The surprising role of insulin in my recovery from depression

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Known best for its role in the body as a regulator of blood glucose levels and fatty acid storage, insulin also acts in the brain to aid memory and thinking. Thus, when insulin regulation is disrupted, as it is in many common medical conditions including obesity and diabetes, the risk for cognitive impairment rises.
M. J. Friedrich, ‘Insulin Effects Weigh Heavy on the Brain’; Journal of American Medicine, 2006

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Vanderbilt University Medical Center researchers, working with colleagues in Texas, have found that insulin levels affect the brain’s dopamine systems, which are involved in drug addiction and many neuropsychiatric conditions.
The results are some of the first to link insulin status and dopaminergic brain function and hold several implications for human health and disease.

Vanderbilt University Medical Center, “Insulin’s Brain Impact Links Drugs And Diabetes”; ScienceDaily, 17 Oct. 2007.

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…diabetes causes a narrowing of the arteries and makes the brain more susceptible to gradual damage. People with diabetes are more vulnerable to depression and are more likely to suffer a decline in mental ability as they age.
The Franklin Institute, “High Sugar Intake Over Time”; ‘The Human Brain’.

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I’ve known for a while that diabetes can cause depression, but I didn’t know how. It was just one more cause on top of all the others and, because diabetes was something I hadn’t been able to control, all the others needed to be looked after first.

But recently I have taken the steps towards taking control over the diabetes, and I have noticed a difference both in body and in mind.

So, is it possible the insulin has already, less than a month since my first dose, begun healing the parts of my brain the lithium and therapy couldn’t touch?

Lithium is a mood stabilizer, it’s meant to stop the extreme ups and downs thrust on us by the manic depression. It plays a crucial role in our recovery from manic depression by giving us back the ability to reason, to think our way through the days where, beforehand, we could only suffer.

Lithium not only stabilized me, but through that stability it took away my desire to kill myself, and then it took away the fantasies, and then the thoughts of suicide being a reasonable option altogether.

But it doesn’t repair the damage done to our brain by a depression-causing disease like diabetes.

It’s like all this time I’ve been fighting two causes of my debilitating depressions — growing up in a commune, raised by no one, then abandoned by two thirds of my family when I was eight. The other, the manic depression, with which I was diagnosed in 1988. But, I only recently found out, there was a third cause. Something I had left untreated, and allowing it to fight against me, since roughly 1992.

In fact they all went untreated for so long. Previous to 1988 I had seen a therapist and a few child counsellors and a guidance counsellor in high school. But nothing with any substance. The first time I got serious about any of it was in 2003, when I moved back home, suicidal and with a head full of PTSD.

So I’ve been fighting a three-pronged attack, but on only two sides. The lithium for the manic depression, the therapy for the abandonment issues and family stuff. I started taking medications to control the diabetes two years ago, but only because I had started worrying about the future state of my feet and legs.

And now, two years later, I’ve started taking insulin. And a few days later I was so sure I was experiencing what I can only call a “clearing of the clouds” that I checked online to see how insulin, as a treatment for diabetes, effects depressions.

And I found this:

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“Symptoms of depression are common in people with diabetes compared with the general population, and major depression is present in approximately 15% of people with diabetes. Depression is associated with poorer self-care behaviour, poorer blood glucose management, health complications, decreased quality of life and psychological well-being, increased family problems, and higher healthcare costs.”

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Insulin, basically, tells cells it’s dinner time. The cells then eat the sugar that fuels every part of out body. If the insulin isn’t around to activate the cells, bad things happen. Like legs get chopped off because they can’t heal from minor cuts and bruises.

Or brain cells starve, and it gets harder and harder for the brain to conduct normal business. Like remembering stuff, like focusing, like getting depressed for no real reason.

Since starting insulin my numbers have plummeted from the high teens, to an average of 9.5mmol/L in the morning, and 16mmol/L in the evening. I’ve seen a 23.9, but that was a mistake, I’ve taken a few readings too close after eating, which defeats the exercise entirely.

But I’ve also seen normal numbers, like 4′s and 6′s, that I’ve never seen before.

So, I’m certain the physical effects of the insulin are not due to a “placebo effect”. It’s not wish fulfillment. The numbers don’t lie. But mentally I feel clearer, more capable, I feel as though I’m using parts of my brain that have been on “standby” for years.

But that clarity is not something I can prove.

