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Major Depression and Bipolar Disorder. The Concept of Symmetry Breaking

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Quantum Paradigms of Psychopathology

Major Depression and Bipolar Disorder: The Concept of Symmetry Breaking

Massimo Cocchi†±, Fabio Gabrielli††, Eliano Pessa‡, Massimo Pregnolato§, Lucio Tonello† and Paola Zizzi†

ABSTRACT In this paper we consider the results obtained by biochemical experimental data on platelet membrane fatty acids processed by a Self Organizing Map (SOM) from apparently healthy, bi‐polar (BD) and major depressive subjects (MDD). The SOM shows that major depressive subjects belong to an area which is completely disconnected from that of healthy and bi‐polar. Looking at the location of the data over the SOM, we find also a region which we attribute to psychotic subjects according to the clinical diagnosis. We translated these facts in terms of symmetry breaking, confirming that MDD is a disease completely trapped apart from healthy, bi‐polar, and psychotic subjects. Key Words: platelets, fatty acids, self‐organizing map, major depressive disorder, bipolar disorder, symmetry breaking

NeuroQuantology 2012; 4: 676-687

“What is opposition is reconciled, and by different things the more beautiful harmony is created, and everything is generated by the contrast.” Heraclitus, fr. 8

Introduction1 Major Depressive Disorder (MDD) is a disorder characterized by sustained depression of mood, anhedonia, sleep and appetite disturbances, feelings of worthlessness, guilt, and hopelessness affecting about 121 million people worldwide. By the year 2020, depression is projected to reach 2nd place of the ranking of the global burden of disease.

Since the mainstream psychiatric diagnosis features aspects of equivocality, in the recent years several research papers have appeared (Cocchi, 2008; Cocchi, 2010a,b; Cocchi, 2011) describing a quantitative approach to psychiatry and in particular to major depression.

Corresponding author: Massimo Cocchi Address: †Institute "Paolo Sotgiu”: Quantitative and Evolutionary Psychiatry and Cardiology, L. U. de. S. University, Lugano, Switzerland. ±Faculty of Veterinary Medicine, University of Bologna. ††Faculty of

Human Sciences, L. U. de. S, University, Lugano, Switzerland. ‡Department of Psychology, University of Pavia. §Quantumbiolab – Department of Drug Sciences – University of Pavia e‐mail: massimo.cocchi@unibo.it

Received June 6, 2012. Revised Setp 21, 2012. Accepted Nov 1, 2012. eISSN 1303‐5150

Cocchi et al. ( 2008) have highlighted the possibility of using the fatty acids as platelet markers in psychiatry describing an experimental protocol for their determination in blood and proposing a mathematical tools such as artificial neural networks (Self Organizing Map-SOM) for the elaboration of data. This computational tool has produced a classification of disorders such as major depression and bipolar disorder compared to the apparent normality by dividing the values obtained for the different subjects in very specific areas of maps. These experimental evidences have highlighted the complexity of the problem. The fatty acid triplet (palmitic, linoleic and arachidonic acids), isolated by SOM, provides a distinction between different values of membrane viscosity implicated in the functionality of the neuronal system. The aim of this paper is to interpret the biochemical results according to mathematical and physical models at both classical and quantum levels.

This paper is organized as follow:

In Sect. 1 we give a short review of experimental data.

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In Sect. 2 we illustrate the appearance of MD in terms of the bipartition of the set Universe “humankind”.

In Sect. 3 we give a model of MDD in terms of symmetry breaking.

In Sect. 4 we explain the logical relation between the bipartition of U and Z2 symmetry breaking.

1. Short review of experimental data In recent works it was described the study of the platelet membrane fatty acid composition as a potential diagnostic tool for major depression (Cocchi, 2008; Cocchi, 2010ab). The choice of this target has been made because of the similarity of some molecular characteristics of platelets with neurons (Evers, 2006; Marangos, 1979; Leonard, 2000; Olesen, 2006).

