It’s estimated that 4% of adults in the United States will experience bipolar disorder at some point in their lifetime. It’s most common in the 18-29 age group, with 4.7% of that population annually experiencing bipolar symptoms. It’s also a common condition in adolescents, affecting about 2.8% of the adolescent population. 83% of those individuals living with bipolar disorder will experience serious impairment. These statistics show the devastating nature of this illness.

What are the current treatments for bipolar disorder?

Dr. Iain Campbell: The treatments we have for bipolar are based primarily on epilepsy treatments, which are anticonvulsants. These seem to turn down the activity of the brain, which, in acute scenarios, can be extremely helpful. If someone’s in a manic episode or hospitalized and they need to be brought down, it can be lifesaving. In the long run, though, when you get to bipolar support groups, many of us are really struggling to function, hold down a job, or have normal relationships with family or friends. You really feel that your brain is suppressed.

I’m an advocate for medication in acute scenarios. Even for some people in the long-term, it can be beneficial, but nobody feels like they’re thriving. In the support groups that I speak to, there are some people who do very well on particular medications, especially lithium or lamotrigine, but in general, when I speak to support groups, people are struggling to have enough energy just to get through the day.

My personal experience with medication is that the anticonvulsants are very suppressive of your brain function. They will stop you from going too high, but they also hold you in a place where it is very difficult to function in normal society for long periods of time.

What has your experience with diet changes been?

Dr. Iain Campbell: At the beginning, I went on a diet purely to lose weight. I went on a very strict Atkins diet, and I got into ketosis. About three days into this, I was on the bus and I remember feeling the light switch back on in my brain for the first time I’d ever experienced in my life. I remember thinking, “This is what normal people feel like. I’ve never experienced this, I’ve never known.” I knew that this is what normal people feel because I was enjoying things. I was looking out the window and enjoying looking at nature. I felt hopeful about the day. I felt like I was looking forward to the day.

With bipolar, you’re normally just trying to protect what little energy you have by retreating and being isolated. You’re just scrambling by with the small amount of energy that you have, and for the first time, I felt, “Oh, so normal people have this abundance of energy that they go out to meet the day with. They’re excited to engage with the day, and they actually are looking forward to all the challenges it brings instead of trying to keep away from them,” so I knew that something was fundamentally different, going from something suppressing my brain versus having the proper energy needed to do its normal function.

How did you get past that stigma?

Dr. Iain Campbell: The only reason someone with bipolar would talk about this is because they feel that there’s something that would really, really help other people with bipolar. That would be the only reason it would be worth doing because it does come with consequences. I experience them all the time, and the reason that I feel it’s worth it is because I experienced something that so fundamentally changed the way my mind works. I can live a normal life, complete my PhD, become a researcher, and have a family with two kids. These are some of the things that I would have considered almost impossible, and for many people with bipolar, they seem completely out of reach.

What has happened thus far through the work that you are doing?

Dr. Iain Campbell: So I have this personal experience, but I’m also aware it’s my anecdotal experience and the thing that really moves the needle is randomized controlled trials. It’s randomized controlled trials that influence psychiatrists. They influence decision-makers and policies, including health policies, and we need to have this standard of evidence through randomized controlled trials to show this, so I decided if I was going to do this, the best thing I could do is contribute towards a randomized controlled trial so I put all my focus there. We’re doing a pilot trial funded by the Baszucki Brain Research Fund that is attached to Metabolic Mind. We are doing 25 patients following a ketogenic diet for eight weeks. They are going into ketosis and we’re measuring mood markers, taking MRI scans, and doing metabolomics. We’re trying to find out what physically shifts in the body when someone is in ketosis because this is an intervention that has one hundred years of clinical use. There’s a Cochrane review of several randomized controlled trials for epilepsy showing it’s very effective at stopping seizures, so clearly, there’s a profound effect in the brain and we want to find out what this does to people with bipolar.

If you enjoyed reading this, take some time to watch the full interview with Dr. Iain Campbell on YouTube.

Sources

Iain Campbell, et al. “Ketosis and bipolar disorder: controlled analytic study of online reports." BJPsych Open, 2019.