I am willing to allow the possibility that either I’m projecting — that the weight I’ve been carrying for so long, the one that told me how far below the knee my prosthetic would attach, the one that told me I’d never see my son graduate — is gone, and therefore I feel lighter and less concerned about the future.

Or, that I’m just reacting to a new treatment the same way I reacted to the lithium way back in 1989, with a few weeks of increased activity, and a few better marks in school, then a long crash that left me in the psych-ward.

Whether what’s happening now is real or not, it will be real sooner rather than later. The years, possibly decades, of abuse done to my body, mind and brain, by the diabetes is coming to an end. Not all of the damage is reversible, the nerves in my legs and hands are permanently damaged, but the damage done to my brain can be fixed by the insulin.

And the insulin, suddenly a vital part of my recovery, will finally take away the last source of my previously uncontrolled depressions.

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...thanks.

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About Gabriel...

...diagnosed with manic depression in 1989, for the next 14-years I lived without treatment or a recovery plan. I've been homeless, one time I graduated college, I've won awards for reporting on Internet privacy issues. In 2002 I finally hit bottom and found help. I have a 4-year old son, I'm helping to raise my 8-year old step-son, I’m usually about six feet tall, and I'm not sure if I still have a book deal.
This entry was posted in Bipolar, Bipolar Disease, Bipolar Disorder, Clinical Depression, crazy people with no pants, Diabetes, Disability, Health, Lithium, Living With Depression, Living With Manic Depression, Manic Depression, Mental Health. Bookmark the permalink.

19 Responses to The surprising role of insulin in my recovery from depression

  1. FoodForThought. says:

    It’s probably not the insulin that is helping your depression, but rather it is chronic hyperglycemia that was depressing you in the first place. The insulin correlates with your brain fog and apathy clearing up because the insulin is mopping up your blood sugar.

    However, your high blood sugar is related to a lot of other things besides a lack of insulin. It is related to the whole state of your nutrition, and I don’t mean calories. Lack of magnesium, lack of omega 3 fatty acids, lack of chromium, just to name a very basic few, all will cause your sugar to inch higher and higher. And guess what, all of these things clearly affect depression independently of their effect on blood sugar.

    Magnesium helps depression and it also brings down blood sugar by making your insulin work better. Chromium is touted to atypical depression what lithium is to manic depression. Some forms of atypical type depression may be chromium deficiency. And then to complicate things further, manic depression usually features atypical depression symptoms…

    And, the 800 pound gorilla in the room: if you don’t eat food that is broken down into glucose (read: sugar and starch) then your blood sugar will come down a lot. Fatty acids require very little insulin to process. Protein requires more, but not as much as carbohydrate. A low carb diet will do wonders for most forms of diabetes, without the risks of insulin (severe hypoglycemic attacks + weight gain).

    No one will tell you this, because most doctors don’t know it, or alternatively they don’t care, and nutritionists don’t know either. Usually they just don’t know, all they know is drugs. Like insulin. And they also know American government food propaganda. LIke eating corn based products is the best thing for health.

    But one thing is for certain: having your brain basting in blood sugar will cause biological depression in almost everyone, and here’s another secret, it can also cause mania. Blood glucose activates protein kinase C which is at the heart of mania. If a person has a biological predisposition to mania, high blood glucose will help that snap. Many manic depressives later turn into diabetics because blood sugar disorders which are not yet diagnosed or subclinical play a role in the etiology of severe mood disorders like mania and depression. If this person had their blood sugar disorder diagnosed in the early stages, when they were young, and if it were controlled with targeted supplemental nutrition and a glucose suppressive diet, their mood disorder might never have been so bad.

    Feel free to disregard this, but I feel an obligation to spout off to others in a similar situation, given I would be a million times worse if I didn’t practice this.

    • Gabriel... says:

      Hi. Judging from the email address you left I’m not sure you’ll be back, but I’ll reply anyway. First, people who try to explain away manic depression as a disorder brought on by a nutritional deficiency, are dangerous. Either you’re working for Suzanne Somers, or you’ve joined her cult. Will better nutrition make me feel better? Of course. Should I stop taking my medications, stop going to therapy, and start taking handfuls of pig food? No.

      Second, people who use phrases like “doctors won’t tell you this, but” are always dangerous… like, Kevin Trudeau dangerous. There are a lot of phrases you use in your comment that lead me to doubt your sanity, like “…nutritionists don’t know either” and “…all they know is drugs”.

      Or blaming chronic diseases on the American Food Guide, and the corn industry.

