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1

Mitochondria Dysfunction

6

2

oxidative stress

Mitochondrial dysfunction

8

Defect in the Na/K ATPase

elevated level of Ca

lose ability to regulate Ca levels

excitatory

ATP

affect neurotransmitters secretion

NS

refractory

Depression and manic episodes

7

3

Neurotransmitters

BD symptoms :

what is Bipolar?

manic episodes symptoms:

10

energy and activity

high or euphoric

manic episodes

sleep or no sleep

delusions, and hallucinations

poor appetite

Depression episodes

2

1

Bipolar Disorder causes :

BD symptoms:

Neurotransmitters

depressive symptoms:

1

2

oxidative stress

mitochondria dysfunction

Oxidative stress

feeling sad

sleep problems

Dopamine

seretonin

3

energy and feeling exhausted

feelings of guilt

Neurotransmitters

Possible Causes of Bipolar disorder:

5

suicidal thoughts

problems concentrating

3

1

2

physical illness

Depression and manic episodes

Genatics

Triggers

11

9

overwhelming problems

stress

4

Bipolar disorder and Ketogenic diet

oxidative stress

decrease oxidative stress by decreasing free redicals

15

Neurotransmitters with KD:

mitochondria with ketogenic diet

it can stimulate mitochondrial biogenesis as the cells adapt to the increased demand for energy production from fatty acids and ketones.

16

Increase in mitochondria mass

there is a 50% increase in the total number of mitochondria in the hippocampus, resulting in more brain ATP.

14

Neurotransmitters with KD:

Dopamine

Serotonin

17

Ketogenic Diet:

fat

from 20 - 35%

to 70-80%

from 45 - 65%

to 5 - 10%

Carbohydrates

13

conclusion:

The ketogenic diet has been linked to increased mitochondria biogenesis, which plays a crucial role in cell energy production and overall health, decreasing oxidative stress, decreasing dopamine, increasing serotonin,and GABA levels causing lower depression and manic episodes in Bipolar Disorder.

18

recommendations:

read more about BD and KD

read about BD and Vitamin D and Omega-3

read about other psychological disorder and the nutrition interventions

19

Reffrences:

Dietch DM, Kerr-Gaffney J, Hockey M, et al. Efficacy of low carbohydrate and ketogenic diets in treating mood and anxiety disorders: systematic review and implications for clinical practice. BJPsych Open. 2023;9(3):e70. doi:10.1192/bjo.2023.36

Bohnen JLB, Wigstrom TP, Griggs AM, Roytman S, Paalanen RR, Andrews HA, Bohnen NI, Franklin JJH, McInnis MG. Ketogenic-Mimicking Diet as a Therapeutic Modality for Bipolar Disorder: Biomechanistic Rationale and Protocol for a Pilot Clinical Trial. Nutrients. 2023 Jul 7;15(13):3068. doi: 10.3390/nu15133068. PMID: 37447394; PMCID: PMC10346691.

Sethi S, Wakeham D, Ketter T, Hooshmand F et al. Ketogenic diet intervention on metabolic and psychiatric health in bipolar and schizophrenia: A pilot trial. Psy. Res. 2024. doi: 10.1016/j.psychres.2024.115866

Brietzke, E., Mansur, R. B., Subramaniapillai, M., Balanzá-Martínez, V., Vinberg, M., González-Pinto, A., Rosenblat, J. D., Ho, R., & McIntyre, R. S. (2018).

Campbell I, Campbell H. Ketosis and bipolar disorder: controlled analytic study of online reports. BJPsych Open. 2019;5(4).

Dhillon KK, Gupta S. Biochemistry, Ketogenesis. 2023 Feb 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 29630231.

Jensen NJ, Wodschow HZ, Nilsson M, Rungby J. Effects of Ketone Bodies on Brain Metabolism and Function in Neurodegenerative Diseases. Int J Mol Sci. 2020 Nov 20;21(22):8767. doi: 10.3390/ijms21228767. PMID: 33233502; PMCID: PMC7699472.

Saraga M, Misson N, Cattani E. Ketogenic diet in bipolar disorder. Bipolar Disord. 2020 Nov;22(7):765. doi: 10.1111/bdi.13013. Epub 2020 Oct 16. PMID: 33021024.

Tondo L, Vázquez GH, Baldessarini RJ. Depression and Mania in Bipolar Disorder. Curr Neuropharmacol. 2017 Apr;15(3):353-358. doi: 10.2174/1570159X14666160606210811. PMID: 28503106; PMCID: PMC5405618.

Chmiel I. Ketogenic diet in therapy of bipolar affective disorder - case report and literature review. Psychiatr Pol. 2022 Dec 31;56(6):1345-1363. English, Polish. doi: 10.12740/PP/OnlineFirst/136356. Epub 2022 Dec 31. PMID: 37098202.

Needham N, Campbell IH, Grossi H, Kamenska I, Rigby BP, Simpson SA, McIntosh E, Bahuguna P, Meadowcroft B, Creasy F, Mitchell-Grigorjeva M, Norrie J, Thompson G, Gibbs MC, McLellan A, Fisher C, Moses T, Burgess K, Brown R, Thrippleton MJ, Campbell H, Smith DJ. Pilot study of a ketogenic diet in bipolar disorder. BJPsych Open. 2023 Oct 10;9(6):e176. doi: 10.1192/bjo.2023.568. PMID: 37814952; PMCID: PMC10594182.

Choi J, Kang J, Kim T, Nehs CJ. Sleep, mood disorders, and the ketogenic diet: potential therapeutic targets for bipolar disorder and schizophrenia. Front Psychiatry. 2024 Feb 14;15:1358578. doi: 10.3389/fpsyt.2024.1358578. PMID: 38419903; PMCID: PMC10899493.

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