The Importance of Postnatal Experience to Persistent Changes in Mood Behaviour

Think of your own postnatal experience. Your mother and father can tell you about your birth experience and your first few days outside the womb. . Your birth and the moments after your birth are important. It is the first time your physiological system adapts to breathing air. It matters! And you probably know little about it. Paula knew very little about the circumstances of her birth, until we became curious about the ventilatory defect or injury we uncovered in an ordinary basic first aid class we took together. Paula found out she’d had an adverse event when she was born. It had consequences her entire life, but she was not aware of this.

The research paper mentioned below found evidence for ” Early adversity being a risk factor for the development of adult psychopathology. Common across multiple rodent models of early adversity is increased signaling via forebrain Gq-coupled neurotransmitter receptors.Chronic postnatal chemogenetic activation of forebrain excitatory neurons evokes persistent changes in mood behavior eLife. 2020; 9: e56171. Published online 2020 Sep 21. doi: 10.7554/eLife.56171PMCID: PMC7652419PMID: 32955432 Sthitapranjya Pati,1Kamal Saba,#2,†Sonali S Salvi,#1,†Praachi Tiwari,1Pratik R Chaudhari,1Vijaya Verma,3Sourish Mukhopadhyay,1Darshana Kapri,1Shital Suryavanshi,1James P Clement,3Anant B Patel,2 and Vidita A Vaidya1Joseph F Cheer, Reviewing Editor and Kate M Wassum, Senior EditorJoseph F Cheer, 

Early adversity. I looked up the definition of early adversity and found the following;

DEFINING IT. WHAT IS EARLY ADVERSITY?

Early life adversity (ELA) involves exposure to environmental circumstances during childhood or adolescence that are likely to require significant psychological, behavioral, or neurobiological adaptation by an average child and that represent a deviation from the expected environment.1 A wide range of experiences meet this definition of ELA, ranging from physical, emotional, and sexual abuse, to prolonged emotional or physical neglect, to chronic material deprivation association with poverty. 

I find that this definition is very misleading. This definition has been influenced by psychological approaches linked to similar concepts found in psychiatry. It depends on the adult seen by the psychologist or psychiatrist reporting memories of adversity. :Ann N Y Acad Sci. 2018 Sep; 1428(1): 151–169.  Published online 2018 Jul 16. doi: 10.1111/nyas.13928 PMCID: PMC6158062 NIHMSID: NIHMS976561PMID: 30011075 Early life adversity and health-risk behaviors: proposed psychological and neural mechanisms Korrina A. Duffy,1Katie A. McLaughlin,2 and  Paige A. Green1

I have the same complaint when looking at definitions of stress. When one looks it up, the description emphasizes feelings.

“Stress is a normal feeling. There are two main types of stress:

  • Acute stress. This is short-term stress that goes away quickly. You feel it when you slam on the brakes, have a fight with your partner, or ski down a steep slope. It helps you manage dangerous situations. It also occurs when you do something new or exciting. All people have acute stress at one time or another.
  • Chronic stress. This is stress that lasts for a longer period of time. You may have chronic stress if you have money problems, an unhappy marriage, or trouble at work. Any type of stress that goes on for weeks or months is chronic stress. You can become so used to chronic stress that you don’t realize it is a problem. If you don’t find ways to manage stress, it may lead to health problems.”

There is no mention of stress due to an internal physical or or chemical or physiological problem. No mention of stress from hypoxia, stress from hypercapnia, stress from organ failure, stress from malnutrition or deficiency, stress from dehydration, stress from blood loss, injury or infection or fever or hypothermia.

The whole stress definition is rigged to ignore the existence of such things. Because psychologists and psychiatrists cannot help with those kind of stressors. Because we all prefer to think that we can have control over the things that have happened to us. And we do not control what happened during our birth or the effects of an infection or the failure of one or another organ due to internal injury. We do not want t think that we may have broken bits that hinder our internal processes and metabolism once we are full grown.

When Paula was sent to a psychiatrist and he diagnosed her with major depression, he was diagnosing what he thought was her depressed feelings. He never thought of the possibility of depressed breathing rate. He never thought of anything medical at all. He gave her a pill to take because he thought it altered the stress of negative feelings. She looked depressed so why not try an antidepressant? To fix her feelings. I think that this kind of thinking is simplistic – a waste of medical training, myself.

Paula knew from the beginning that she was physically sick, she knew that feelings do not cause cognitive impairment. She knew that feelings do not cause the chronic and continual anguish she was experiencing. She knew that this anguish and distress was not related to anything resembling normal feelings. She knew that the psychiatrist was limited to one idea and that the psychiatrist knew nothing about injury, infection or the real causes of severe depressive attacks.

Paula eventually found out what the likely cause of her attack was. She had suffered an adverse event, at birth. She found out that she had been born nor breathing, anoxic, having swallowed meconium. She was suctioned, resuscitated [and so hyperopic] and transfused [with foreign adult blood products]. And it worked! It worked for a long long time! Until her first major depressive attack.

This is the real meaning of an adverse event. This is an example of an “Early adversity being a risk factor for the development of adult psychopathology”. An adverse event is one that causes permanent injury to the brain or to the nervous system and to the ability to maintain homeostasis in the face of further injury or infection.

I think that serious attacks of depressive and manic and mixed attacks come from some kind of physical internal injury which makes further injury, blood loss or infection difficult without supportive medical [not psychiatric] care.

The first step to finding a physical injury is to carefully measure vital signs- minute ventilation [respiratory rate times tidal volume], blood pressure, heart rate and heart function [is disturbed in depression], and body temperature; the general circulation should be assessed too. [vasodilation, vasoconstriction].

This medical investigation will be the roadmap to finding out what is wrong with patients with serious psychiatric illness, in particular patients with serious depressive disorders.

*************To understand our ongoing ideas mind and loss of mind and the role of PCO2 and hypercapnia,   please look at our post on     *** a Potential two Step Marker for Bipolar Depressive Illness [to start] and our post on      *** How to Save a Manic Depressive Life.

1] https://ofsoundmind.life/2020/11/09/we-have-a-2-step-marker-for-bipolar-illness/ We have a potential new 2 step biomarker for bipolar illness. Ventilatory issues and [hidden] hypercapnia can cause specific patterns of “odd behaviour”, mood and locomotor activity.    

AND

2]  https://ofsoundmind.life/2020/11/11/how-to-save-a-manic-depressives-life/

At the very least!

Paula and I have identified a ventilatory injury/defect in that I can be most clearly identified in the  depressive stage of manic depressive insanity.  Kraepelin seems to have identified the same injury/defect over 100+ years ago. This is what is guiding us to new research to connect the dots. It is a lot of fun. It is something that scientists can follow up on. And we think this will make a huge difference in the new updated understanding of the reversible syndrome of bipolar illness and its treatment.**********

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