      You’ve made a few good points about diabetes and nutrition but, like most lunatics, you couldn’t stop there. You had to throw in a few pages from your anti-pharma and anti-psychiatry paranoia manifesto.

      If you do come back, there’s a 600 word limit on comments.

  2. zoom says:

    Whatever the reasons, I’m very happy to hear that you’re feeling so much better!

    • Gabriel... says:

      Thanks zoom.

      Here are some of the reasons, for those who haven’t been paying attention (I’m looking at you FFT, you giant Sci3ntology whore):

      …lithium, therapy, seroquel, sleep, sometimes family, the Internet, insulin, whole wheat toast, occasionally friends, my camera, Bo Diddly, Wellbutrin (which also helped me quit smoking)… and I should definitely give a shout-out to Nicole de Boer and ‘Phil The Alien’. Actually, this might make a great post.

  3. PiedType says:

    Nice takedown on Foodforthought. I get a kick out of seeing people like that dismembered.

    Personally, I credit the unique synergy between the insulin and Bo Diddly. So glad it’s working for you. Enjoy!

    • Gabriel... says:

      I probably should have waited until I was awake and my son was in a better mood. There were other things I could have said. FFT isn’t the first anti-everything troll who has dropped in, it’s a hazard when you blog about mental illness, especially if the blogger is writing about getting better by using medications and psychiatry.

      It’s pretty easy for the anti-everything people to keep track of what’s happening in mental health blogging, especially with the tags and categories I use, so I’m never surprised when the trolls show up.

      I made a mistake, when I was writing my reply to zoom I thought I was listening to Bo Diddly, but it was actually “Killing Floor” by Howlin’ Wolf. Thanks for the comment PiedType.

  4. thordora says:

    It’s funny, cause when my Dad got a diagnosis, and I did some reading where they mentioned mood swings, I thought, gee, maybe now he’ll stop being such an asshole…the other stuff makes sense too, the lack of self care, etc, so I’m kinda hoping to see my “dad” this fall, not the guy he’s been lately.

    It all makes sense to me, and I’m glad it’s all part of a healthier you. You so totally deserve it.

    And jebbus he’s big! Where does time go?!?!

    • Gabriel... says:

      Hi Thor, thanks for the comment.

      I don’t know if insulin or better nutrition cures all manner of asshole-itis, but they’re a good start. I hope you see your dad get better with his treatment. I see the effects of eating better, or eating in a way that fights the diabetes, as having the same basic effect on my recovery as taking the seroquel has. I can get a full, restful sleep with two little pills, and I can feel healthier by taking proper care of the diabetes.

      Good luck with your dad, just make sure he stops eating the unhealthy stuff.

      …there are times when Victor looks big, but then, when I’m changing him, and his shirt is off, he looks so fragile and small.

      His mother found him a little car-buggy at a yard sale. So she dressed him up like a golfer, and a pageboy hat, and pushed him around town. Ador-a-freaking-ble. I’ll post the photo next time.

  5. zoom says:

    If you want to see him looking huge, just have another baby. Victor will become a giant overnight.

  6. FoodForThought. says:

    Sir, you are jumping to conclusions. In no way at no point in time did I suggest dropping your lithium for manic depressions, and in no way at in no point in time did I present myself as an anti pharma nutbag. Mental illness is real, it needs medication, depending on the severity of symptoms, and your symptoms sound(ed) pretty severe.

    What I was trying to show you was that all of these diseases – your manic depression, your glucose intolerance and now diabetes – may have an underlying root link. There are studies showing a link between high brain glucose and the onset of maina, and certainly tons of evidence which show that glucose intolerance and high glucose levels lead to depression.

    AT the very least, it is well demonstrated that high brain glucose leads to brain fog and apathy. Your improvement in well being is not necessarily from extra insulin, but from less blood sugar which is a side effect of taking the drug insulin.

    However, there are other, and arguably better ways to get less blood sugar in your brain, without the risks of insulin. I am not arguing you stop using insulin – the most important thing is glycemic control. I am merely trying to show you that there is so much more out there you can and should be doing to improve your hyperglycemia. A bottle of magnesium and chromium costs pennies and has been pretty much proven to reduce insulin needs and glucose levels in diabetic people. These nutrients also help mood and mind independently of blood sugar.

    The main thing I wanted to communicate is that your diabetes is not separate from your bipolar, it’s quite possible and even likely that your life long glucose disorder may have triggered it or made it worse. It is shown that diabetic people have subclinical glucose processing abnormalities well before developing frank hyperglycemia, even in childhood. Controlling your diabetes is very important not just for your feet, but for your mind too.

