March: Mental Health Awareness Month

Introduction
Our brains are very similar to those of apes and those of chimpanzees. They probably feel very similar emotions to those that we feel. I feel that it is possible that these animals may also develop mental illness.
Mental illness is thought to be a disease of the brain. However, peripheral cells may be affected also. Some studies have shown abnormal platelets, red blood cells, muscle cells, etc.

These facts are very useful because it is difficult to study brain cells until after the patient is deceased. Blood cells can be studied while the patient is alive.

"The structural changes observed in the brain of patients with chronic depression lends support to the neurodegenerative hypothesis of depression [ 57 ]." Leonard (1)
Leonard has reported "insulin resistance" in depression. What this means is that the metabolism of glucose, vital to the brain, is slow in depression.
Depression
Ref. 2 has reported abnormal tryptophan metabolism in depression.
"The mean tryptophan breakdown index was higher (p=0.036), and mean kynurenic acid concentration and mean neuroprotective ratios were lower, in depressed patients (p=0.003 and 0.003, respectively)." Myint et al (2)
This appears to be a very important finding and should be investigated further. This brilliant work was done at the
University of Maastricht, Department of Psychiatry and Neuropsychology, UNS 50, Maastricht, 6200MD, The Netherlands. mm_ayemu@yahoo.com

Tryptophan

Different approaches have been favored by different scientists. Some scientists favor the use of cellular pathology (3).

Other scientists, including the late Linus Pauling, have favored studying diseases on a molecular level. My own view is that Paling's approach is superior because it can lead to treatments. If the brain has an excess of tryptophan, which is found in the diet, then a diet low in tryptophan would be suggested.

There are certain drugs that can cause symptoms of depression (4). These drugs alter tryptophan metabolism. They increase the metabolism of tryptophan (4). Thus the possiblity exists that tryptophan may be the Rosetta stone of mental illness.

Schizophrenia

Tryptophan metabolism has also been reported to be abnormal in schizophrenia (5). It has been reported to be excessive in bipolar disorder (6). Ref. 7 reported hypercatabolism of tryptophan in neuropsychiatric disorders (including schizophrenia).

Conclusions

Reports from all over the world including India, Sweden, etc. have shown excessive tryptophan metabolism in psychiatric disorders. These results would be explained if too much tryptophan were entwering the cells. The India study included certain neurological disorders with psychiatric symtptoms as well as schizophrenia. Thus research on tryptophan appears to be fertile ground for both psychiatry and neurology.

My own theory is that a diet very low in tryptophan but supplemented with niacin (so as to avoid pellagra) should be tried as a therapy. This could be called an orthomolecular treatment. References
1. Curr Immunol Rev. 2010 Aug;6(3):205-212. The concept of depression as a dysfunction of the immune system. Leonard BE .

2. Myint A-M, Kim Y-K, Verkerk R, et al. Kynurenine pathway in major depression: evidence of impaired neuroprotection. J Affect Dis. 2007; 98 :143-151.

3. Stockmeier CA, Jurjus G. In: The postmortem brain in psychiatric research. Agam G, Everall IP, Belmaker RH, editors. Kluwer Academic Publishers; Boston, Dordrecht, London: 2002. p. 363.

4. Wichers MC, Kock GH, Robays G, et al. IDO and IFN-alpha induced depressive symptoms : a shift in hypothesis from tryptophan depletion. Mol Psychiat. 2005; 10 :538-544.

5. Miller CL, Llenos IC, Dulay JR, Barillo MM, Yolken RH, Weis S. Expression of the kynurenine pathway enzyme tryptophan 2,3-dioxygenase is increased in the frontal cortex of individuals with schizophrenia. Neurobiol Dis. 2004; 15 :618-629.

6. Elevated levels of kynurenic acid in the cerebrospinal fluid of patients with bipolar disorder. Olsson SK, Samuelsson M, Saetre P, Lindström L, Jönsson EG, Nordin C, Engberg G, Erhardt S, Landén M. J Psychiatry Neurosci . 2010 May;35(3):195-9.

7. Neurol India. 2000 Sep;48(3):231-8. Tryptophan and tyrosine catabolic pattern in neuropsychiatric disorders. Ravikumar A , Deepadevi KV , Arun P , Manojkumar V , Kurup PA .