I thought I'd share some excerpts from a most interesting opinion piece by Moises Velasquez-Manoff, a science writer for the New York Times. I found the article in the Sunday Review section (page 7) in the September 30, 2018 edition. You may be able to access the full article at Opinion | He Got Schizophrenia. He Got Cancer. And Then He Got Cured. - The New York Times, if interested. Though much of the article focuses on observations of treatments that seem to have significantly eased, or even seemingly “cured”, psychosis in people with schizophrenia diagnoses, there are also references to a possible link between the immune system and conditions like bipolar disorder, depression, and even at least some forms of epilepsy and dementia. [I'll highlight the sections that specifically mention bipolar and depression in red font.] The title is “He Got Schizophrenia. He Got Cancer. And Then He Got Cured.”

Please take what is written in the article as just interesting research results. They may not be firm answers to difficult questions regarding some mental illnesses or potential new treatments, let alone cures.
______

“The man was 23 when the delusions came on...Dr. Tsuyoshi Miyaoka, a psychiatrist treating him at the Shimane University School of Medicine in Japan, eventually diagnosed paranoid schizophrenia. He then prescribed a series of antipsychotic drugs. None helped. The man’s symptoms were, in medical parlance, “treatment resistant.” Later down the line...

“...it turned out he had a cancer of the blood called acute myeloid leukemia. He’d need a bone-marrow transplant to survive. After the procedure came the miracle. The man’s delusions and paranoia almost completely disappeared. His schizophrenia seemingly vanished...Years later, ‘he is completely off all medication and shows no psychiatric symptoms’ Dr. Miyaoka told me in an email. Somehow the transplant cured the man’s schizophrenia...A bone-marrow transplant essentially reboots the immune system...his recovery suggests that his immune system was somehow driving his psychiatric symptoms...a growing body of literature [suggests] that the immune system is involved in psychiatric disorders from depression to bipolar disorder.”

According to the article, the above-mentioned theory has been around for quite a while, though overlooked. Other examples that support this theory date back to the late 19th century, when “physicians noticed that when infections tore through psychiatric wards, the resulting fevers seemed to cause an improvement in some mentally ill and even catatonic patients...”

The article further states that an Austrian physician, Julius Wagner-Jauregg, went so far as to deliberately infect psychiatric patients with malaria to induce fever. Unfortunately, some patients died from that experiment, though many others recovered from their psychiatric ailments after recovering from the malaria. Certainly such an experiment would be considered criminal now, but the results earned him a Nobel prize in the end. A more recent case study result documents a schizoaffective woman's psychosis and depression ending “...after a severe infection with high fever...”

“...in the past 15 years or so, a new field has emerged called autoimmune neurology. Some two dozen autoimmune diseases of the brain and nervous system have been described. The best known is probably anti-NMDA-receptor encephalitis, made famous by Susannah Cahalan’s memoir “Brain on Fire.” These disorders can resemble bipolar disorder, epilepsy, even dementia...when promptly treated with powerful immune-suppressing therapies, [some peoples’]...psychosis evaporates. Epilepsy stops…”

“...Dr. Robert Yolken, a professor of developmental neurovirology at Johns Hopkins, estimates that about a third of schizophrenia patients show some evidence of immune disturbance. “The role of immune activation in serious psychiatric disorders is probably the most interesting new thing to know about these disorders,” he told me…”

“...Another case study from the Netherlands highlights this still-mysterious relationship. In this study, on which Dr. Yolken is a co-author, a man with leukemia received a bone-marrow transplant from a schizophrenic brother. He beat the cancer but developed schizophrenia. Once he had the same immune system, he developed similar psychiatric symptoms…”

“...A decade ago, Dr. Miyaoka...treated two schizophrenia patients who were both institutionalized, and practically catatonic, with minocycline, an old antibiotic usually used for acne. Both completely normalized on the antibiotic. When Dr. Miyaoka stopped it, their psychosis returned. So he prescribed the patients a low dose on a continuing basis and discharged them…”

“...Larger trials suggest that [minocycline is] an effective add-on treatment for schizophrenia. Some have argued that it works because it tamps down inflammation in the brain. But it’s also possible that it affects the microbiome — the community of microbes in the human body — and thus changes how the immune system works…”

“...Dr. Yolken and colleagues recently explored this idea with a different tool: probiotics, microbes thought to improve immune function. He focused on patients with mania, which has a relatively clear immunological signal. During manic episodes, many patients have elevated levels of cytokines, molecules secreted by immune cells. He had 33 mania patients who’d previously been hospitalized take a probiotic prophylactically. Over 24 weeks, patients who took the probiotic (along with their usual medications) were 75 percent less likely to be admitted to the hospital for manic attacks compared with patients who didn’t…”

“...We now seem to have reached such a threshold with certain rare autoimmune diseases of the brain. Not long ago, they could be a death sentence or warrant institutionalization. Now, with aggressive treatment directed at the immune system, patients can recover. Does this group encompass a larger chunk of psychiatric disorders? No one knows the answer yet, but it’s an exciting time to watch the question play out.”

