Resolution of Refractory Bipolar Disorder With Psychotic Features and Suicidality Through Lifestyle Interventions: A Case Report.

Background • This case illustrates the relationship between gut, hormonal, and brain function in that dietary change, mindfulness interventions, and detoxification led to resolution of disabling luteally exacerbated psychiatric symptoms. Summary • A 45-y-old, married, Caucasian female with a history of diagnosed bipolar disorder with psychotic features, premenstrual dysphoric disorder, panic disorder, and repeated occurrence of suicide attempts and self-mutilating behavior presented for outpatient management. She reported limited gains through conventional treatment consisting of medication. The patient was prescribed a dietary, detox, and meditation regimen for 1 mo, after which supplementation was added to support detoxification, digestion, hormonal balance, and nervous system structure and function. Additional lifestyle management therapeutics included daily meditation, dry-skin brushing, and coffee enemas. Conclusion • This case exemplifies dramatic clinical remission after cessation of medication treatment and engagement of lifestyle interventions, which include dietary change, meditation, and detoxification. When medication demonstrates limited results, tapering combined with dietary interventions as the first-line therapy should be considered.