Improving Quality of Life in Bipolar Disorder - with Mayo Clinic's Dr. Mark Frye

Individuals with bipolar disorder are at an increased risk for heart attack, stroke, diabetes, and obesity, often resulting in a decreased lifespan. Clinicians must address this critical issue. There is a complicated, interconnected set of factors driving this correlation, including: medications that increase cardiometabolic burden, symptoms of the illness itself, as well genetic factors that confer risk for both bipolar disorder and metabolic complications. Dr. Mark Frye has more than twenty-five years of experience as a clinician, researcher and advocate. He is the former chair of the psychiatry department at Mayo Clinic, where he is now a professor of psychiatry. He is also the director of the scientific advisory board for the Depression and Bipolar Support Alliance (DBSA).
Dr. Frye sees the early signals of the efficacy of ketogenic therapy for some patients with mental health conditions as really impressive and encouraging. He would like to see further research and exploration of the biomarkers, mechanisms, and neurobiology behind this intervention so that it could be targeted to the individual patients most likely to benefit. There is a need for the whole field to shift toward precision psychiatry.
Dr. Mark Frye
www.mayo.edu/research/faculty...
Studies discussed:
Treating Insulin Resistance With Metformin as a Strategy to Improve Clinical Outcomes in Treatment-Resistant Bipolar Depression (the TRIO-BD Study): A Randomized, Quadruple-Masked, Placebo-Controlled Clinical Trial pubmed.ncbi.nlm.nih.gov/35120...
Insulin Resistance and Blood-Brain Barrier Dysfunction Underlie Neuroprogression in Bipolar Disorder pubmed.ncbi.nlm.nih.gov/34113...
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Learn more about metabolic psychiatry and find helpful resources at metabolicmind.org/
About us:
Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.
Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.
Timestamps
0:00 Introduction
1:58 Dr. Frye's approach to treating patients
4:02 Advances in psychiatry
6:31 Gaps that still remain in psychiatry treatment
8:37 Why regulatory approvals are needed in psychiatric care
11:04 Cardiometabolic burden in bipolar disorder
15:43 Bipolar depression
17:07 Insulin resistance & depression
19:54 Dr. Frye's on ketogenic therapy (a keto diet) for mental health
24:35 Is a specific mechanism needed to support the use of keto for mood disorders?
27:08 Balancing being a psychiatry researcher, clinician, and advocate
29:52 Adopting nutritional practices in psychiatry care
34:15 A systems approach to addressing nutrition in psychiatry
36:28 Nutrition as a medical intervention & the support systems needed
39:44 What's next for Dr. Mark Frye
41:50 Conclusion & what Dr. Mark Frye does for his mental health
#MetabolicMind
#KetoForMentalHealth
#MetabolicPsychiatry
#BipolarDisorder
#MetabolicNeuroscience
#KetogenicMetabolicTherapy
#NutritionalKetosis
#MentalIllness
#AlternativeTreatment
#CardioMetabolicRisk
#Obesity
#Diabetes
#MedicationSideEffects

[@karenohanlon4183]

My Doctor agreed with me that meds have such dreadful side effects. Affecting appetite sleep and the ability to feel real and not like a zombie. A lot of meds psyche meds can make matters worse. I wonder if they would ever consider controlled trials with keto versus meds. The other issue I have is the classification of the various terms used to describe clusters of symptoms that mostly overlap. It may be a matter of lowering stress and keto and water therapy and talking about how problems may be really a better option. And rather than being genetics or inherited traits could similar people growing up in similar environments have similar symptoms? People with mental health issues are starting to prefer keto and excercise to swallowing pills. Keep up the good work Brett

[@BarrelTitor91]

That would destroy pharma and food processing industry. I hope that happens but I doubt it.

[@janebutz5375]

Thank you so much for this thoughtful interview. I am coming at this from a couple of different directions. I’ve always had a weight issue (9+lb. baby), food scarcity as a child, food addiction as an adult, nursing as my first career and clinical depression for the past 30 years. This is an exciting time to see real advancement in mental health treatment. I now much better understand the need for research in terms of convincing reluctant clinicians both for efficacy and because it would mean a real shift in approach. At the same time, keto diets can be used now if supervised. I am pleased to report that I will be doing my own “research” this Spring with the support of my VA nurse-practitioner, my VA psychopharmacologist and my VA RN- health coach. They were willing to do ALL of the suggested lab work to establish baseline. And I have support from family and years in various support groups. Never underestimate the determination of a patient who just wants to feel normal! I never take that for granted. “Thanks for letting me share.”

