Hypercapnia can cause long attacks of madness, partial dementia, depression, euphoria, mania, irritability, etc..

and if treated with supportive medical care, is completely reversible; it does not cause permanent brain damage [although with time, I am not so sure about the heart.] Paula has neural injury affecting her ability to meet her metabolic needs when physically ill and/or exposed to poor quality indoor air. Kraepelin found the same neural injuries in thousands of manic depressive unmedicated patients. https://archive.org/details/manicdepressivei00kraeuoft, 1921Topics Psychiatry — Early works to 1900Manic-depressive illnessParanoiaPublisher Edinburgh : LivingstoneCollection gersteintorontomedicalheritagelibraryuniversity_of_torontoDigitizing sponsor MSNContributor Gerstein – University of TorontoLanguage English

They also needed supportive medical care.

That is it! That is all! Manic depressive insanity and many types of depression are due to mechanical neural difficulties meeting one’s metabolic needs. It is not mysterious at all. One simply has to measure respiratory rate at rest when awake to see if there is a chance of neural injury affecting control of breathing. All findings regarding manic depressive illness can be explained by this unknown unconscious involuntary unlooked for broken breathing. Lungs are normal or the patient would be dead. We do not understand why these patients live, albeit in a diminished way…

Perhaps it is because the culprit is carbon dioxide in the blood, something that the brain is well equipped to handle, even with mildly toxic levels.

Perhaps it is because these people work so hard to breathe all the time and this is protective.

Perhaps it is because their too slow breathing and inability to meet their metabolic needs- tends to make these patients mildly hypothermic during respiratory depression; in any case this is also clearly protective.

Perhaps it is because these folks are often otherwise healthy young adults with strong hearts.

Perhaps there are phenotypic advantageous changes to the blood of these patients.

Paula has recovered completely [other than her permanent neural injury] and is OK with her neural defect…….as long as she never never never has an attack again.

Manic depressive attacks occur due to neural injuries affecting breathing. Research is needed. Theories need to change. Treatments badly need to help breathing in non invasive ways [if at all possible] and [hidden] infections need treatment with antibiotics.

Otherwise manic depressive patients will never recover to their highest mental baseline physical, mood and cognitive function, as did Paula.

Spread the word.

Fast.

The next generation of manic depressive patients deserve proper care.

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