I have taken ayurveda medicines and fish oils to increase serotonin, but now psychiatrist (from nimhans) has diagnosed me with bipolar depression, so he prescribed me oleanz plus 20 mg/5 mg tablet for 30 days (one tablet daily at night after food). He also given me a general advice on regular exercise which helps increase serotonin and dopamine. So, my question is?the mechanism of the prescribed drug: oleanz plus tablet is a combination of two medicines: fluoxetine and olanzapine. They work by increasing the activity of certain chemicals called serotonin, norepinephrine, and dopamine in the brain. These chemicals help relieve the symptoms of bipolar depression. But can I replace the prescribed drug with natural treatments like exercise, meditation/breathing exercises, gratitude, new hobbies like reading good books which naturally increase serotonin and dopamine in the brain? I want to replace it because, according to the psychiatrist, the prescribed drug (oleanz plus 20 mg/5 mg) will work 50% for me and with that if I do regular exercise, it will work more than 50% (but not 100%) I did?t start the medication (the prescribed one) yet? so can I replace it with exercise/fitness/meditation although the mechanism is similar i.e. To increase serotonin? And in past I used to take fish oils/ ayurveda medicines and I stopped it now.

Ankit GuptaPsychiatrist10yrs exp

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Dear Lybrate user, if the diagnosis of bipolar depression is correct then some form of medication will be required in addition to all the lifestyle and dietary changes. The choice of medication can be discussed with doctor and there are several options available. The role of medication is not only to treat depression but also to prevent its recurrence or to prevent excited manic state. There is ample evidence of physical exercise, regular sleep schedule, mindfulness, dietary supplementation, avoiding drug and alcohol, and psychotherapy in helping with the symptoms but they are not sufficient enough to prevent relapse in bipolar disorder. Best would be to use combination of medication and other measures which will minimise your dosage requirements. I cannot comment on efficacy of ayurvedic medication for this illness. You have also mentioned several different psychiatric diagnosis in the past, it will be a good idea to get a detailed assesment to confirm the diagnosis.  

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Mr. Saul PereiraPsychologist49yrs exp

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The problem is that there is a chemical imbalance to your disorder, which means that your brain which is capable of producing the same is not doing so for various reasons. Your intention is not only good but admirable. But the way to go about it is to gradually get the support of supplementary actions to enable the brain to restore the actual production with certain exercises and habits. This must be a carefully monitored process and is ideally done by a professional. So don't do it on your own and my sincere advice is for yo to seek the help of a good counselor to support your intentions and help the natural process to take over by using appropriate adaptations. Comply with all the medical prescriptions and work in tandem with a counselor for a long time and learn coping skills and techniques to handle the daily challenges you will face. There are certain adaptations that will suit you during the elation phase and there are certain behaviors that are required during the depressed phases. In the meantime you can do certain things that will give you benefits anyway. Emotional therapy will alleviate a lot of the problems faced in this condition because it is a mood disorder. You need to particularly look at your levels of anger both for its reasonableness and to express it in appropriate manner. Talk to your parents and explore that anger and fear angle. This information will help the counselor too. Also you will need to check whether there is any genetic factor involved. You must exercise regularly, eat healthily and sleep normally too. If your motivation and cooperation is good much can be achieved. You must have a time-structured schedule filled with interesting and reasonable activities and it must be monitored for compliance and delivery. The reason I say this is that many times you will be inclined to have grandiose notions and confidently believe that you can do without the medication. This will set you back many months in the treatment and delay and sabotage the recovery: forewarned you are forearmed. If this combination of medication with therapy is maintained for at least three years without any episodes or breakdowns, it is possible to taper the medication in consonance with the doctor. 

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Dr. Satheesh Nair SPsychologist31yrs exp

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Hi. lybrate-user there are several studies now on nutrional suppliments on brain and how neuro transmitters are being produced or balanced. Particularly omega3, folic acid, minerals like zinc, magnesium etc but a correct diagnosis is primary. Acute management of your problem may need medication also. Also avail psychologists evaluation and counselling. Take care.  

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