In the US, most people have tried at least one form of alternative medical treatment for one ailment or another, such as saw palmetto extract for prostate problems or avoiding wheat products to ease the pain of celiac disease. Many of these non-pharmaceutical interventions are widely accepted, even by doctors. In fact, medical studies are proving that quite a few of the vitamins, supplements, tonics, exercises, and diets long touted for various illnesses can be effective, and they often do not carry the same risks and side effects as prescription drugs.

But before you leave your psychiatrist for the nearest health food store or alternative healthcare provider, there are two things you should know.

First, it is very unwise to rely solely on alternative measures to treat bipolar disorders, with the possible exception of mild cyclothymia or seasonal affective disorder. The risks of going without medical treatment include death by suicide or accident, and the terrible personal consequences of self-injurious behavior, manic spending sprees, hypersexuality, and all the rest. Parents must be especially careful to ensure proper medical care for bipolar children and adolescents, as minds and bodies cannot develop properly when a child is in the throes of depression, mania, or psychosis.

Second, there is much misinformation--some of it deliberate--abroad in alternative healthcare. Botanical formulas can differ wildly in their potency, both from manufacturer to manufacturer, and from vial to vial. There is also a potentially dangerous lack of scientific and regulatory oversight in this field, and sometimes a blatantly anti-science attitude. Some alternative practitioners are well-trained and highly competent, while others are charlatans.

Accordingly, you must be wary of the claims you read in advertisements, in magazine and newspaper articles, or on the Internet. Check the credentials of alternative practitioners before you heed their advice, especially if it involves expensive tests or remedies. And be doubly doubtful if an alternative practitioner encourages you or your child to forego prescription medications. None of the herbal remedies or other alternative treatments available today is known to cure bipolar disorders; in fact, if you see or hear such claims, you should be highly suspicious right away.

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Note for non-US readers:
Your experience may differ from that of US patients, depending on where you live. In Germany, for example, standardized herbal remedies are available by prescription and are widely used. There have also been more clinical trials of herbal formulas in Europe. However, parents must still research carefully and proceed with caution, especially if they are planning to use an herbal remedy at the same time as a prescription drug.

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Despite the ease with which adults demand the latest prescription pill for everything from premature balding to weight loss, many people are very much against giving psychiatric medications to children. Well-meaning friends and relatives may approach you with information about natural cures for childhood behavior problems or mental illness, and get angry if you say you're not interested. Often these people either don't know your child's actual diagnosis, or have no idea what a serious illness it is. Just as you have a right to consider alternative medical treatments, you also have a right to stick with your doctor's regimen--especially if it's working.

I haven't tried anything alternative yet. I have read about these treatments, but he is stable on prescribed meds, and I don't want to play with that. --Lynn, mother of 11-year-old Michael (diagnosed BPI with mixed states and psychosis, OCD, tic disorder)

The role of alternative treatments

A holistic approach to health takes into account all aspects of physical, emotional, and spiritual well-being. That's important when treating bipolar disorders because of their far-reaching impact on personal functioning. You can complement pharmaceuticals with some alternative treatments, often reducing the dose and thereby eliminating some of the dangers and side effects carried by many psychiatric medications. This combination approach is called complementary medicine: using the best of what medical science has to offer, and complementing it with less invasive techniques.

Many alternative treatments have a preventive focus, rather than merely treating symptoms of illness after they emerge. Alternative practitioners also stress empowering the patient, making him responsible for self-care measures. Even if all that does is make patients feel better because they're putting out more effort on their own behalf, the effects can be powerful.

Finally, a few people with bipolar disorders never find full relief from any medication, especially those who are rapid cyclers. Don't give up on finding a better medication or combination of medications, but if your child has seemingly tried it all for an adequate amount of time without benefit, you may find at least partial relief with a different approach.

Occasionally a patient will have very valid health reasons for giving up pharmaceutical treatments that are actually working. For example, almost all of the medications used to treat bipolar disorders are believed to cause birth defects, so pregnant girls and women who are bipolar can find themselves faced with a terrible choice. Temporary reliance on alternative methods under careful supervision, with a return to the use of effective medication as soon as possible, can protect both the developing fetus and the mother's health. Should your child develop another serious health condition, such as cancer, conflicting medications might have to be temporarily discontinued during chemotherapy, preparation for surgery, or certain types of medical treatment. So even if alternative treatments are not right for your child now, they might be useful someday.

Alternative treatments rarely produce dramatic changes. When they work, they usually assist your body's own self-righting mechanisms, promoting better sleep, fewer and less severe mood swings, improved general health, and a better frame of mind.

Evaluating alternative interventions

To get the clearest picture possible of any alternative interventions, you must introduce them independently of each other, and independent of pharmaceuticals or therapeutic interventions. Obviously, this will often be impractical--you wouldn't stop lithium just to see if B vitamins might be useful.

Barring the one-thing-at-a-time scenario, keep careful, daily records of supplements and dietary changes you introduce, when they are given and in what amounts, what brands you used, and any visible effects that you observe. If after four to six weeks you have not seen improvements with a supplement, it's unlikely that it will be of benefit. Dietary changes, bodywork, and other interventions may take much longer to bear fruit.

Remember that many parents report initial problems with supplements and dietary changes, and some children may be resistant to bodywork at first as well. Don't gloss over dangerous side effects, but expect to weather some behavior problems for a couple of weeks.

If you can convince your physician to make alternative therapies part of his prescription, you're in luck. Some actively oppose them, and that may force you to find a new doctor. Whatever you do, don't operate behind your doctor's back in any significant way. If you're philosophically incompatible, you should simply part ways--but you need a medical expert on your team.