I’m disgusted with a lot of things: my meds, my perpetual brain fog (meds?), my recent 15 pound weight gain, which, on my 5 foot tall person, is a lot and is quite demoralizing, adding to the general feeling of gloom in my environment; my lack of energy, my lithium-induced tremors and muscle weakness, and I’m sure there’s more, if I could only think of it. Oh yes, that’s it: word-finding difficulty.
At one point in my bipolar journey, nothing was working, med-wise, and my shrink planted an idea in my brain that had consequences I don’t think he intended. There is a great deal of similarity between bipolar illness and seizure disorder: both share the phenomenon of kindling, where a little spark gets going and if it’s not stopped, it spreads until it causes generalized dysfunction. In Bipolar-land we usually call that a trigger, but there is functional MRI evidence that demonstrates similar changes in brain metabolism during the moments leading up to a seizure, and the moments leading up to a bipolar decompensation. So it should be no surprise that anti-epileptic drugs also treat bipolar symptoms.
When my son was a teen going through a bipolar meltdown, his psychiatrist told me, and showed me clinical papers to back his words up (which unfortunately I do not have and am not in the mood to dig up), that if, in the young brain, bipolar disorder could be suppressed for a two-year period without a breakthrough, it could be considered cured, just in the same way as epilepsy. The theory is that in the growing brain, suppressing the kindling effect for that long gives the brain a chance to literally “grow out of it.” My son, now 28, recently went through a battery of neuropsychiatric testing which showed that although he does have Major Depressive Disorder, he has no remaining features of Bipolar Disorder. Bingo.
Back in the olden days before they had anti-seizure drugs like Depakene and Tegratol and Lamictal, there was very little in the anti-epilepsy arsenal. The ancient Greek physycians noted that if you fasted a person with epilepsy, the seizures stopped. Eventually, over a couple of thousand years, this observation led to development of the Ketogenic Diet. If you look at the Wikipedia article under this link, it will tell you as much as or more than you ever wanted to know about the Ketogenic Diet.
The basic idea is that the brain can function on only two kinds of fuel: glucose, which is a product of sugar and carbohydrate (and in some cases protein) breakdown, and ketone bodies, which are small molecules that result from the breakdown of fat. Ketone bodies also have the ability to regulate blood sugar, so if the balance of glucose and ketones is correct, the body literally shifts from a glucose based metabolism to a ketone based metabolism. This has a wide range of effects. The Atkins Diet works on this principle: if you stop feeding the body carbohydrates, then it has to break down fat to get ketones to feed the brain and the rest of the body.
For reasons still unknown, ketone metabolism, or ketosis, suppresses kindling in the brain and controls seizures. It can be a miraculous thing. If you read through the Wikipedia article you’ll be astounded at the numbers. I was, anyway. The only problem is, it’s a very difficult diet to do. You have to really be committed to it, and one little slip-up can set you back weeks.
So, at the time when meds were not working to suppress my bipolar fire, I was a little overweight anyway so I decided what the heck, I’ll try the Atkins diet, and do the most extreme version just for kicks and chuckles. It was a bitch to do. It’s a fat and protein based diet, so you have to pretty much live on eggs and cheese and (at that time I was not religiously observant) bacon, which was my staple food, cheeseburgers (God, I miss those), mayonnaise all over everything, heavy cream (for a treat, I would whip up a carton of heavy cream and eat it), cream cheese, and lots of leafy greens. Oh man, it’s hard. But: my BP symptoms stabilized, and I lost 30 pounds in the bargain. I stayed on the diet for three years, then got religious and couldn’t eat bacon or cheeseburgers anymore, and started eating challah and kugels instead. The thirty pounds came back, and my brain went wacko again. Hmmm.
Now my brain isn’t wacko, really, thanks to Seroquel, but the problem is, with the Seroquel I just don’t feel anything. I’d like to feel happy, or sad, or excited. I was just walking by the river here which is just a couple of feet from flood stage, and in fact did flood last night, and I kept thinking, jeez, I should be feeling fear, this thing is so awesomely powerful and out of control. But all I felt was, I should feel fear but I don’t.
So I decided to go back into the land of Ketosis, just to see what will happen. At the very least maybe I’ll drop those two pants sizes I picked up over the winter, and if I’m lucky, my brain might start working better and I might be able to drop part or all of the Seroquel so I can feel things again. Stay tuned!