[Blueberrybook]

Thanks for sharing. The auto-immune link with BP and the immune system is interesting. I've got fibromyalgia, which isn't exactly autoimmune, more in a gray area or present with other autoimmune issues. One of my aunts on my mom's side has lupus and depression. She had the depression first, way before the lupus diagnosis.

It is interesting when scientific findings come out and are published though sometimes a bit disturbing to me, such as many findings suggesting bipolar inheritance/tendency tends to come from the maternal side (though still if a child has 2 parents with psych issues, they are much more likely to have psych issues than if just 1 parent has the issue). And I know bipolar is not all inherited, but it does seem to be one of the mental disorders more highly linked to genetics even though environmental factors still play a significant role. I do believe my BP issues came from my mom's side of the family and not my father's, so I worry about my daughter on that count.

Thanks for sharing that, Blueberrybook. Did you read the whole article? I only ask because the article did include a couple of bits about genes and even a mention about lupus. I didn't include those bits in my post of excerpts. Here are the relevant brief excerpts mentioning those two topics:

"Studies on the role of genes in schizophrenia also suggest immune involvement, a finding that, for Dr. Yolken, helps to resolve an old puzzle. People with schizophrenia tend not to have many children. So how have the genes that increase the risk of schizophrenia, assuming they exist, persisted in populations over time? One possibility is that we retain genes that might increase the risk of schizophrenia because those genes helped humans fight off pathogens in the past. Some psychiatric illness may be an inadvertent consequence, in part, of having an aggressive immune system."

And the lupus mention:

"Modern doctors have also observed that people who suffer from certain autoimmune diseases, like lupus, can develop what looks like psychiatric illness. These symptoms probably result from the immune system attacking the central nervous system or from a more generalized inflammation that affects how the brain works."

I had never heard of bipolar disorder coming predominately from a mother's side. In my family's case, it would seem it comes more from my dad's side. My paternal grandmother clearly had bipolar disorder, experiencing a severe depression, then clear manic symptoms with psychosis soon after. She had remission, then only milder symptoms later in her life. We also have suspicion that my dad has bipolar disorder, but he only admits to depression and anxiety. My sister has a bipolar dx, my cousin on my paternal side does (though her mother is said to have it, too), my sister's son did (he passed away), and I do. Though my father once told me that my maternal grandmother had a severe "nervous breakdown" after having my uncle, nothing more was really mentioned. The only person from my mother's side that has a confirmed bipolar dx is my mother's paternal first female cousin's youngest daughter. It's hard to know if she got it from a blood relative or not.

[Blueberrybook]

The maternal linkage to bipolar comes from genes on mitochondrial DNA, which are only inherited from the mother to the child, whether male or female. Male offspring don't pass the mDNA on while female offspring do pass along the mDNA, and even then it is complex with many genes not on the mDNA involved, studies of certain diseases linked more to bipolar, even whole symptoms like the auto-immune system, which are very complex and can be affected by things like hormones, vitamins. So it is not a given bipolar comes from the mother alone, it is thought that the contributing mDNA affecting bipolar, even mDNA affecting systems with genes that affect bipolar not on the mDNA (gets confusing) gets involved, and all that gives the maternal line a larger chance than the paternal side of passing on bipolar genes, genes linked to bipolar, anything linked to the mitochondrial DNA, really. But the human body is complex. Identical twins have somewhere from a 40-70% chance of both developing bipolar in their lifetime if one twin has it.

[Christopher1990]

I received the gene from my mothers grandmother who had schizophrenia, nobody else in my family has mental illness. My mom's mother had a nervous breakdown but is fine now. So, in my case it did come from my mothers side. I guess I got screwed in that department.

[Wild Coyote]

This is fascinating and certainly offers some possibility for hope!

Thank you for sharing and thanks for the discussion, thus far.
All food for thought!


WC

[HopeForChange]

This is fascinating--thanks so much!!!

[~Christina]

So much to think about.

Than you for posting