A member of the Healer’s Community, Sabine Martens, recently asked about bipolar disorder.   Sabine is helping someone with the condition and asked for recommendations that might help her client.  She also asked abut the drug, lithium, which is being used to treat her client.

Here are some of my thoughts.

Bipolar disorder, also referred to as manic depression, arises in people with a genetic vulnerability to the illness.  Only recently have scientists begun to unearth clues as to its origin, which very likely arises from a combination of insulin resistance and inflammation of the brain. 

Insulin resistance, which is the basis for type 2 diabetes, is a condition in which cells are fed too much glucose, or blood sugar, well after they have had enough and reached their full capacity for fuel.   The blood sugar is forced into the cell because the blood is simply too loaded with sugar.  Eventually, the cells say, “No more!”  They block their own doors and windows – the insulin receptors on the exterior of the cell — and become “resistant” to insulin.  Without insulin, cells die.  Other events happen, as well. 

Insulin signaling within the cell becomes disrupted and cells begin to malfunction.   That includes the cells in the brain. 

Insulin resistance, as I have said in previous articles, is the basis for metabolic syndrome, a condition in which a person suffers from increased weight, high blood pressure, high cholesterol, high triglycerides, high glucose, and high insulin.   Metabolic syndrome predisposes a person to diabetes, heart disease, and several forms of cancer.  It is also directly linked to Alzheimer’s disease and other brain disorders.  Now scientists are finding that insulin resistance, and in some cases metabolic syndrome, is linked to bipolar disorder.

Writing in the Journal of the American Medical Association (October 11, 2006), M.J. Friedrich noted the following:  “Known best for its role in the body as a regulator of blood glucose levels and fatty acid storage, insulin also acts in the brain to aid memory and thinking.  Thus, when insulin regulation is disrupted, as it is in many common medical conditions including obesity and diabetes, the risk for cognitive impairment rises.”  

The July 2006 Journal of Clinical Nutrition reported that ““Bipolar disorder and metabolic syndrome share features of hormonal, immunologic, and autonomic nervous system dysregulation.” 

Insulin resistance can spread from body cells to the nervous system and the brain.  Once it affects the brain, it alters the way cells function.

The brain is constantly passing whole bundles of information from neuron to neuron.  Among the carriers of these packets of information are substances known as neurotransmitters.   One of these is a substance called glutamate, a chemical neurotransmitter that causes states of arousal, excitement, and even mania.

Within the brain’s cells, production of these neurotransmitters are regulated by set of chemical enzymes in brain cells.  These enzymes are called kinases.  One of these kinases, known as GSK3, regulates production of a couple of different neurotransmitters, including glutamate. 

GSK3 is regulated itself by insulin.  As insulin function becomes impaired in the brain, GSK3 becomes elevated, which in turn produces more glutamate, which triggers states of excitement and mania. 

As mania increases, the brain races.  Neurotransmission increases dramatically, making the person think and speak rapidly.  Brilliant ideas appear to flash across the rippled cortexes of the brain.  The person feels empowered beyond imagination.  Everything is beautiful.  Everything makes sense.  The world can finally be grasped.  Many believe that if they tried hard enough, they could fly.  

But brain chemistry cannot stay in overdrive forever.  Eventually, it must crash.  And when it does, glutamate production finally falls and the person plummets into depression.

Other neurotransmitters play a role as well.  In manic depression, levels of serotonin – the neurotransmitter that is responsible for our sense of well being, optimism, ability to concentrate, and sleep deeply – also fall.  Dopamine, the chemical neurotransmitter responsible for rapid action, can become relatively elevated, causing anxiety to increase.

The net effect is depression and anxiety, which sometimes trigger even terrible states of fear.    

All of this disruption within the brain is triggered by insulin resistance, which itself creates a cascade of cellular changes, all of which make the brain function abnormally. 

Insulin resistance is essentially a yin, acidic condition.  Lithium is given to balance the condition in the brain.  Lithium is highly alkaline, and thus yang.  In fact, it is very similar in chemical composition to sodium, also highly alkaline and also very yang.   It is well known that lithium can interfere with sodium regulation in the kidneys, which is one reason why those on lithium must be monitored closely with regular blood tests.    

For decades, lithium was used without anyone knowing why it worked – to the extent that it does.  However, scientists recently learned that lithium deactivates GSK3 and, by doing this, reduces the levels of glutamate in the brain. 

In the Healer’s Community Forum, Sabine mentioned that her client no longer experiences mania.  This is the consequence of lithium.   By neutralizing GSK3, and thus lowering production of glutamate, the person no longer has the chemical imbalance needed to create mania, or the highs associated with bipolar disorder. 

However, this will not treat his depression.  Serotonin will still be low, which will sustain the depression. 

Here are my recommendations. 

First, the person must stay on his medication.  He should tell his doctor that he is working with a holistic health counselor and that he is making dramatic changes in his diet and lifestyle.  The doctor will be able to monitor his blood and make changes in his medication, if he sees the need for such changes. 

Many people with bipolar use sugar, chocolate, processed foods, alcohol, and marijuana to self-medicate.  All of these substances increase acidity and form the basis for insulin resistance.   These extremes must be reduced significantly.  Yes, the person is going to keep eating sugar, and he may drink some alcohol, but he must take in less of these foods.  The client must do all he improve his diet and lifestyle, and in this way bring his insulin levels back into balance. 

Every day, he must eat three servings of whole grains, such as brown rice, millet, barley, and quinoa.  These grains are all slowly absorbed in the blood stream and will gradually elevate brain levels of serotonin.  Sugar and alcohol create dramatic highs and lows in blood sugar and brain levels of serotonin.  Whole grains, on the other hand, keep serotonin elevated over many hours.  Eventually, his brain will recognize the high levels of serotonin as normal and will form a new baseline.  At that point, the brain itself will sustain higher levels of serotonin as its normal baseline, and thus sustain higher mood.   But that will take time – at least a year – and will depend on his eating well for the entire year.  

Next, he must eat 7 to 12 servings of vegetables every day.  Green and leafy vegetables (at least four servings), round and sweet (at least two servings), and roots (at least two servings), should be eaten daily.   Also, he should eat miso soup, tamari broth, pickles, and sauerkraut regularly throughout the week.  The vegetables, miso, tamari broth, and pickles will further alkalize his blood and help control his insulin levels.  He can eat small servings of cooked fruit and other healthy desserts three or four times per week.

He must be engaged in physical exercise every day – walking, some form of sports activity, dancing, chi gong, tai chi chuan, or some other martial art.  Exercise is essential, because it balances insulin levels and increases insulin sensitivity in cells. 

In time, insulin levels will become more stable and the brain will start to function in a more balanced and peaceful manner. 

I hope this helps.