“The number twos cured my blues.”

SCIENCE

As the blender whizzed and Jane Dudley prepared for a radical procedure, the concept of being at the forefront of a potentially revolutionary change in the treatment of bipolar disorder was far from her mind. Mostly, Jane was thinking about how revolted she was by what was about to happen.

But months after her husband Alex, a zoologist with a lifelong interest in ecology, first proposed the “gross” idea to Jane as a way of managing her crippling bipolar, she decided it was worth a try.

“I was at a point of desperation where I felt I can’t continue living with this level of suffering,” Jane tells Australian Story. “It was a desperate act.”

Eight years ago, Jane began a series of home-administered faecal microbiota transplants (FMT), or “poo transplants”, with the hope it would “take the edge off” her mental illness, which had led to her being hospitalised a number of times.

The couple took Alex’s faeces, blended it with saline, passed it through a sieve, put the slurry into an enema bottle and “then head down, bum up, squeeze it in”.

To Jane’s astonishment, as the months went on, she began “to feel joy for no reason”.

“I started to have self-esteem for no reason,” she says. “I started to have motivation.”

Jane hasn’t had a manic episode since September 2017 and feels confident in saying she’s been cured of an illness psychiatry labels incurable.

And it was a world-first — the first use of FMT to cure bipolar and experts were stunned.

Jane’s psychiatrist, Russell Hinton, monitored Jane’s progress during the treatment. He describes the change in Jane as “bordering on miraculous”. And Professor Gordon Parker, who heads the School of psychiatry at the University of NSW in Sydney says Jane’s recovery through FMT was one of the most exciting developments in his 50 years of psychiatry.

But Jane and specialists warn the DIY method can carry significant risks — including death — if the faecal donor is not properly screened. There is a risk that serious disease, obesity or antibiotic resistance can be transferred from an unscreened donor to a recipient. That’s why there is now a push to raise A$10 million to enable the Food and Mood Centre at Deakin University in Melbourne to run a randomised control trial of faecal transplants for depression.

“The fact that people are finding my story and doing DIY FMT … scares me because I’m worried that people are going to get even sicker, that it’s not going to work, or they’re going to end up with an autoimmune disease or have a severe reaction, which just speaks to the urgency of why we need clinical trials now,” Jane says.

Jane’s background

Jane had once been a bright, sporty child with expectations of going to university and becoming a professional soccer player. But, by her teenage years, anxiety crept in. Then, at age 15, she was sexually abused by an uncle.

“It broke me on a fundamental level and was definitely the trigger for me developing serious mental illness,” Jane says.

An extended bout of tonsillitis and glandular fever followed and the illness and her mental health conspired to keep her from school. Jane says she dropped out at year 11 and “lost myself for the next 18 years”.

For vast chunks of time, Jane’s depression was so severe she couldn’t get out of bed or tend to her basic needs, requiring family or friends to look after her. At times, she was suicidal and would flip into mania, where she would travel to other planets and speak with aliens.

“I would be talking to spirits . . . I would feel like I had godlike powers and that I was the chosen one,” she says.

Alex says it was only when Jane went into psychosis that he realised the severity of her mental illness. “She wasn’t living . . . she wasn’t living in a way that was sustainable,” he says, choking back tears.

Alex became desperate to help and knew that the gut biome — a range of bacteria, viruses, fungi and other microbes in the gut — influenced the production of serotonin and dopamine, neurotransmitters that were crucial for mood and motivation.

He recalls Jane’s stories of being given a lot of antibiotics over almost two years to combat her tonsillitis. He figured her gut biome could have been starved and diminished by the antibiotics and began delving into the scientific literature and came across a study in which the faeces of a depressed human were put into a rat. The rat developed depression. He wondered if that could be reversed.

Parker says the fact that FMT — a procedure already approved to manage a severe gut infection — did cure Jane’s bipolar could represent a paradigm shift in the way some mental illnesses were treated.

“Jane’s story knocked my socks off,” he says. “It was a story that caused me to say ‘wow’ and keep on saying ‘wow’ for quite a long time.”

Parker investigated the details of Jane’s recovery — speaking to her psychiatrist, analysing her medication intake, consulting gut specialists — and it stood up to scrutiny.

He has since written a book, A Gut Mood Solution, presenting five FMT case studies other than Jane’s, including one of his own patients. Two of those people have experienced remission.

“The concept of our gut microbiome and how that might be actually influencing our mood for the worst or for the better is the new paradigm and that has huge implications in terms of managing mood disorders,” he says. “We’ve now got strongly suggestive evidence that we have an intervention that will help people with intractable mood disorders, be it depression or bipolar. We now need the science to be put in place.”

It confounds Jane that the Food and Mood Centre has been unable to attract funding for a clinical trial despite being ready to launch after conducting a successful pilot study based on her case.

“If we can show with clinical trials that faecal transplant could help a large proportion of people with serious mental illness, the social impact will be huge, but also the financial impact,” she says.

Jane is no longer on medication, no longer does she need the disability support pension, no longer is she being hospitalised every year. The weight she gained from bipolar medication has fallen away and she is now focused on a healthy diet to “keep my gut bugs happy”. Her university ambitions have returned and, having completed high school at TAFE, she is now in the second year of an environmental science degree, with plans to become a field ecologist.

The couple grow their own vegetables and cook predominantly plant-based food from scratch, eschewing processed food.

“In a very real way, the number twos cured my blues,” she says.

ABOVE Alex and Jane Dudley

PHOTO Australian Story/Marc Smith

We’ve now got strongly suggestive evidence that we have an intervention that will help people with intractable mood disorders, be it depression or bipolar. We now need the science to be put in place.

Gordon Parker

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