The platelet membrane of depressed people is characterized by a higher degree of unsaturation than the group of clinically healthy subjects (Cocchi, 2010a; Tonello, 2010). Direct and inverse correlations of the platelet membrane viscosity with the concentration of serotonin have been experimentally demonstrated, respectively, in Bipolar and Unipolar subjects, according to the classification of the Self Organizing Map and B2 Index (Cocchi, 2012).

During the first step of the experiment we have evaluated 144 subjects [(60 apparently healthy (green) and 84 generically diagnosed as depressed (red)]. The biochemical data obtained from the blood of these subjects have been elaborated by the SOM which identified four areas: two specific ones (exclusively normal and exclusively pathological) and two mixed ones with different concentrations of pathological and apparently normal subjects. The red subjects of the two intermediate areas (yellow and orange) have been interpreted as a misleading diagnosis of Major Depression (Bowden, 2001).

The SOM has highlighted the peculiar characteristic of the fatty acids triplets for each group of subjects considered. Each subject had a specific degree of viscosity of the membrane which was expressed by means of a specific index, called the B2 index, based on the sum of the percentages of Arachidonic Acid (AA), Linoleic Acid (LA) and Palmitic Acid (PA), which represent the majority of the total

platelet fatty acids (53.3%), in relation to their molecular weights and melting points.

We can see, in SOM, that the pathological subject are clearly divided from the apparently healthy subjects, the distribution of the B2 index in the mono-dimensional map shows negative and positive indexes belonging, the first to the major depressive subjects, the second to the bi-polar subjects (Fig.2).

Figure 1. Distribution of subjects (normal [green] and

depressed [red]) on the SOM (two‐dimensional).

From the above figures you may see that the region concerning MDD is totally disconnected from bipolar and normal subjects’ areas, because of the negative index (extreme right side of the two maps). In particular it must be considered the bottom of the left side of the map (Fig.1) where three pathological subjects (red) have been diagnosed as psychotic. This area is

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characterized by a very high level of palmitic acid, which determines a high and anomalous membrane viscosity and, as a result, the serotonin uptake is very high.

Up to now it is very difficult to explain, in a consistent way, from a mathematical, biological and clinical standpoint, the reasons why a mathematical function (the SOM that has allowed the classification of the subjects) finds such a precise correspondences between

diagnosis and distribution of B2 indexes. It is not, in fact, understandable, how an index, that provides, albeit indirectly, the degree of viscosity of the membrane, can be elaborated by the SOM which distributes the patients on a map, without knowing the concept of membrane viscosity, and, of course, the significance and biological properties of fatty acids involved.

Figure 2. B2 index distribution on a one‐dimensional map.

The correspondence of the numbers identified by the SOM with their biological significance, has allowed what seemed impossible, i.e., the ability to distinguish between unipolar and bipolar disorders using a biochemical marker:

a. A high platelet membrane degree of fluidit (mobility) and a negative B2

index for the unipolar disorder

b. A high platelet membrane degree of viscosity (mobility) and a positive B2

index for the bipolar disorder

These features, which were deeply examined through extensive clinical evaluations, led to a series of considerations about the role of the membrane viscosity with

respect to the serotonin reuptake (Heron, 1980; Lee, 1985) and the phenomena that influence its connections with the Gsα protein and with the cytoskeleton (Donati, 2008; Cocchi, 2010b).

The supposed similarity between neuron and platelet membranes can be attributed to the arachidonic acid exchange between the two cell which, in this way, modify their viscosity (Cocchi, 2009a,b): the higher the viscosity, the greater the uptake of serotonin and vice versa. This concept has found full support from experimental data (Heron, 1980; Lee, 1985), furthermore it is well known, that in Major Depression, both, neuron and platelet, have lower levels of serotonin (Dreux, 1985; Kim, 1982).

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The logic of mathematics (SOM) and biology (B2 index), have allowed to represent the distribution of fatty acids, identifying the positions corresponding to their maximum and minimum concentration, as expressed by

the curves of level. The same, for the B2 index. The spectrum evidenced in SOM, from right to left, shows that the B2 is in progression from -2.64 to +8.23.

