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My Original Theory-1 DAM Theory in English (Depressive-Anankastic-Manic Cells Theory :Conprehensive biological theory for manic depressive disorder ,mood disorder and premorbid character traits)

My Original Theory-1

 

DAM Theory (Depressive-Anankastic-Manic Cells Theory :Conprehensive biological theory for manic depressive disorder ,mood disorder and premorbid character traits)

 

Tadashi Kon(Shinagawa Psychosomatic medicine Clinic)

〒108-0075 2-14-10-10F Kounan,Minato-Ku,Tokyo,Japan  

 

1. DAM Cells :Enthusiasm, regularity and the persistence of negative mood are biological indexes

 

When we assume chronic continued stress to a neuron, three types of neurons are predictable according to the responses to the repeated stimulation.

First, there are neurons whose reaction speed gets gradually faster, such as neurologic kindling (epilepsy) and hysteresis (schizophrenia). I call these types of neurons M (Manic) neurons as they relate to the manic state. They also relate to enthusiasm, excitement (hyperthymia), and energy.

Secondly, there are neurons that always react steadily to the repeated stimulation.

I call these types of neurons A (Anankastic) neurons. A neurons are an element of regularity.

Thirdly, there are neurons whose response to the repeated stimulation rapidly diminishes. I call these types of neurons D (Depressive) neurons because they relate to the duration and weakness of the negative mood.  The majority of the human brain neurons are considered to be this D type.

 

2. DAM Theory : the onset mechanism of depression

 

When M neurons respond more and more actively to the recurrent sustained stress, the body is in a manic state. When M neurons burn out and stop functioning, D neuron traits emerges, and the body is now in a state of depression. Once M neurons recover from the damage after a sufficient interval, they restart their activities and become in  a manic state again. Repetition of this procedure creates symptoms of bipolar disorders. I think that depression doesn’t exist alone. It is always accompanied by a manic state where M neurons are activated, at least immediately before the depression, no matter how subtle the manic state is. The obsession element of A neurons appears and disappears because the obsession comes to the foreground and recedes into the background according to the state of bipolar disorder. When M neurons cease to  function and A-type neurons are enough in number, the obsession comes to the foreground instead of depression. If we assume that M neurons are related to circadian rhythm, insomnia and diurnal change (depressive mood and inhibition are strongest in the early morning and remit in the afternoon to the evening) are explained by the lack of M neurons’ element.

 

3. Explanation of Premorbid Character

 

Quantity and distribution of M, A, and D neurons in the brain explain part of premorbid characters. Intermediate types of the three types will exist and they construct a continuous spectrum.

 

(1)  Brains with high M neuron elements are enthusiastic, having characters of bipolar and cyclothymia. BP (Bipolar mood disorder) Ⅰ and Ⅱ belong to this type. BPⅠ consists of a manic state and depressive mood; BPⅡ consists of a hypomanic state and depressive mood. One affected by bipolar disorder with a premorbid character as cycothymia belongs to this type.  The immature form of depression is for immature and narcissistic cyclothymia, and is usually an early-onset type. It is difficult to distinguish the immature form of depression from personality disorders. Avoidant depression is also close to this type.

 When the society itself is in a hypomanic state, that of BPⅡwill be hidden. From the Meiji era to the high economic growth period, BPⅡ were diagnosed as single episodes of major depressive disorder. Madness towards the war and the devotion to company organizations probably belonged to a hypomanic state. Good adaptation often turns out to be a hypomanic state.

 

(2)  Brains with significantly more A neuron elements than M neuron elements are regular and have strong compulsive elements. Typus melancholicus, premorbid character of melancholic type depression, belongs to this type. While A neurons are responding to repeated stimulations, compulsive tendencies are presented. After A neurons get too tired, they cease to function.  At that time, usually, M neurons are also too tired and resting, and they are in a depressive mood.  If M neurons recover quickly, mixed episodes of manic-depressive are shown. Retreat neurosis is close to this type.

Tardy and nonchronic type of atypical depression is close to the melancholic type. Premorbid character of juvenile-onset chronic type of depression has not been clearly explained yet. Beard type depression is said to occur in the narcissistic immature type character when the office (workplace) is melancholic (where perfection is required of workers).

 

(3)  Brains with relatively few M neuron elements and A neuron elements possess weak characters without strong enthusiasm nor regularity. People with modern weak characters have lost self-confidence superficially, but mostly hold on to exaggerated egos inside them. Sometimes exposure of that exaggerated ego is observed. That is, it is not a unilateral weakness, and it strongly possesses a narcissistic element most of the time. It is a combination of weakness and immature narcissism. When it becomes depression, one may call it an immature narcissistic type of weak character type depression. However in DSM it is close to dysthymic disorder(long lasting mild depressive tendency) as the symptom of the first, Ⅰ axis, and it is close to dysthymia-affinity-depression among modern types of depression.

 

(4)  Brains with plenty of M neuron elements and A neuron elements show immodithymic characters with strong enthusiasm and regularity. According to the temporal profile of functional breakdown and recovery of both elements, manic, depressive, mixed episodes of manic-depressive, and further mixed episodes with compulsive tendency are observed. It is difficult to distinguish from personality disorders, if one onsets around 20 years old.

 

 



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