[@lexamdelac28]

Interesting! I wonder how important the diagnosis is. I've read online before that schizophrenia, schizoaffective, and bipolar are really on the same spectrum, making me think they're related/very similar but he's wanting medicines/treatment specifically for bipolar. I've had diagnoses of all three conditions I mentioned all on numerous separate occasions by different doctors (one said to not pay attention to the diagnosis) and I take a medication that targets at least two of the conditions and has worked though I'd much rather be off it someday and not need any medicine so just curious about the relations of the conditions. Anyways, I am glad Dr. Frye is so open to nutrition helping his patients and how that system can look for success.

[@replaceablehead]

Emil Kraepelin dedicated most of life to figuring out if these two diseases were distinct. Towards the end of his career he speculated that they probably shared the same root cause. His work is worth reading, and IMHO his description of bipolar is the best ever written. His work on Schizophrenia is not nearly as good. He also recommends good diet and discusses autointoxication as a cause.

[@lexamdelac28]

thank you!!@@replaceablehead

[@jamescalifornia2964]

Very interesting how diet can improve mood and mental health. 🤔"'

[@susanbeever5708]

Great interview! I took the anti seizure medication oxcarbazepine that up-regulates TRPV1 and TRPV4. Glp-1 stimulates TRPV1 as the neurolymphocrine axis and stimulates insulin. Insulin then stimulates more TRPV1 that puts glucose into the cell independent of the insulin receptor. This leads to glucose and lipid oxidation in excess of the cell’s antioxidants. I developed severe osteoporosis within a couple years of being on oxcarbazepine and atherosclerosis, Brugada syndrome, ovarian and other cysts throughout my body. Glp-1 receptor and TRPV1 in the hypothalamus increases gonadotropin releasing hormone that stimulates ovaries. TRPV1 over stimulation in primary cilia on cell membranes leads to out pouching of tissue diverticula and cysts. I switched to the low carbohydrate diet and the diseases began to resolve and resolved significantly with the cessation of oxcarbazepine in addition to the low carbohydrate diet.

[@bradje12]

@susanbeever5708 Great! My wife had numerous complications from the antipsycotics also. All gone with Keto/carnivore diet. Off all drugs. Her Dr is amazed.

[@susanbeever5708]

@@bradje12 I’m so glad to hear that she found and followed the truth❤️

[@MistyRane]

Thanks for interviewing a variety of professional s with unique perspectives

[@akhusal]

Can reframing expectations be effective in satisfaction. For example if you expect ten dollars and someone gives you twenty dollars you'd be happy. If you frame your mind and reduce expectations you will mostly succeed. On a larger scale of reducing expectations, consider you are an insignificant super micro spec in the vast infinity of time and space. Your personal troubles are insignificant and will be forgotten. Then look at how lucky you are to be at the top of the evolution on this planet with the most sophisticated supercomputer, your brain and an elegant self growing/healing body. Plus you are living in time where any question you have can be found on the internet ofter with Bret Sher!

[@user-fr4lm1or7c]

Metabolic Mind should start a bilibili account, patients in CN need you

[@biologiclogic5904]

Is it possible that keto can diminish gender dysphoria?

[@bruceberry1111]

Dr. Frye mentions a study relating dietary quality and depressive symptoms. Hoping someone will have a link to that.

[@metabolicmind]

There are a couple of studies that demonstrate this. An important caveat as that these are all observational and may not prove cause and effect. But, here are a couple of links. www.sciencedirect.com/science/article/abs/pii/S0165032720332456 www.ncbi.nlm.nih.gov/pmc/articles/PMC9828042/

[@bruceberry1111]

@@metabolicmind Thanks for these, and also for the caveat!

[@replaceablehead]

I think he's bought a little too much into the promise of atypical antipsychotics, he ought to know about the enrichment and the "Mexico effect". Still good information.