Figure 3, 4, 5. Palmitic Acid and Arachidonic Acid determine the macro area to which a subject belongs. Within the macro area,

is the intervention of linoleic acid which modulates the correct position of the subjects.

Figure 6, 7. Distribution of linoleic acid and B2 index on the map.

The apparently healthy subjects

belonging to the green area (Fig. 1) are characterized by a mean value of B2 equal to 2.8 and this value is the midpoint between the extremes of -2.64 and +8.23.

Referring to the disposal of fatty acids (PA and AA), it can be considered that the B2

index is governed, practically, by the AA and PA concentrations.

Within the macro-area characterized by these two fatty acids which determines the position of each subject, we find the linoleic acid, which modulates the precise location of the subjects, as if it was the "fine tuning" that supervises the system, practically, the balance of the system itself.

2. The Bipartition of the Universal Set “Humankind” In the light of the experimental data, humans can have either positive or negative values of the B2 index. Those humans having positive values of B2 are normal (N), bipolar (B) and psychotic (P) people. On the contrary, major

depressed people (MD) have negative B2

values.

In order to build a theory describing and explaining such a circumstance we must first start from the language of Set theory. Then we will use the language of Logic in order to understand the possible ways to account for the experimental facts.

In the framework of set theory, the Set “Humankind” will be our Universal set, U.

2.1 The Equivalence relation on U The equivalence relation ~ on our Universal set U is: “Has the same sign of the B2 index”.

Then, all elements with positive value of B2 will fall in the equivalence class:

| ~ a b U a b , a has a positive value of B2

(2.1)

and all elements with negative value of B2 will fall in the equivalence class:

' | ' ~ a b U a b , 'a has a negative value of B2

(2.2)

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Due to the fundamental theorem on equivalence relations (Pinter, 2010), the equivalence relation ~ on U corresponds to a partition of U into two cells, which are the equivalence classes (2.1) and (2.2).

2.2 The Bipartition of U Let us now discuss the partition of U in more details. In this regard let us consider the subset A of U, whose elements are humans with a positive B2 value. Then, the proper subsets of A are N, B, and P. The complement of A in U, AC, is then the set whose elements are MD. In this way, the set U has been partitioned into two non-overlapping and non-empty blocks, or cells, A and AC. A partition of a whole into two parts is called a bipartition or a dichotomy.

Formally, given the universe U, the (absolute) complement of A in U, denoted CA , is defined as: |CA x U x A (2.3)

Here A and CA are mutually exclusive and mutually exhaustive with respect to U:

CA A Ø (2.4)

CA A U (2.5)

where Ø is the empty set. See fig.8.

A bipartition of U is a dichotomy. Some well-known dichotomies occurring in philosophy are, for instance, that of the Self and the Other, and the Mind-Body duality. In our case, the dichotomy in U would lead to the unpleasant conclusion that MD subjects will be forever isolated from the rest of humankind. However, in a holistic approach any dichotomy could be overcome. In our case, the holistic aspect is inhered in the collective character of a topological soliton (more

specifically a domain wall). In fact, in Sect. 3, we will see that the soliton will support a correlation between the two degenerate vacua (of the physical theory) corresponding to the two “cells” of the bipartition of our Universal set U.

Figure 8. Bipartition of U. U is the Universal set representing humankind. A is the cell whose elements are characterized by a positive value of B2. A

C, which is the complement of A in U,

is the cell whose elements are characterized by a negative value of B2.

3. Symmetry breaking In what follows, we will suggest a possible theoretical explanation of the reason why MD people, who have a negative value of the B2 index, fall in a completely separate category from the rest of humankind, having instead a positive value of B2. By introducing a metaphor based on Quantum Field Theory, we view the splitting of positive and negative values of the B2 index averages as due to a kind of spontaneous symmetry breaking (Landau, 1937; Tolédano, 1987; Brown, 1991; Brading, 2003).

In this regard let us consider the following table of experimental data (Table 1).

