** Could the Stress in Bipolar Illness be abnormal Inter cranial Pressure?

And why didn’t we think of that before?

Why didn’t we immediately check the basic physiological signs of the person who became sick from these attacks. It is obvious that these attacks are beyond their control, they are not volitional and they last too long to be due to any fight or flight responses. Something is internally wrong with a person to cause these attacks. Yet we still do not wish to check out this hypothesis. Paula and I have not managed to persuade any scientist , physiologist or psychiatrist or family doctor to check out the respiratory rates of their depressed patients. They also do not know how to check out altered mental status causing mental slowing or euphoria [a sign of lower PO2 levels in the after cal blood or a sign of some other spontaneous internal intoxication/poisoning. Euphoria is not part of the normal range of emotions, not this kind of long lived irrational euphoria. Neither is the immense sense of physical distress that accompanies bipolar depression. We think that the wide range of respiratory rates in healthy people [from 3 to 30 breaths per minute at rest], probably is an adaptation to the brain’s level of pressure inside the skull. Both extremes represent a physiological issue affecting air and fluid control of blood, PCO2 , PO2 and body water in the body that we do not yet understand.

The hypothalamus first detects crucial changes in the body and responds by stimulating various glands and organs to release hormones. And these responses can alter thermoregulation and pressures and fluid shifts in the body and can also affect behavior.

The hypothalamic–pituitary–adrenal axis (HPA axis or HTPA axis) is a complex set of direct influences and feedback interactions among three components: the hypothalamus, the pituitary gland (a pea-shaped structure located below the thalamus), and the adrenal (also called “suprarenal”) glands (small, conical organs on top of the kidneys).

These organs and their interactions constitute the HPA axis, a major neuroendocrine system^[1]that controls reactions to stress and regulates many body processes, including digestion, the immune system, mood and emotions, sexuality, and energy storage and expenditure. It is the common mechanism for interactions among glands, hormones, and parts of the midbrain that mediate the general adaptation syndrome (GAS). Wikipedia March 5, 2021

The hypothalamus is the main point of interaction for the body’s two physical control systems: the nervous system, which transmits information in the form of minute electrical impulses, and the endocrine system, which brings about changes of state through the release of chemical factors. It is the hypothalamus that first detects crucial changes in the body and responds by stimulating various glands and organs to release hormones. Discovering the Brain. Ackerman S.Washington (DC): National Academies Press (US); 1992. 2 Major Structures and Functions of the Brain

There is some scientific support for Idiopathic Intracranial Hypertensive patients and depressive disorders being linked.

” Our results suggest that there is a high risk of MDD co-morbidity in patients with IIH, as recent reviews of epidemiological literature of MDD have established a global point-prevalence (current or past month) of 4.7% and a pooled period prevalence of mood disorder (point of 12-month) of 5.4% [30,31], as compared to our cohort the prevalence was sevenfold, 37%. There is little information as to the psychosocial impact of IIH, but there are some hypotheses on how psychiatric disorders might develop in individuals with IIH. The development of IIH has been suggested to be accompanied with HPA-axis dysfunction [16,27] which has been also implicated in the pathophysiology of a variety of mood and cognitive disorders. For example, neuroendocrine studies have consistently demonstrated HPA axis dysfunction in major depression [32]. Another proposed mechanism that could explain why patients with IIH more frequently suffer from anxiety could be related to elevated catecholamine secretion observed in IIH [33]. MDD was common in patients with IIH and in our study the patients had received their MDD diagnoses prior to the IIH diagnosis. Depressive symptoms may represent prodromal symptoms of IIH rather than a consequence of elevated ICP, but our register-based data did not allow drawing pathophysiology-based conclusions on the causal relationships between the two conditions.” Clinical Neurology and Neurosurgery Volume 186, November 2019, 105527 Psychiatric disorders are a common prognostic marker for worse outcome in patients with idiopathic intracranial hypertension Tero Puustinen^a Joona Tervonen^a Cecilia Avellan^b Henna-KaisaJyrkkänen^a Jussi J.Paterno^c PäiviHartikainen^d UllaVanhanen^a VilleLeinonen^ef Soili M.Lehto^ghijAntti-PekkaElomaa^a1 Terhi J.Huttunen^a1