    • Gabriel... says:

      “It’s probably not the insulin that is helping your depression, but rather it is chronic hyperglycemia that was depressing you in the first place.”

      “No one will tell you this, because most doctors don’t know it, or alternatively they don’t care, and nutritionists don’t know either. Usually they just don’t know, all they know is drugs.”

      “…having your brain basting in blood sugar will cause biological depression in almost everyone, and here’s another secret, it can also cause mania.”

      “If this person had their blood sugar disorder diagnosed in the early stages… their mood disorder might never have been so bad.”

      Hello again FFT… you wrote that you don’t trust doctors, you don’t trust nutritionists, and you don’t trust drugs “like insulin” — you dismiss all three “…all they know is drugs. Like insulin.”, you also wrote about “American government food propaganda”.

      Like I wrote, you came across as reasonable until you started down the ‘doctors are keeping cures from you’ road.

      I haven’t had a “lifelong glucose disorder”, the bipolar was diagnosed five years before I assume the diabetes kicked in — an assumption based solely on weight gain, but the first test that confirmed diabetes was almost thirteen years after the bipolar diagnosis.

      Being told the suffering I went through between diagnosis’s could have been lessened if only I ate the proper amounts of fatty acids is frustrating and a little insulting. Whatever depressions I went through that were caused by the diabetes, whenever it started, would have added to the ones caused by the manic depression in the same way a cup of water adds to a hurricane.

      I know this because the “depression” or “fog” I believe I’m feeling peel away, thanks to the introduction of insulin into my recovery, is minor, and probably about as significant as how I feel when I think there are people who believe, next year, Mayans will appear and kill us all.

      I appreciate your coming back to clarify your original comment, which had a few… “off-beat moments”, with a second comment that was passionate and pretty much all sane. I also appreciate that you are obviously trying to help.

  7. Amazing! I didn’t know there was a scientific link between blood sugar and depression, but it makes so much sense! Glad you’re getting proper treatment for the diabetes!

  8. FoodForThought. says:

    I didn’t say this in my first response, because I thought you would flip out and call me antipharma, but since you’ve already accused me of it (even though I am not) I might as well share.

    Inositol deficiency caused by lithium therapy for manic depression can cause or exacerbate glucose intolerance/diabetes, and neuropathy. Given that you are suffering from neuropathy as well as severe diabetes, and you have been taking lithium for many years, it is likely you are inositol depleted. Other signs of inositol deficiency are depression, skin disorders/flaking, weight gain and hair loss.

    You should consider, under supervision of your psychiatrist, inositol supplementation along with your lithium therapy. There is some evidence that lithium’s depletion of inositol may be part of its antimanic action (as inositol deficiency is depressant) so it should be done carefully under medical supervision. It’s worth it, if it improves your neuropathy and diabetes, and any signs of instability can be handled if your doctor is supervising. It is not proven that inositol deficiency actually helps manic depression – it’s just one theory that this is the mechanism of action of lithium in manic states (as well as depakote/valproates, these medicines also cause inositol deficiency, thus glucose intolerance/diabetes/hair loss, and are known to be antimanic). As you know lithium does a whole lot other than affect inositol so it’s possible you can be stable as you are without as severe of a problem with diabetes and nerve death if you add on some inositol.

    People on depakote routinely take acetyl-l-carnitine to avoid ruining their liver quite as much, it’s not unheard of.

    • Gabriel... says:

      I was writing a response to your second comment when you wrote this one. I think it covers this one as well… especially this part:

      “Being told the suffering I went through between diagnosis’s could have been lessened if only I ate the proper amounts of fatty acids is frustrating and a little insulting. Whatever depressions I went through that were caused by the diabetes, whenever it started, would have added to the ones caused by the manic depression in the same way a cup of water adds to a hurricane.”

  9. nursemyra says:

    I’m glad you’re feeling better Gabriel

  10. Liz Lane says:

    Hiya! I really like your blog and was wondering how I go about following you? Cheers Liz

  11. Gabriel... says:

    Hi Liz. Thanks very much. WordPress and Blogger don’t translate very well, but from what I understand there’s a section in your dashboard / admin area where you can add links to your sidebar. Other than that, I’m really not sure… unless you subscribe to salted’s feed:

    http://saltedlithium.wordpress.com/feed/

  12. Erin says:

    Yes, I totally agree with you FoodForThought.

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