What if depression, bipolar disorders or schizophrenia were primarily metabolic disorders? This is the thesis developed by Dr. Christopher Palmer, psychiatrist and researcher at Harvard Medical School, in his book Brain energy. Here are his main arguments.
In 2016, Dr. Christopher Palmer takes care of Tom, 33, who suffers from schizoaffective disorder, a mixture of schizophrenia and bipolar disorder. For 13 years, he has suffered from hallucinations, delusions and daily anxiety. The medication calms him down but does not make his hallucinations disappear. “Worse, they made him gain more than 50 kg. Already weakened by low self-esteem, this excess weight had only worsened his discomfort. »
Dr. Palmer decides to help him lose weight. After several failures, they tried a ketogenic diet, very low in carbohydrates and high in fat. Tom is starting to lose weight, but that’s not all: “Above all, his psychiatric symptoms evolved in a striking way. He was less depressed, less apathetic. His gaze changed. I observed more eye contact, a new presence, like a spark I had never observed in him. » And after two months, his hallucinations subsided. Finally, he will lose 70 kg, leave his father’s home and follow a diploma course. “I was stunned. I had never seen anything like this in my entire career. »
Read: Ketogenic diet: hope for treating mental illnesses
The problem: brain energy
This case challenges the classic vision of mental illness. Depression or bipolar disorder is generally attributed to life accidents or genetics. They are treated with psychotherapy and medications intended to correct a neurotransmitter deficiency. For Dr Palmer, the problem lies elsewhere. Disorders as different as depression, bipolar disorder, post-traumatic stress or hyperactivity have one thing in common: metabolic dysfunction. This explanation also makes it possible to link them to other diseases, such as diabetes, obesity, and even cardiovascular diseases.
Here are his main arguments.
Metabolic diseases and brain diseases are often associated
The link between the diabetes and mental illnesses has been known for a long time. Many mental disorders are associated with high rates of diabetes. Thus, people with schizophrenia have a three times higher risk than others of developing diabetes (1) and people suffering from depression have a 60% higher risk (2). The opposite is also true: people with diabetes are more likely to develop mental disorders. “People with diabetes have a two to three times higher risk of developing major depression. Furthermore, when they are depressed, their depression lasts on average four times longer than in people without diabetes. says Dr. Palmer.
Similar relationships are observed with theobesity. It is known that people who suffer from mental disorders are more likely to be overweight or obese. One study followed people diagnosed with schizophrenia or bipolar disorder for 20 years. At the time of diagnosis, the majority of them were not obese. 20 years later, 62% of people with schizophrenia and 50% of people with bipolar disorder were obese (3). Furthermore, children with autism have a 40% higher risk of being obese (4). A meta-analysis of 120 studies found that people with serious mental illness had a three-fold increased risk of being obese compared to people without mental illness (5).
For what ? “Many people believe that drug treatments are the cause of this obesity. There is no doubt that psychiatric medications are associated with weight gain. It is a common side effect of antidepressants and antipsychotics, explains Dr. Palmer. However, treatments are not enough to explain this phenomenon. »
The brain is a big consumer of energy
The brain consumes nearly 20% of the body’s energy resources at rest. “Brain cells are extremely sensitive to disruption. In general, when a
metabolic problem occurs in the body, the brain detects it. »
As proof, blood sugar problems affect the functioning of the brain: with hypoglycemia, for example, you can be more tired, more irritable and have difficulty concentrating. In the case of diabetes, the patient tends to have problems with hyperglycemia, but this does not mean that his cells are well supplied with energy. “In diabetes, cells have difficulty converting glucose into energy. The level of glucose in the blood can be high, sometimes very high, but this glucose has difficulty entering the cells to be used. »
Mitochondrial dysfunction is associated with mental disorders
Mitochondria are the energy powerhouses of our cells. They produce ATP, the molecule that provides the energy necessary for cellular reactions. To do this, they use cellular respiration, which consumes oxygen and releases CO.2.
According to Dr. Palmer, mitochondrial dysfunction has been identified in the following disorders:
- schizophrenia;
- schizoaffective disorder;
- bipolar disorder;
- major depression;
- autism;
- anxiety disorders;
- obsessive compulsive disorder;
- post-traumatic stress disorder;
- attention deficit/hyperactivity disorder;
- anorexia nervosa;
- alcohol use disorder (or alcoholism);
- marijuana use disorder;
- opioid use disorder;
- borderline personality disorder.
“When the mitochondria are not functioning properly, the brain is also not functioning properly, said Christopher Palmer. Symptoms can be highly variable, but mitochondrial dysfunction is both necessary and sufficient to explain all symptoms of mental illness. »
When we understand this, then we can put in place strategies to promote the functioning of mitochondria and regain good brain health.
Mental illnesses can be cured through metabolic changes
The ketogenic diet is a well-known treatment for epilepsy, but it could act on other mental disorders, as we saw in Tom’s case, at the opening of this article.
Other metabolic interventions should be considered: eliminating harmful, ultra-processed foods, rich in sugars and additives, but also doing sport. Fasting can also stimulate autophagy, a process that helps eliminate faulty cellular structures, such as used mitochondria.
