It this possible? Is this true? I think that Dr Kraepelin thought so; he clearly identified insufficient breathing patterns in debilitating bipolar depression and bipolar mania. https://archive.org/details/manicdepressivei00kraeuoft, 1921Topics Psychiatry — Early works to 1900, Manic-depressive illness, ParanoiaPublisher Edinburgh : LivingstoneCollection gerstein; toronto; medicalheritagelibrary; university_of_torontoDigitizing sponsor MSNContributor Gerstein – University of TorontoLanguage English
Aside from possible respiratory defects, these young adults were otherwise healthy, but prone to acute on chronic ventilatory failure with any additional physical insult.
This fits explains what happened to Paula, although we cannot explain how she survives with a breathing rate of 3 regular breaths per minute at rest when awake. [We do not what happened during sleep. Her Tidal Volume when well is a normal .5L so her minute ventilation is 1.5 L instead of the usual 6-8 L.
We are surprised she only got sick once in her life. She got sick at menopause so, it would seem that sexual hormones help breathing somehow. Her lungs have always been normal.
This hypothesis can be easily tested by getting the minute ventilation evaluated in first episode mentally ill patients with bipolar illness. Some first episode schizophrenics should have their minute ventilation evaluated also, since it is difficult to tell clinically which disorder they have. Both disorders can produce psychosis and it is hard to tease them apart.
to be continued.