Getting at the Gut

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A Solution for Treating Bipolar Disorder

The Merck Manual describes bipolar disorder as “a condition in which periods of depression alternate with periods of mania or lesser degrees of excitement.” ¹ Historically known as manic-depressive disorder, this psychiatric condition is typically defined by the presence of abnormally elevated energy levels affecting mood and awareness, with or without states of depression. Manic states are often accompanied by psychotic symptoms such as delusions and hallucinations.

Allopathic medicine’s solution generally involves one or more pharmaceuticals for a lifetime; it never offers a cure but rather, management of erratic behavior via medications that often need to be changed from time to time. Quite commonly, those suffering from bipolar disorder are very bright, creative and loving individuals. Sadly, when brain chemistry goes out of balance, the sufferer most often deals with chaos involving hallucinations, as well as extreme mania and rage. Hippocrates, the father of modern medicine, once said, “All disease begins in the gut.” While not all individuals with gut dysbiosis experience psychological or psychiatric disease, I have yet to find in thirteen years of practice the absence of gut dysbiosis in those suffering from psychological or psychiatric challenges.

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In September 2008, I had the privilege of meeting a very bright but troubled nine-year-old girl, whom I will call Mary. Mary had been diagnosed bipolar eleven months earlier by a psychiatrist. This conclusion came after years of deeply concerning behavior. By the second grade, she was expelled from her private school due to her aggressive behavior towards students and her teacher. This prompted her parents to make the decision to home school. Mary’s mother quit her practice in the health field in order to give full time attention to her daughter’s daily needs.

DISTURBING BEHAVIOR

Prior to seeing the psychiatrist, Mary described in detail to her counselor how she planned to kill herself some day. It was at this point the counselor and her parents realized Mary needed serious help. Her parents’ “gut sense” was that pharmaceuticals would not offer the long-term solution they desired for their daughter. It was at this junction they were referred to my office.

During my first meeting with the family, Mary was in a state of mild agitation with constant fidgeting and head shaking. She described the sensation of “things crawling” in her head. Mary presented with a very red and expansive rash on her bottom, which had been longstanding.

HEALTH HISTORY

Before focusing on Mary, I took a look first at her parents’ health history and habits. I suspected that Mary might be a GAPS patient. GAPS is an acronym for Gut and Psychology Syndrome, based on the work of neurologist Natasha Campbell-McBride, MD. This work finds that those individuals with psychiatric disorders, as well as depression, anxiety, ADD and ADHD also have digestive problems. This is evidenced by many symptoms including (but not limited to) acne, allergies, asthma, constipation, diarrhea, eczema and other skin rashes. Dr. Campbell-McBride’s findings echo the words of Hippocrates that “all disease begins in the gut.” Given the GAPS research, and the fact that children inherit many gut and psychology issues from their parents, I examined her parents’ histories.

Mary’s mother had been a frequent user of the birth control pill and numerous rounds of antibiotics to address chronic bladder infections. She also had a history of vaginal yeast infections, which is common following the use of antibiotics. Antibiotics wipe out most bacteria, good and bad, leaving room on the mucosal lining of the gastrointestinal tract and the vaginal canal for opportunistic yeast to grow.

Mary’s mother also followed a typical American diet with an emphasis on lowfat foods, based on Dean Ornish’s recommendations, prior to conception. Mary’s father was addicted to sugar, Cokes and Oreos. He presented with chronic subcutaneous dermatitis, inflammation of the skin, most commonly seen as eczema. This condition is the result of imbalance of good flora in the gut. Both parents’ diet had a history of strict adherence to the USDA’s recommended food group of choice: grains. They both had used Accutane for the treatment of acne and appeared to suffer from the typical distressed liver function, which generally follows Accutane usage.²

The history of both parents gave me great insight into the weak links in Mary’s development. Both parents suffered from gut dysbiosis. Both parents were unable to pass on strong immunity to their child due to their own weakened states from diets composed primarily of processed foods, high in sugar and gluten and their exposure to antibiotics and other pharmaceuticals that weaken liver function.

Mary showed signs of large motor skill delays in her first year of life. I learned that Mary was conceived in the Sierra Mountains at a time when Lyme disease was widespread. Mary’s mom was an avid hiker, as well as a veterinarian, making it likely that she had come in contact with the spirochete that causes Lyme disease. Research has shown that pathogens like the spirochete, Borrelia burgdorferi, and its hitchhiking partners, Babesia, Ehrlichia, Bartonella, Mucoplasma and Anaplasma, can cross the placenta barrier and infect the developing child.³

A breached gut wall barrier leaves a child— or adult—vulnerable to pathogenic invaders and bacteria that are simply looking for a home. The gut wall barrier can become breached when there is an absence of life-giving, probiotic bacteria protecting the gut lining and the presence of partially digested proteins, creating lesions in the gut lining. The result is impaired assimilation of nutrients along with inflammation. This is in part due to consuming highly refined grains, or grains not properly soaked and properly prepared. The lack of lacto-fermented foods is another contributing factor in developing a breached gut wall barrier.