Table 1. Description of the B2 Index.

Category Average B2 index

N. subjects Total % Initial average B2 value for the Universal set

Final average B2 value.

P=Psychotic +5.2 5 2.89 (P+B+N+MD):4=2.02 (P+B+N):3=+2.81

B=Bipolar +0.81 67 38.72

N=Normal +2.44 60 34.68

MD=Major Depressed

-0.34 41 23.69 MD= -0.34

The initial B2 expected value (e.v.) = 2.02 can be interpreted as the e.v. before symmetry breaking, while the final B2 e.vs. +2.81 and -0.34 can be read as the two e.vs after the symmetry breaking.

By plotting the above data, we get the following diagrams in figure 9a, b.

In figure 9.a, we represented the hypothetical potential 2V B .

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The minimum is at 2 1.23B , which is the

mean between the averages +2.81 and – 0.34.

In figure 9.b, we represented the situation after the breaking of the symmetry,

in which the potential has minima at

2 0.34B and 2 2.81B .

Figure 9. Unbroken Symmetry (left); Broken Symmetry (right).

By making a translation of the origin of the coordinates: 2 2' 1.23B B , 2 2( )' ( )V B V B ,

the diagrams in figures 9.a,b, become those in figures 10.a and 10,b respectively, which are plotted below.

In figure 10.a, the potential 2V B has a

minimum at 2 0B .

In figure 10.b, the potential 2V B has

two minima, corresponding to 1.58v .

Figure 10. Unbroken Symmetry (left); Broken Symmetry (right).

After having performed the translation of the origin, the similarity with the situation occurring in a well-known model used in

Quantum Field Theory – often called 4

theory - becomes apparent (Itzykson, 1986). This model is a sort of prototype useful to describe, in the simplest way, most phenomena occurring in presence of a Symmetry breaking. It is to be underlined that here our aim is not the one of introducing a detailed microscopic model of the quantum dynamics of B2, based on the complex

interactions between cytoskeleton, neuronal membrane, proteins, intra- and extracellular liquid. Rather we are searching for the simplest phenomenological model of a possible quantum dynamics accounting for the observed experimental data. This, of course, does not exempt us from building a more detailed microscopic model justifying the approximations we adopted and assessing their range of validity. In fact, such a model is under construction and we will report about it in further publications.

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Turning now to our phenomenological model, we recall that the Lagrangian density of

the 4 theory has the form:

2 2 2 41 1 1

2 2 4L (3.1)

and is invariant under the discrete symmetry 2 :Z .

Here the scalar field is real, and and

are two parameters.

If 2 0 , the potential V :

2 2 41 1

2 4V (3.2)

has a single minimum, at the origin.

The solution 0 is invariant under the

Z2 symmetry.

Conversely, if 2 0 , the potential V

has two minima (double well potential), and the two lowest energy states (the ‘vacua’ in the quantum version of the model) are not invariant under the symmetry Z2. In this case, the Z2 symmetry is said to be spontaneously broken.

The 4 model in D=1+1 dimensions

(one spatial dimension plus the time

dimension), with a negative 2 , has a kink

solution, which is a topological soliton (Manton, 2004).

The kink solution, in D=1+1 dimensions, written in a simplified form is:

1,

1ax vt

x te

(3.3)

where x is the spatial variable, a is a real constant, v is the velocity, and t is time. The velocity v is given by the field equations, resulting from the initial and the boundary conditions. The kink solution in (3.3) is plotted in fig.11.

The kink solution interpolates between the two different vacua of the double well potential.

In D = 2+1 dimensions, namely the two spatial dimensions x, y and the time t, the kink solution (3.3) becomes:

1,

1ax by vt

x te

(3.4)

this is called a domain wall. The domain wall solution (3.4) is plotted in figure 12.

Figure 11. The kink in D = 1+1.

Figure 12. The domain wall in D = 2+1.

