Hacker News Reader

Comment by quantumwoke | Hacker News Reader

This seems at least tangentially related to the psilocybin thread currently on the front page. I have read in journals that bipolar is a disease of neuroinflammation upregulated by cytokines etc. in the brain. My hypothesis is that this could be related to the gut microbiome which has been proven in studies to affect the brain directly. Maybe you really are what you eat?

View on HN

Also bipolar. Episodes often start with life-changing events. I highly doubt that food is to point a finger at here. My last episode was really triggered by me leaving my job and going jobless for the first time. I was eating well, fresh and self-cooked. Then during mania I could not eat a single thing. Also could not sleep. For 3 months straight.

The worst thing you can do here is to generalize.

Anecdotally the symptoms can already be present - but manageable - then severe trauma(s) trigger an extreme worsening of the cycle between the highs and the lows.

Getting back to a "manageable" state would be ideal however future (and even perhaps far more minor) trauma may prove to be a significant barrier and potentially trigger relapses resulting in quite a vicious cycle.

Certainly a very complex thing to explain to people and carries a lot of stigma.

In my case, looking back, I think I have already lived through a handful of episodes of lower but still damaging intensity. I first really started recognizing this pattern when I had this sort of episode where it became clear to each and every person around you, that there is something off. It was like I was on cocaine 24/7, paired with extreme paranoia (I moved to a rather bad neighborhood in a big city two years before).

Ever since this initial awareness and diagnosis, I have stepped back from a lot of people, and many stepped away from me. I was left in a void where I had basically I social interaction.

While it was extremely depressing I have the feeling, at least in my case, that less communication can help to find a manageable state. Today it’s easier for me to manage, although still not perfect. I declined any medical treatment except for one dose of Haloperidol which I agreed to after I had freaked out and the police had to tie me down and send me to psychiatry. (As it happened I accidentally ran into a drug handover in the midst of my mania, I was afraid to die and started losing it completely)

Nobody really understands the hurricane of feelings one is going through, it doesn’t really make sense to try and explain it to people.

> Nobody really understands the hurricane of feelings one is going through, it doesn’t really make sense to try and explain it to people.

It can be done but it requires finding the points in a person's experience that mirror my own to some degree. Building on that, you can paint a picture they can understand.

I like the example of telling a person they need to keep eight words in their head all day long with no notes. Then they'll be quizzed about those words randomly throughout the day. If they fail, they have to sit quietly in a chair for the next hour.

Then I ask them how pissed off they'd be if they were interrupted in the middle of a task by me asking them to list the words in reverse alphabetical order by the fifth letter. Repeat several times an hour with different sorting and filtering criteria.

The closest thing I could make some people relate to was that it was like being on LSD, just that it comes in waves.

I also happen to have experimented with lots of psychedelics in the prior years and I’m not gonna deny that this may have intensified the symptoms. Mania felt like an acid flashback.

All this sudden energy and creativity, but also the scatteredness (not sure this is a word). It was too much to handle.

At the time I was programming up to 10h per day. I could not remember names of people I met the day before, also I had blackouts. My brain was not able to process. With your experiment I would have failed miserably because sitting still for an hour was not manageable.

I'm bipolar. It is far more complex than "what you eat."

Forgive me for being slightly facetious with the saying, of course there are many more factors involved that require close and careful study.

Almost all bipolar people have relatives that were bipolar. That points rather strongly to a genetic cause than an environmental one.

My understanding from the research is that the aetiology is not well understood at all, and that certain individuals are more susceptible to triggers. Note that although you may be genetically susceptible to a disease it does not mean that another cause (or organism!) might interact with those genes and result in said disease.

The problem is... "Maybe you really are what you eat?" seems to put the blame solely on the bipolar person for not eating properly.

I don't know about other bipolar people but I'm tired of being told it's my fault I'm bipolar.

Ah, that was not my intention at all. I know people with bipolar and would never suggest that it was their fault. It's a poorly understood and vastly complex disease and any clue as its possible origin and possible therapeutic targets would be good.

This is not a good way to look at it, frankly.

The problem with "bipolar disorder is caused by diet" is that it's wrong. There's no evidence of it, plenty pointing in other directions, it's just a non-starter.

Which sucks, because if bipolar was caused by, I dunno, seed oils, great news! Just don't eat seed oils!

And if someone goes to the doctor and says "I'm bloated and gassy all the time and I feel terrible" and the doctor says "yeah you're lactose intolerant, avoid dairy and take these pills when you eat it", that's not blaming the person either.

I'm sure that there are people in your life who blame you for being the way that you are. I don't see this as a case of that. They probably read some woo-woo nutritional site with bad advice, and thought they were helping.

The complicating factor is that every disease/disorder/condition (both mental and physical) is a combination of genetics, environment, and the nonlinear interaction of genetics and environment. We can measure the genetic factors, and with somewhat more difficulty, the environmental factors. But that interaction term is extremely difficult to measure. It encompasses things like those mentioned in the article: the fact that "sick" people often don't appear sick unless there is an environmental stressor exacerbating their condition. This kind of conditional effect is very hard to measure scientifically.

Bipolar is one of the more heritable diseases. If one person has bipolar, every one of their direct relatives (children, bothers, parents) have a 10% chance of also having bipolar.

As part of my experience coming to terms with bp2, I did a family history and found out that almost everyone in my father's (high-functioning and accomplished) family had been institutionalized.

From what I understand the etiology of bipolar is not well understood, with different correlations like dopamine dysregulation or the inflammatory markers you mention (which could indeed be influenced by the gut biome), but as with unipolar depression it's probably too simplistic an approach to try and reduce it to a single factor.

One of the "doctors" who recently published research on "psychobiotics" was later selling a brand of "clinically tested" probiotics tailored for mood disorders. Gut microbiome studies, at this point in time, need to be taken with a pinch of allum.

Feel free to link/create/sponsor/recommend clinical trials or research.

Reply on news.ycombinator.com