Mary was born via C-section, therefore she would have missed out on the natural inoculation of friendly bacteria that should have been residing in the vaginal canal. However, due to mom’s history of antibiotics, birth control pills and regular sugar consumption, she would have lacked sufficient beneficial bacteria to impart to Mary during delivery anyway.

Mary was breastfed for sixteen months. Nonetheless, she suffered from chronic constipation beginning at five months of age. She was fed rice cereal with mineral oil per the advice of her pediatrician. Mineral oil, a petroleum-derived product, can be contaminated with cancer causing PAHs (Polycyclic Aromatic Hydrocarbons) and is known to be immunosuppressive.⁴ In the European Union’s Dangerous Substances Directive (UNECE 2004), in September 2004 banned all petroleum oils with the following caveat: “The classification as a carcinogen need not apply if the full refining history is known and it can be shown that the substance from which it is produced is not a carcinogen.” Her pediatric gastroenterologist concluded “nothing is wrong with Mary,” and confirmed the use of mineral oil.

After her first birthday, Mary began five years of chronic ear infections. Within this five-year period she was placed on ten different antibiotics. At the age of four, her tonsils and adenoids were removed. The tonsils were so enlarged due to chronic infections that they were touching one another. As a result, Mary’s snoring could be heard throughout the house.

FROM ANGER TO FLAT LINE

Up until Mary entered kindergarten, her parents thought she was just very strong willed and bright. Bright she was. Mary has an IQ of one hundred forty. It was soon after she began kindergarten that Mary’s parents realized that her anger and behavior were far from normal. By first grade she was throwing chairs and other objects in the classroom at children, especially boys. She would threaten homicide to others. Despite many attempts by patient teachers trying to redirect her behavior, Mary was uncontrollable. By the beginning of second grade, Mary was suspended.

Mary understood she was different from her peers. She would run down the hall at home flailing her arms and raging for two hours at a time. Often she crawled in between her mattress and box springs or buried herself under the bed for hours on end. Other times she would withdraw into herself and her books. (To date, at age thirteen, Mary has read over two thousand books.)

As her parents saw Mary “going dark,” they sought help from a local marriage and family therapist, who had a PhD in education with an emphasis on gifted children. At the same time they began working with several neurological developmental specialists and eventually the psychiatrist who diagnosed Mary as bipolar.

All agreed that Mary likely had a genius level IQ but, sadly, no long-term solutions for her disorder were offered. As her obstinate behavior grew and threats of suicide increased, their therapist felt something immediate needed to be done. After four hours of meetings with the psychiatrist, the mood disorder diagnosis was given. The psychiatrist was reluctant to prescribe anti-psychotic drugs to such a young, smart child—Mary’s parents agreed.

Many times Mary’s eyes would “flat line,” to use her father’s words. She would become completely disconnected and unable to communicate. Often after an hour and a half of head butting, biting, and raging, Mary would pass out and then wake with words of apology.

ADDRESSING THE GUT ISSUES

With full history in hand, we ran a comprehensive three-day stool test. Proper Lyme testing, which can be done through a specialty lab, is very costly and therefore, the parents chose to forego the testing and began addressing the diet and support for the gut. To best accomplish this, I recommended they use the Gut and Psychology Syndrome (GAPS) Diet as designed by neurologist Dr. Natasha Campbell-McBride. We decided to keep her nutritional supplementation to a minimum, using primarily fermented cod liver oil and high quality probiotics. After several months, we added various homeopathic remedies and eventually, some botanical products that have antimicrobial effects.

The GAPS Diet was a huge shift for this family of three whose diet had been primarily centered around refined carbohydrates with some lowfat dairy and meats. But in desperation, they made it a family affair. Within a few weeks, Mary’s rash began disappearing. Within three months of the GAPS Diet and our nutritional support, Mary’s raging ended.

We limited her nutritional supplementation to Bio-Kult, minerals, and Blue Ice Royal, a combination of X-factor butter oil and fermented cod liver oil. This combination was used often by Dr. Weston A. Price in treating many different states of deficiency. Bio-Kult helped us quickly populate Mary’s gut with much needed beneficial bacteria as she adapted to eating lacto-fermented foods on a daily basis. The Blue Ice Royal, a rich source of vitamins A and D, and daily bone broth, supplying amino acids and minerals, provided all the nutrients needed to heal the gut lining. I also included homeopathic drainage remedies to assist her body in slowly eliminating toxins in the gut and brain. Botanical tinctures were used to address infection in the body.