As in the case of the kink, also the domain wall interpolates between the two vacua. Because of the above considerations, we conjecture that the potential 2V B should

have the same form of that of the 4 theory:

2 2 42 2 2

1 1

2 4V B B B (3.5)

The unbroken symmetry in fig. 10.a is

relative to the case with 2 0, while the

broken symmetry in figure 10.b corresponds to

the case 2 0 . We should remind that our

theory is in 2+1 dimensions. In fact, in a first approximation, we can suppose that we are dealing with an entity which, from the point of view of spatial dimensions, is two-dimensional. The chemical meaning of the B2 index induces us to identify this entity with the

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neuron membrane. Then, after the symmetry breaking, a domain wall solution will correlate the two degenerate vacua corresponding to the two minima of the potential V(B2). The domain wall could, in suitable circumstances, transmit energy from one vacuum to the other. By taking into account that we are in fact considering the case of a finite volume, two different kinds of mechanism may occur. The first kind of mechanism is classical, and is described as follows. The amount of energy carried by the domain wall creates an excited state in the region with negative B2 value, which can overpass the potential barrier, and get the region with positive B2 value.

Here it is to be recalled that the dynamics of domain walls is ruled by a number of influences which can occur after a symmetry breaking and are currently studied in QFT. In ideal conditions the domain walls are static solutions of the field equations and, as such, they cannot transmit energy from a vacuum to the other. However, moving domain wall solutions are mathematically allowed, but only in presence of suitable initial conditions, granting that the domain walls themselves were already moving from the beginning. The latter solutions, as it is easy to understand, are practically unrealistic. It is now to be remarked that this picture is only an abstraction. In the real cases we must take into account the influence exerted by other actors: the noise and the disorder. It is possible to show that, in presence of noise of suitable amplitude, the static domain wall solutions are transformed into dynamical ones. In fact the noise induces unpredictable local changes of the form of the potential, which produce a motion of the domain wall itself. In presence of the disorder it is possible to have the occurrence of a phenomenon called “Anderson localization”, which gives rise to a very complex law of dependence of the potential on local field values.

This phenomenon, in principle, could prevent from the occurrence of a constant velocity motion of the domain wall and even stop the motion itself.

The second kind of mechanism is of quantum nature and would occur in the context of a quantum theory of the neuron membrane. In this case, the excited state passes across the potential barrier instantaneously, by a quantum tunneling. It should be remarked that the second

mechanism is much less probable than the first one. Nevertheless, in both cases, the domain walls correlate the MD people with the rest of humankind. However, this correlation is not global, but regards only the excitations. This fact puts strong limitations to a possible treatment of MD, although it does not exclude it completely.

At this point, it might be worth to spend a few words on the possible occurring of symmetry restoration. The critical parameter of the symmetry breaking might be dependent on some external input. In this case it could happen that suitable amplitude of an external input can produce a variation of the value of the critical parameter, shifting the latter to a region corresponding to the symmetry holding before the breaking. Such a situation is usually denoted as “symmetry restoration”. In correspondence to it the domain walls disappear.

4. The Logical relation between the

bipartition of U and 2Z symmetry

breaking In this section, we will consider the logic (the object-language) and the metalanguage of MD subjects, both at the classical level of consciousness, and at the quantum level of the unconscious. 4.1 The classical logic of MD The discrete group Z2 is the group of addition mod 2. It has only two elements, the identity e, and an element a, which satisfies 2 1a . The truth table of the addition mod 2 is equivalent to the truth table of the exclusive disjunction (the “XOR”, whose symbol is ):

Two propositions are exclusively disjoint when they cannot be neither both true nor both false at the same time.

As we have seen in Sect. 2, the two blocks into which U is partitioned are mutually exclusive and mutually exhaustive. Turning now to logical terms (the technical details of the following arguments can be easily found on a textbook about logic, like, e.g., Langer

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1967), we remind that in the latter context two propositions are mutually exclusive when they cannot be true at the same moment. This is expressed by the logical connective NAND, whose symbol is . This connective NAND is defined as A B A B , where the symbols

, stand respectively for “not”, “and”.

Also, two propositions are mutually exhaustive when they cannot be both false at the same moment.

