Manic -Depressive Insanity

Why aren’t we working harder to find the pathophysiology of this illness?

“The [loss of] youth and vitality and promise, horrified. The waste of their promise, horrified. He [the research scientist] worked harder”. from The Great Influenza by John M. Barry

This disease robs us and changes and destroys so many of our children, during the prime of their lives. Insanity makes them incapacitated, dependant, diminished; we seem OK with that, as long as they are not too difficult. Why aren’t we fighting this hard and looking into many different biological theories. Many biological psychiatrists believe that these attacks are due to chemical imbalances…..and they are correct! But this chemical imbalance will not appear on a biochemical panel………. It is most likely a respiratory acidosis or alkalosis. And if the body’s ability to compensate is disrupted, then the compensatory mechanisms will fail and there will be a very large chance of one becoming insane [ insanity being a one pattern of altered mental status]. And we have solutions for acid base disturbance! Especially if we know that respiratory rate at rest is abnormal. We cannot fix any respiratory deficits, but we can help the body to restore a better acid base balance and we can restore baseline mental status.

I helped do this for Paula and I am not a doctor, but I knew a lot about her condition, more than any doctor or psychiatrist, thanks to Kraepelin’s observation in Chapter One of Manic Depressive Insanity [these attacks are REVERSIBLE; even if the delirium lasts a long time.] and in Chapter Three, Bodily Signs, I recognized the body’s response to bleeding and blood loss described by Desborough in his 2000 study of how this response is similar to the psychological stress response, but not quite identical. [see my earlier blog on Desborough and his surgical research. Also due to Kraepelin’s chapter on bodily signs, I realized-as did Kraelpelin, that these patients are prone to hypercapnia respiratory failure due to their disrupted ability to compensate. Paula had the same injury as those thousands of patients Kraepelin described.

Would you like to meet Paula? Would you like to check for yourself what her “too slow at rest” baseline breathing rate is? Would you like to watch as her Hexoskin respiratory plethysmograph continually measures her breathing rate for hours while she reads a thriller? Would you like to see how or if her breathing rate goes up normally when she exercises? [it goes up but not normally ] In the 21st century we have tests to measure this.

Would you like to see what her PCO2 is in health? Is it normal? And what about her PCO2 during mania or depressive attacks of insanity? Aren’t you a little bit curious?