Mary and her parents agreed the two biggest challenges presented by the GAPS Diet are the elimination of gluten and casein. The elimination of these are essential in healing the gut, which is almost always required in healing psychiatric conditions.

GLUTEN AND THE BRAIN

One of the earliest works showing the effects of gluten on the brain was done by psychiatrist F. Curtis Dohan, who noted that schizophrenic patients had fewer hospitalizations when bread became unavailable during World War II. This trend was seen throughout Canada, the United States, Finland, Norway and Sweden. He found similar correlation in New Guinea, where schizophrenia was basically nonexistent in people on primitive diets until cultivated wheat products and beer made from barley (a gluten-containing grain) were introduced. At that point schizophrenia rates increased sixty-five fold.

One of the most extensive clinical trials of our time regarding food and behavior took place in Denmark. Fifty-five autistic children were placed on a gluten- and casein-free diet. Tremendous improvement in behavior was seen in these children. Dr. Dohan and his colleagues at the Veterans Administration Hospital in Philadelphia saw similar results in schizophrenic patients in the mid-sixties after putting patients on a gluten-free diet for four weeks. There was a reduced number of auditory hallucinations, delusion and less social detachment. Once gluten was reintroduced, the disturbing behaviors returned.⁵

Obviously not everyone who is gluten- or casein-sensitive exhibits the extreme symptoms of autism, schizophrenia or bipolar disorder. But other health issues may ensue when the gut wall lining has been breached. Allergies, acne, eczema and gastrointestinal complaints are just a few of the symptoms that can point to gut dysbiosis.

I have found the GAPS program to be the body’s best support for healing. Prior to using the GAPS Diet in 2005, I saw the Specific Carbohydrate Diet assist many to a certain degree of wellness. The GAPS Diet, however, because of its emphasis on nutrient-dense, gut-healing foods like cod liver oil and bone broth, can bring complete healing to those with gut disorders.

A HAPPY ENDING

Several months after I began working with Mary, we re-tested her stool to find that the high levels of previously detected MRSA (methylresistant Staphylococcus aureus) had left her body. Over the next nine months her behavior gradually normalized. Exactly one year from beginning the GAPS Diet, Mary and her parents attended a family reunion where family members were shocked at Mary’s transformation.

Today, Mary is a vivacious, happy, normal thirteen-year-old, still reading books and bringing laughter to those around her. Her kind and loving spirit touches all who are blessed to know her. Mary is fortunate to have parents dedicated to her healing.

THE WISDOM OF HIPPOCRATES

Today, modern cultures are seeing soaring SUMMER 2012 Wise Traditions 49 rates of ADD, ADHD, allergies, autism and psychiatric disorders in the very young as refined carbohydrates, particularly modified gluten products rapidly produced in sixty minutes or less, and pasteurized, denatured dairy products continue to dominate diets. More and more research points to the wisdom of Hippocrates that “all disease begins in the gut.”

Hippocrates also offered this insight: “I know, too, that the body is affected differently by bread according to the manner in which it is prepared. It differs according as it is made from pure flour or meal with bran, whether it is prepared from winnowed or unwinnowed wheat, whether it is mixed with much water or little, whether well mixed or poorly mixed, overbaked or underbaked, and countless other points besides. The same is true of the preparation of barley meal. The influence of each process is considerable and each has a totally different effect from another. How can anyone who has not considered such matters and come to understand them possibly know anything of the diseases that afflict mankind? Each one of the substances of a man’s diet acts upon his body and changes it in some way and upon these changes his whole life depends.”

This truth is never more evident than today. We are bearing the consequences of departure from traditional food preparation in exchange for modern technology and so-called convenience. The fallout lies in the minds and guts of our young. The good news is our bodies are capable of self-healing. As we return to the wisdom of our ancient forefathers and foremothers, we can help our children to recapture their potential for wellness.

 

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SIDEBAR

THE MIRACLE BABY

Connor, age two years and nine months, came to see me after his mother, Kelley, spent his entire life seeking help from the conventional medical community, including one of the nation’s most prestigious university hospitals. Kelley realized when Connor was just a few days old that something was sorely wrong. It was determined that he was having seizures throughout the day. In December of 2011, Connor was experiencing forty seizures daily, spending many days hospitalized. On bad days, he was registering one hundred seizures within a twenty-four-hour period. His hospice doctor told the parents not to expect him to live to see his third birthday due to the effect of the constant seizures.

