Bipolar and fasting in Ramadan

by Aminah
(Qatar)

Hi. I have bipolar 1 disorder. I am Muslim and I am American and living in the middle east. It is Ramadan this month (the month of fasting). I have been fasting today for 11 hours so far. But I have become really angry and then I started crying for no reason and my head doesn't feel quite right. It's hard to explain but I guess kind of lightheaded. I take my medicine before bed so I know it's not from a lack of medicine. Am I feeling this way as a reaction to fasting because I am bipolar? Any advice you can give me is appreciated, thank you.


Ben's Response:

Yes, fasting can have a huge effect on mood and energy and it should only be done with great caution. I respect your religious reasons for fasting, but it may not be worth the risk to your health to continue this way. Is there any way you could do a modified fast? I've seen people experience all of the symptoms you mention - crying, fragile emotions, lightheaded, anxiety, feelings of depersonalization - all due to lack of food. Food is grounding. It puts you in your body. Not eating can induce states of mania. It can also affect your metabolism to only eat at night, when the body is normally shutting down it's metabolic activity and storing up sugar/energy to use the next day. For someone with bipolar disorder, the regularity of sleep/wake cycles, and a stable metabolism are especially important to their stability. Food is medicine.

Take Care,
Ben Schwarcz, MFT

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Jun 02, 2018
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May God Reward You! NEW
by: Frank

Thank you for your clear and balanced response to this question. As a Muslim, American with at least mild bipolar, I have strugggled with Ramadan since I accepted Islam in Ramadan four years ago. I work in construction, lifting, pushing, hammering, crawling, holding, carrying, you name it between 30-40 hours a week. I asked some Muslim brothers what I should do about work and fasting. I often received "Take time off work or cut back on hours." How do I put it? This ain't the career for "Hey boss, I need a little time off?" I cannot work effectively through an entire day in this state. I have tried it. Couple weeks ago, I fasted at work one day. I was so looped out and tweeking on details and acting rude and quick to anger. By 3pm I called it. I shuffled over to where my car was parked in a fragile, worn and torn state of self pity. Quivering and gasping, I drank from my water bottle. I cannot remember if I had any food to eat with me but, I really just wanted the water. I would not have been able to drive home in that state. Just mental fog and frustration. So I had been fasting for around 11 hours and working for 6 at that point, having eaten breakfast and starting my fast at 3:30am, then going back to sleep until I had to wake up again and drive to site. This was a bad situation and it is the kind of thing that sends me right through the doors of a manic state into a headspace that is mentally charged, rapid, and so intently focused yet shaky and wildly unfocused. At the same time I am emotionally squirrelly, in flux. My brain just won't quit, ascending in mania while my body state descends and I wear out, get tired, and finally crash like a person strung out on methamphetamine. I have looked into the basic rulings for fasting exemption myself and have read a handful of websites that summarize from the hadith (sayings and biographical accounts of Prophet Muhammad, peace be upon him), on of which says "Individuals who are mentally challenged or they are victims of any sort of mental illness which affects their cognition as a whole, are not required to fast in Ramadan, or on any other occasion. They are automatically exempt." (https://www.islamicfinder.org/iqra/who-is-exempt-from-fasting-in-ramadan/)
I believe this life is a test. God places in front of each soul strengths and weaknesses. We succeed in this life by realizing worthy goals. Who or what is more worthy than God?

Jun 15, 2017
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hey
by: Anonymous

hey that's pretty good

Jul 11, 2016
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Fasting or ketogenic diet
by: TiTo

Ketogenic diet
Because many of the medications that are effective in treating epilepsy are also effective as mood stabilizers, it has been suggested that the ketogenic diet— used for treating pediatric epilepsy— could have mood stabilizing effects.[61] Ketogenic diets are diets that are high in fat and low in carbohydrates, and force the body to use fat for energy instead of sugars from carbohydrates. This causes a metabolic response similar to that seen in the body during fasting. This idea has not been tested by clinical research, and until recently, was entirely hypothetical. Recently, however, two case studies have been described where ketogenic diets were used to treat bipolar II.[62] In each case, the patients found that the ketogenic diet was more effective for treating their disorder than medication and were able to discontinue the use of medication. The key to efficacy appears to be ketosis, which can be achieved either with a classic high-fat ketogenic diet, or with a low-carbohydrate diet similar to the induction phase of the Atkins Diet. The mechanism of action is not well understood. It is unclear whether the benefits of the diet produce a lasting improvement in symptoms (as is sometimes the case in treatment for epilepsy) or whether the diet would need to be continued indefinitely to maintain symptom remission.

Jun 07, 2016
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Thank you
by: Aminah

Thank you for commenting on my post. You are right, it is very disheartening that we cannot fast and it is very encouraging to know that there are others the same. Like you I was wondering is it me? Is it my faith etc. thank you again for responding.
Ramadan Mubarak to you both.

Jun 07, 2016
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Bipolar 2 and Ramzan Fasting
by: Anonymous

I am sharing this post for anyother person who is in the same boat as me since I had been trying to find relevant info about fasing and bipolar disorder and i never got success in that. I am a non practising physician living in USA. I had been a person who used to observe fasts very regularly. Nothing mattered more than observing the fast specially during Ramzan.

After my second baby I was finally diagnosed with Bipolar 2. In Ramzan, I started fasting and suffered from severe and sudden episodes of anger, irratabilty, rage during the day time. i discussed it with my doctor and she also suggested me the same. Sometimes I get a feeling that is it something at subconscious level or is it real me not being able to fast??? And then I start searching for peple like me on internet to know It does happen.

It is really very heart breaking and leaves me with a feeling of guilt. Please share ur experience!

Jun 07, 2016
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Bipolar fasting in Ramadan
by: Tahir Mahmood Anonymous

It's not always the fasting that changes you mood it's the holy month of Ramadan. I've always relapsed in Ramadan with mania and maniac symptoms. I don't know why this happened but Allah (swt) knows best. But my advice is to take extra care in this holy month

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