I do not know if you are aware of this but heightened CO2 in the blood will cause the dysregulation of GABA seen in depression and other disorders. Difficulty regulating PaCO2 and/or regulating CO2 inside the head, if not the blood, is made more difficult for some of us due to long term unknown effects on the skeletal system.
There is evidence that injury to the head, to the neck, to the throat, to the torso can affect the skeletal motor ventilatory system of the body [despite an intact brain and intact lungs] ….making sufficient exchange of air difficult in health and harder after viral illness.
The expression, you can’t see the forest for the trees is useful here; it means that you can get so lost in the details that you cannot see what the problem is.
The problem, in debilitating depression is any injury, incurred at any time during life, making it difficult for you to move air in and out of your body at a normal rate [15 breathes per minute give or take 5 either way] and depth [enough to achieve normal minute ventilation] without needing to resort to use of the accessory muscles .
I do not know if you know that Dr Emile Kraepelin looked at the trees to interpret the forest; meaning that Dr Kraepelin looked to see if bipolar depressed patients had normal physiological signs.He looked at the BIG picture First! Imagine! Before making any assumptions, Dr Kraepelin measured the vital signs of his severely bipolar patients in the different stages of the illness [over 100 years ago]. Imagine that! Dr Kraepelin found depressed breathing rates in bipolar depression. This is how he would have known that the abnormal breathing was the reason for the signs and symptoms of these attacks and also the reason for the GABA issues. Paula has the same depressed breathing, we tested her respiratory rate, tidal volume and minute ventilation with a lung function machine set to investigate these factors. Her lungs are fine. Her ventilatory pattern is altered and may fail during conditions challenging her physical health and strength. Same as Kraepelin’s patients. [with no medication effects or yoga involved]. Imagine! Kraepelin was correct. Who would think of investigating the vital signs of the mentally ill? This is only recommended in every first year medical textbook that students are required to read. Imagine . It seems that Kraepelin was one of the few to practice what is now preached [in the introductory textbooks, not the psychiatry textbooks, unfortunately.
Krepelin discovered a ventilatory defect or injury making respiratory acid base regulation difficult in times of respiratory distress. [the lungs are fine].
Please discuss this and research the effects of hypercapnia [and hypocapnia] on animals and their GABA systems.
The first step in unmasking the underlying cause of any illness or past injury affecting regulation of homeostasis must be checking respiratory rate [for one minute with a stopwatch], heart rate, blood pressure and body temperature…to see if there is a physical problem [especially with the motor system moving air in and out of the body…in the correct ratios no less.
Supportive medical care would be helpful if ventilation was impaired and the lungs were fine.
No one has looked into this possibility since Kraepelin.And one does not have to be a doctor to count respiratory rates at rest, it is part of first aid assessment which anyone can do.
If abnormal rates are detected then getting a minute ventilation of the next noninvasive step, and if that is abnormal, then blood gas tests.
Proper cognition, mood and memory requires the correct ratio of air supplied by the motor respiratory pump which is a part of the peripheral system and can easily have parts damaged due to wear and tear and injury of any kind.
It would take an interdisciplinary team to explore; I think it could provide answers to interesting medical and scientific and physiological puzzles.
I hope you agree.
Please discuss with colleagues.
The next blog explores suggestions for rehabilitation of severely depressed patients and those with bipolar syndrome due to ventilatory injury, that they are unaware they have.