Metabolic Encephalopathy should be the first thing doctors rule out in chronic mood disorders.

Checking the physiology of the patient is something any doctor can do, and should do but doesn’t. Why? Because of mistakes in thinking, which can effect all of us, including doctors and especially psychiatrists. It is normal to place knowledge into categories, there is just too much to know otherwise. Categories are very useful , and they can be misleading. Mood disorders and the neuropsychiatric diagnosis are an example of how these categories are often completely misleading and leave out a lot of clues that might explain what is wrong with the patient. And no one knows this better than Paula, myself and Dr Emile Kraepelin whom we consider a fellow researcher [even though he is long gone]. Dr Kraepelin was a celebrated experimenter and scientific thinker, the way most doctors are not…But you do not have to be a genius to realize that once you have observed that respiratory rate is abnormal, then the likelihood of a diagnosis of metabolic encephalopathy is likely and the treatment should follow the respiratory motor defection order to restore homeostasis of the blood to recover baseline normal brain and cognitive function.

So before we categorize any mental disorder, any time it occurs, in any person, no matter their age, all of us including doctors, should check out the basic physiology of the patient in order to see whether or not it could affect the blood and thus the brain and could be treated in order to recover as much as is possible. And often, complete recovery is possible.

It does mean acceptance of a huge serving of humble pie on the part of all doctors and all health professionals, especially psychiatrists but this is the only way forward if we are to be able to help neuropsychiatric patients such as Paula, such as Kraepelin’s manic depressive patients and perhaps such as patients with unknown causes of delirium and dementia,

To automatically decide that “mood Disorders” are due to disturbed mood is very concrete and certainly undeserving of all the scientific knowledge that has been learnt about the complexity of the human body and of the human brain. It is almost childish, really. And yet, this is how psychiatrists and most doctors think. For the patients who suffer, this is tragic, and for the families of these patients who know their family member is ill, it is even more tragic. And if one says this aloud, people argue with you. they do not check respiratory rate, mind you, EVER, they just argue and argue and argue.

What they should be doing is counting baseline respiratory rates of unmedicated patients with the appearance of mood disorders.


to be continued…………………..


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