian participants in the bipolar disorder group than in any other group.
"Establishing alternative coping strategies can potentially help reduce the use of eating as a "self-medication" strategy."

How Doctors and Professionals Can Help

The results of this study demonstrate a need for greater emphasis on healthy eating behaviors and nutrition in the treatment of adolescents and young adults with bipolar disorder. In particular, individuals with higher levels of impulsivity and emotional dysregulation may benefit from certain interventions related to eating behaviors. Dr. Goldstein explains several steps that can be taken to further emphasize the importance of healthy nutrition.

  • Be Aware of What is Happening: Traits such as emotional dysregulation and impulsivity, are associated with binge-eating and emotional eating. Being aware of this association between emotional dysregulation and negative eating behaviors can serve as a target or guideline for clinicians when treating patients with bipolar disorder.
  • Counsel Patients Individually: Dr. Goldstein says, "It's important that strategies for optimizing dietary intake and nutrition are personalized to the individual. There are several common triggers for overeating and/or for choosing carbohydrate-rich foods, among people with bipolar disorder, and these could serve as part of the focus for counseling strategies." It is important to personalize counseling strategies in order to have the best impact on each individual patient.
  • Establish Alternate Coping Strategies: It is common for people with bipolar disorder to use food and eating to alleviate stress, anxiety, sadness or depression. Dr. Goldstein mentions, "Establishing alternative coping strategies can potentially help reduce the use of eating as a "self-medication" strategy."

Overall, Dr. Goldstein says, "Helping patients develop better coping strategies that allow them to better tolerate distress and/or inhibit impulses may yield improvements in eating behaviors as well as other related behaviors such as substance use."

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Date of original publication:

Updated: January 18, 2017