In January of 2012 Connor’s mother switched him to a ketogenic (high fat) commercial formula. This change brought his seizures down to six to ten daily. In April they were referred to me. At this point Connor had not crawled, talked, sat or walked. He exhibited signs of chronic indigestion. A look at Kelley’s preconception and prenatal history was very telling. She had been a vegetarian since she was nine years old. She had one child who was sixteen months older than Connor. This child had a history of chronic ear infections. At the time of their first visit with me, the older child had been on thirty rounds of antibiotics. They also now had a six-month old son who was showing signs of gut disorder, including eczema and vomiting after feedings.

Kelley had miscarried several months prior to conceiving Connor. Her doctor had put her on antibiotics during her complete pregnancy due to supposed urinary tract infections. She was also being given opiate drugs for the pain simultaneously. Unfortunately she was not properly overseen during her prenatal period and learned just prior to delivering her son via C-section that she was severely anemic. She required four pints of blood before delivery.

Connor was receiving most of his nutrition via a G-tube that entered his stomach. He was on a commercial formula, which boasted a frightening list of synthetic ingredients including high fructose corn syrup. We immediately changed his formula to the meat-based formula designed by Sally Fallon Morell and Dr. Mary Enig found in Nourishing Traditions. I made a few minor changes to accommodate Connor’s special needs. I referred him to an excellent osteopath, Dr. Jim Murphy, for osteopathic manipulation as well as emotional healing.

We focused on increasing his animal fats, as these do not exacerbate seizures the way other fats often do. Within ten days Connor’s seizures ended. Roughly thirty-five days after being seizure free, Connor began to make eye contact for the first time in a year and a half. A day later, he was smiling and then giggling.

Connor is currently on the GAPS Introduction Diet. He has learned to chew for the first time and is thoroughly enjoying his egg yolks scrambled in ghee, homemade cultured sour cream, avocados and of course, bone broth soups and stews.

The hospice doctor saw Connor about thirty-five days after his seizures stopped. She was floored but insisted that “these things don’t happen” and while they shouldn’t get their hopes up, they should continue whatever they were doing. At the end of the visit she burst into tears, admitted that Connor’s progress defied everything she has been taught and had to leave as she was crying too much. Our hope is that this doctor will learn through her observations of Connor.

Connor continues to improve. Recently he began talking, greeting friends and family with “hi”; saying “up” when he wants to be held and voicing “ah” when wanting his pacifier. He is learning to sit and can presently stand by himself for thirty seconds at a time. Needless to say, many tears of joy are being shed in Connor’s home, as well as my office. Connor’s father, Randy, calls him their “miracle.” I thank God for the privilege of working with such incredible parents and watching their miracle unfold.

Connor’s six-month-old baby brother has adapted excellently to a homemade formula using raw camel and sheep milk. Kelley continues to learn to cook the GAPS way as her entire family of five is now on the GAPS Diet (although baby brother, Cameron, will continue his raw camel and sheep milk). Kelley and I are starting to make plans for Connor’s third birthday party, GAPS style.

In addition to nutritional support, Connor’s parents, Kelley and Randy, are incorporating Recall Healing and osteopathic treatments with Dr. Jim Murphy. One day, Connor’s parents asked Connor for forgiveness for their times of hopelessness. Connor smiled and has been beaming ever since. He woke the next day and started all the big steps in his cognitive development, chewing his food for the first time ever, saying “hi” to greet people and learning to sit.

It is obvious that Connor came into the world to be a blessing to his family, and to lead them, however painfully, to the right dietary practices for his parents and siblings.

 

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REFERENCES

1. Merck Manual, pg. 409.

2. Stephen P. Stone, M.D., president American Academy of Dermatology and clinical professor of medicine Southern Illinois University School of Medicine, Springfield; Lee T. Zane, M.D., assistant professor, clinical dermatology, University of California, San Francisco; August 2006, Archives of Dermatology.

3. John Drulle, M.D. in December, 1990; The Lyme-Autism Connection; Rosner, Bryan with Tami Duncan.

4. www.hallgold.com/toxic-chemical-ingredients-directory.htm#mineraloil.

5. F. Curtis Dohan, M.D. Genetic Hypothesis of Idiopathic Schizophrenia: Its Exorphin Connection Oxford Journals: Schizophrenia Bulletin; Volume 14, Issue 4, pp. 489-493; Dohan FC, Grasberger JC. Relapsed schizophrenics: earlier discharge from the hospital after cereal-free, milk-free diet. Am J Psychiatry 1973; 130: 685-8; Lorenz K: Cereals and schizophrenia. Adv Cereal Sci Technol 1990; 10: 435–469. [iii]. Dohan FC, et al. Relapsed schizophrenics: More rapid improvement on a milk and cereal free diet. Br J Psychiatry 1969; 115: 595–596; Dohan FC, Grasberger JC. Relapsed schizophrenics: Early discharge from the hospital after cereal free, milk free diet. Am J Psychiatry 1973; 130: 685–688.

 

This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Summer 2012.

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