• Acupuncture
  
• Ayurvedic and other traditional medicine
  
• Chiropractic
  
• Massage and bodywork
  
• Naturopathy
  
• Holistic psychology
  
• Homeopathy
  
• Nutrition-based therapies
  
• Orthomolecular medicine
  
• Osteopathy
  

Alternative treatments may be suggested by your family doctor or psychiatrist, or by a specialist in a particular type of treatment. The most common types of alternative medical practices are explained in the following sections:

Acupuncture

Developed in China, acupuncture is based on the idea that an energy force called ch'i flows through the human body. If your ch'i is blocked, as acupuncture theory states, illness results. Modern acupuncturists use tiny, sterile, disposable needles inserted into the skin to undo these blockages. Some also employ heat, (noninvasive) lasers, magnetic devices, or electrical stimulation.

You don't have to believe in the ch'i concept to enjoy the benefits of acupuncture. Even the alternative medicine skeptics at the National Institutes of Health admit that it has value for treating chronic pain, and as an adjunct to other methods in the treatment of drug addiction (in fact, NIH is currently funding several studies on acupuncture). Some Western doctors think that acupuncture may work by influencing the body's production of natural opioid chemicals and neurotransmitters.

Reputable research indicates that properly applied acupuncture treatments may help heal nerve damage, which may in turn reduce anxiety and mood swings. There have been anecdotal reports from bipolar adults about acupuncture as an effective treatment for manic episodes (actress Margot Kidder, who has bipolar I disorder, claimed to have been successfully treated by an acupuncturist after a much-publicized manic/psychotic episode a few years ago). If you can find a good acupuncturist, it might be a worthwhile adjunct to other types of medical care.

Ayurvedic and other traditional medicine

Before the advent of modern medicine, people everywhere relied on herbal remedies. India's Ayurveda and traditional Chinese medicine (which also includes acupuncture) are two herbal systems that have been studied to a great extent. The Ayurvedic medicine concept revolves around a life-force called prana, which is comparable to the Chinese ch'i mentioned previously.

Ayurvedic practitioners will give you a thorough exam and tell you which "type" you are in their diagnostic system. Then they'll suggest an appropriate diet, lifestyle adjustments, and probably meditation. They may also have various suggestions about cleaning out your digestive tract, and may prescribe herbal remedies.

Chinese traditional medicine practitioners take a very similar approach, although their dietary recommendations tend to be less strict than a typical Ayurvedic plan. They may recommend physical and breathing exercises as well as herbs.

There is a vast array of Ayurvedic and Chinese herbal remedies available, most of which have not been tested by Western researchers. Some of these concoctions are probably quite effective, while others could be dangerous to your health. Try to find out exactly which herbs are in a remedy, and then check out their known effects in a reference book on herbs. For example, the popular Chinese herb Ma Huang (ephedra) is a common ingredient in traditional "nerve tonics." It is also a powerful central nervous system stimulant, and should be taken with caution.

Chiropractic

Chiropractors use their hands or special equipment to make "adjustments" to the spine and related body structures. This is useful for some people with back pain, and sometimes appears to help with other disorders.

There is no scientific reason for chiropractic adjustments to alleviate the symptoms of bipolar disorders, but some people have reported symptom reduction. There could be something about chiropractic and the nervous system that's yet to be discovered.

Massage and bodywork

"Bodywork" is a general term that covers a wide variety of therapeutic practices. Most of them involve massaging, manipulating, or moving the muscles and body parts in specific ways. These practices differ in style, intensity, and intent, and include:

• Acupressure. Similar to acupuncture, it employs firm or light pressure applied to specific sites on the body rather than needles. Acupressure does have a track record in helping with chronic pain and some physical disorders. Its efficacy for bipolar symptoms is unknown.
• Massage. There are many forms, including Swedish, Shiatsu (which resembles acupressure), and more. It can promote relaxation, physical comfort, and body awareness. It may also help decrease sensory defensiveness. Its efficacy for other bipolar symptoms is unknown.
• The Feldenkrais Method. Developed by Moshe Feldenkrais, this concentrates on rebuilding sensory and movement systems, particularly through unlearning poor movement patterns. A number of Feldenkrais practitioners work with children who have neurological problems. The therapy is gentle, and some children have experienced gross-motor, fine-motor, sensory, and relational improvements. A variant called Feldenkrais for Children with Neurological Disorders (FCND) is specially geared toward this population. The efficiency of Feldenkrais for bipolar symptoms is unknown. For more information on FCND, see the Movement Educators web site.
• Craniosacral therapy. Involves delicately manipulating the plates of the skull and the "cranial tides" of the body. Some may question the scientific basis of craniosacral work, but it is gentle, noninvasive, and parents of many children with neurological problems say it has been helpful. Most craniosacral therapists employ a certain amount of talk therapy along with the bodywork, which may or may not appeal to your child. Its efficacy for bipolar symptoms is unknown. Although it was developed by osteopath John Upledger, craniosacral therapy is practiced by trained members of other professions, including some occupational therapists and physical therapists. Upledger includes some accounts of beneficial use of this therapy for people with mental illness in his book Your Inner Physician and You: Craniosacral Therapy and Somatoemotional Release (1997, North Atlantic Books). For more information, see the Craniosacral Therapy web site.
• The Alexander Technique. Used to help patients streamline and increase the gracefulness of their movements. Practitioners teach patients new, more balanced movement patterns. Since self-awareness is an important part of this approach, the Alexander Technique is probably more applicable to teenagers and adults than to children. Its efficacy for bipolar symptoms is unknown. For more information, see the Alexander Technique web site.