This is expressed by the logical connective OR, denoted by the symbol .

The truth tables of the “NOT”, “AND”, “NAND” and “OR” are respectively:

where: 1 = True, 0 = False.

Notice that the logical connective “XOR” is equivalent to the conjunction of “NAND” and “OR”, namely:

A B A B A B ,

as it can be easily checked by the use of the truth tables of the “AND”, “NAND”, “OR” and “XOR”.

Then, when the Z2 symmetry is broken, the “XOR” naturally splits into the pair

,NAND OR , which characterizes the

bipartition of U.

The logical connective “OR” plays a relevant role in the logic of human thinking, together with its dual, the “AND”. This relevance has been evidenced by a number of psychological experiments on human subjects using the so-called paradigm of ‘concept learning’ (Nosofsky, 1994; Feldman, 2000). Instead the “XOR” (the aut-aut) seems to be better suited for artificial intelligence (AI). In fact, the “XOR” is active only before the symmetry breaking. After the symmetry breaking, we have the “OR”, which is common in reasonings performed in our everyday life, if we are supposed to belong to the equivalence class with a positive value of B2, and the “NAND”, which instead we do not use. The “NAND” must pertain then to the logic of people in the other equivalence class with a negative value of B2. Such an argument is supported by a number of experimental findings about the reasoning abilities of human subjects. These results are accounted for by a theory proposed by P. Johnson-Laird (Johnson-Laird, 2006; 2010) called mental models theory. The theory shows that the forced use of the logical connective NAND by human normal subjects produces reasoning difficulties. These difficulties explain the bad performance of subjects when trying to solve logical problems whose premises are expressed in terms of negated propositions.

Notice in fact that the “NAND” (the negation of the conjunction of two propositions) can be rewritten as the disjunction of two negated propositions:

A B A B A B .

Then, MD subjects have a different (classical) logic from the one of normal, bipolar and psychotic subjects. This means that also the (classical) MD metalanguage is different as it consists of negative assertions. In fact, when we, as elements of the equivalence class [a] in (2.1), assert that

A B is true, namely: A B , the elements

of [a’] in (2.2) assert that A B is false, namely: A B , where the symbol is the

metalinguistic link “yields”, used in the formalism of sequent calculus (Gentzen, 1935).

Negative assertions are in fact the symptoms of pessimism and negative mood. When the negative assertions are the only possibility, that is when they cannot alternate with positive assertions (because only the

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connective “NAND” is available), MD takes place. 4.2 The quantum metalanguage of MD Quantum metalanguage (Zizzi, 2010) is the metalanguage of quantum logic (the quantum object-language) of the mind. It describes the metathought of humans in an unconscious state, and is not algorithmic (Zizzi, 2012). As in the classical case, the metalinguistic links between assertions of the quantum metalanguage are reflected, by the definitional equation, into the quantum logical connectives between the propositions of the quantum object-language. Every logical connective (classical or quantum) is introduced via the definitional equation (Sambin, 2000).

The definitional equation of the classical AND is:

A B iff A and B

where “iff” stands for “if and only if” and “and” is the metalinguistic link between the assertions A , B .

The classical dual of a classical assertion A denoted by ( )A , where is the

primitive negation, is:

( )A A

that is, the proposition A is negated, and the sense of the sequent is inverted. Let us

recall that for the classical NAND it holds:

A B A B A B

The dual of the definitional equation of the classical AND is:

( )A B iff ( )A and ( )B

namely:

( A B iff A and B

which is the definitional equation of the classical NAND.

The Quantum AND is denoted by& ,A B where , are complex numbers,

which are the assertion degrees of the quantum assertions, and are physically interpreted as probability amplitudes. The Quantum AND is also called the connective of quantum superposition.

The definitional equation of the Quantum AND is:

&A B iff A and B

This quantum metalanguage is used by normal subjects only when they are in the quantum state of the unconscious. Instead, it is used permanently by schizophrenic subjects.

The dual of a quantum assertion A ,

denoted by '( )A is:

*'( )A A

where * is the complex conjugate of .

The Quantum NAND is denoted by

* *A B , and it holds:

'

* ** * &A B A B A B

The dual of the definitional equation of the Quantum AND:

'

( & )A B iff '( )A

and '( )B

namely:

* *( A B iff *

A and

*B

is the definitional equation of the Quantum NAND.

In conclusion, MD subjects use permanently a quantum metalanguage which is the negation of the quantum metalanguage of schizophrenic subjects.

The partition of the Universal set concerns set theory, and equivalence relations on sets.

The Symmetry breaking, instead, concerns classical and quantum field theories. These two apparently disconnected issues are unified by logic when the partition is a bipartition and the original symmetry is the discrete Z2 symmetry. The latter is equivalent to the logic gate “XOR”, which is the logical conjunction of the two logic gates “NAND” and “OR”.

A bipartition is equivalent to the pair of the two logic gates “NAND”, “OR” into which the “XOR” can be splitted. Then, a bipartition of the Universal set is logically equivalent to Z2 symmetry breaking. Topological solitons are collective configurations, which interpolate between degenerate vacua in presence of a symmetry breaking. In the case of Z2 symmetry breaking in two spatial dimensions, the corresponding solitons are domain walls.

All that said, in this paper we are faced with a bipartition of the Universal set

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“Humankind” into two cells. The first cell consists of elements with positive B2 value, that is, by normal, bipolar and psychotic subjects. The second cell consists of elements with negative B2 value, namely, by MD subjects. Because of the previous arguments, we interpret this bipartition as a Z2 symmetry breaking occurring in the corresponding physical theory. The two degenerate vacua, corresponding to negative and positive values of the B2 “field”, are put in communication by the domain walls, which interpolate between them.

We then expect:

1. From the experimental point of view: Finding domain wall solitons on the neuron membrane;

2. From the philosophical/psychological side: Finding a different logical thinking, based exclusively on the connective NAND (negative assertions), in MD subjects;

3. From a theoretical point of view: Finding explicitly a law giving potential energy in terms of B2.

Conclusion Physically, the restoration of symmetry requires an energetic input from the environment. In other words, in the context of spontaneous symmetry breaking, it holds the rule that the whole is not the same as the sum of the parts (this because the system is not linear).

This fact suggests that a suicide happens when it is triggered by some external event, although the latter may remain unknowable even to the same suicidal.

In this regard it should be noted that the logic of the initial symmetry is based exclusively on the XOR (the aut-aut), which is the denial of free will. So, a person who

decides to go back to the initial symmetry (the suicide), should use the XOR, but he cannot take any decision, because the XOR does not allow free will, and this is a paradox.

Some external factor should make the aut-aut to the MD and BD patients, and force him to commit suicide.

For all the societies, disease is event that should be interpreted (Augé, 1984). That, is not only a biological factor but also cultural. In short, the disease is representation, interpretation of a portion or of all the real by individuals in a social context (Young, 1982). The medical description of both human body and diseases culturally refers to specific meanings (Good, 1994). In terms of medical anthropology, we can talk about disease (biomedical classification), illness (experiences of illness) and sickness (social determinations of the disease). In the case of mental illness, the social and cultural conditioning, takes almost a metaphysical value, due to the mismatch between classification and natural object, nosology and reality of the disease.

Hence the danger of medical ideologism so marked which risks to deflagrate in the diagnostic imperialism. The fragility of the DSM classifications, especially in case of the distinction between DM and DB, borns from the lack of a strong biological consideration, able to make real diagnosis and not just narrative. In the light of these considerations, we believe we have found in our experimental path, biomarkers capable of providing the diagnosis of MD and BD from a real substrate, to build a non ideological DSM.

Acknowledgements The PRIN 2009 funding on tubulins is acknowledged.

NeuroQuantology | December 2012 | Volume 10 | Issue 4| Page 676‐687 Cocchi M et al., Major depression and Bipolar disorder: the concept of symmetry breaking

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