Some bodywork believers make extravagant claims. For any bodywork method, including those not mentioned here, check the practitioner's credentials, and make sure you feel comfortable with both the person and the methodology.

All of the modalities listed here have accrediting bodies in most Western countries. Generally speaking, accredited, well-trained practitioners are more likely to do beneficial work than self-trained or non-accredited practitioners.

If you happen to be near a massage school or a training center for another bodywork method, inexpensive classes may be available. Some schools also operate free or low-cost clinics that allow students to practice on patients under close supervision.

Naturopathy

Naturopaths are licensed to practice medicine in some countries, and also in some US states and Canadian provinces. They use the designation ND rather than MD. Their focus is on preventive and holistic healthcare.

Naturopaths vary in their personal philosophy about Western medicine. Some will refer patients to an MD for ailments they feel are out of their league, others prefer to rely only on nutritional and natural medicine.

When Lili was 13, she saw a naturopath a few times who tried to treat her with B-vitamin injections and a better diet. It seemed to clear up her constant bronchial symptoms a bit and brighten her mood, but the effects wore off quickly. On the other hand, the herbal remedy he gave her for a urinary tract infection worked as well as any pharmaceutical I've ever seen. --Sarah, mother of 17-year-old Lili (diagnosed bipolar II disorder, OCD)

Be careful when you choose an ND. In the US, some people calling themselves naturopaths have not completed an accredited program. Properly licensed naturopaths receive medical training that is roughly comparable to traditional medical school, but with a different emphasis.

For information about finding a licensed naturopath in the US or Canada, contact the American Association of Naturopathic Physicians or the Canadian Naturopathic Association.

Holistic psychology

Technically, a holistic psychologist should have the same credentials as a regular psychologist, plus training in holistic health-promotion practices. In practice, this may not be the case, so be sure to ask. Depending on the practitioner, holistic psychology would appear to be of significant value to people with bipolar disorders who would like to combine talk therapy with alternative healthcare practices.

A holistic psychologist might recommend a combination of dietary changes, nutritional supplements, exercise, biofeedback, and mood control techniques, such as meditation or self-hypnosis. Helping the patient build an effective support system should also be part of the plan. These interventions would have the overall goal of helping to normalize physical health, improve mental stability, and help the patient have a more enjoyable and productive life.

Homeopathy

Homeopathy is based on the principle that remedies containing infinitesimal amounts of substances that could cause the medical condition being treated can instead prod the immune system into action against the condition. Homeopathy is considered to be fairly mainstream in the UK.

In the US and Canada, homeopathic physicians are not licensed to practice medicine. However, some MDs and NDs do recommend homeopathic treatments, and a few homeopaths are also fully licensed medical or naturopathic doctors. For information about homeopaths in North America, see the National Center for Homeopathy web site.

Homeopathy does not seem to have a good track record as an intervention for bipolar disorders, although some patients report that certain homeopathic remedies can occasionally provide relief from anxiety and physical distress associated with mood swings. Most mainstream physicians believe that homeopathic remedies contain too little of the active ingredient to have any medical effect. That said, homeopathic remedies are also too diluted to cause any harm, and it's a well-known fact that if you believe a placebo will help, you may actually experience a reduction in symptoms.

Nutrition-based therapies

Nutritionists are experts in how food intake affects health. Some are employed by hospitals, clinics, and long-term care facilities to improve patient care through appropriate diet. Others work in private practice. Some nutritionists have very traditional views about diet, while others may recommend what seem like radical changes. Be sure to check the credentials and training of any nutritionist you consult, and pay attention to your intuition if her suggestions seem unreasonable or potentially unhealthy.

If your child has an eating disorder in addition to a bipolar disorder, a nutritionist with background in dietary interventions for these disorders should definitely be part of your treatment team. You may also want to consult a nutritionist about dietary changes that could be beneficial, such as the special diets mentioned later in this chapter.

Orthomolecular medicine

The most famous proponent of orthomolecular medicine was its late founder, Dr. Linus Pauling. Better known for receiving the 1954 Nobel Prize for Chemistry and the 1962 Nobel Prize for Peace, Pauling spent most of his later life studying and publicizing the effects of megadoses of vitamins, particularly vitamin C. Many of Dr. Pauling's more extravagant claims have not been substantiated by research, but his reputation forced the medical establishment to take his ideas seriously.

Some MDs, NDs, nutritionists, and other practitioners are firm believers in orthomolecular medicine, and Pauling's principles underlie many of the megadose vitamin concoctions on health food store shelves. Since large doses of vitamins can have side effects as well as potential benefits, be sure to talk with your doctor about what to watch out for and how any benefits will be assessed. You definitely shouldn't do megadose vitamin therapy without consulting a competent professional first.

Osteopathy

Osteopaths operate somewhat like chiropractors, adjusting the musculoskeletal system to effect improvement. In the UK, licensed osteopaths participate in the National Health scheme. Osteopaths are licensed to practice medicine in all US states, and use the initials DO (Doctor of Osteopathy) instead of MD.

One area of osteopathy-related treatment, craniosacral therapy, is often recommended for children with neurological challenges.