Global Journal of Medical Research, A: Neurology & Nervous System, Volume 23 Issue 3

observed on functional [62] and electroencephalographic [63] studies of depression. Now imagine that an affected person were confronted with a stressful situation. The hyperexcitability of the neurons would cause all of the person’s anxious thoughts to run through his or her mind more times than they should, and it would cause all of the person’s uneasy emotions to be abnormally intense and persistent. In addition to being experienced as inappropriately excessive worry and anxiety, the added mental and emotional tension would cause the related circuits in the brain to be further stimulated, thus creating a vicious cycle of mutual overstimulation between the mind and the brain. Moreover, this vicious cycle would, over time, be further amplified by “primed burst potentiation,” a natural kindling effect through which neurons that are repeatedly stimulated become increasingly responsive to further stimulation [64]. Another factor that would add fuel to the fire is the tendency for neuronal circuits to compete for dominance. From the study of epilepsy, it is known that pathologically hyperactive circuits tend to inhibit the activity of competing circuits [65]. This phenomenon would tend to prevent the mind from shifting attention to less anxious and more productive thoughts. In other words, it would leave the mind and the brain caught in the “default mode,” a psychophysiological state of unproductive internal processing that has been observed on functional imaging of clinical depression and other neuropsychiatric disorders [66]. It could also lead to aberrant circuit induction. This process, which is analogous to a short-circuit in a wired electrical system, hypothetically involves the inappropriate stimulation of relatively hypoactive circuits by pathologically hyperactive circuits [67]. As the feeder circuits quiet down due to synaptic fatigue [68], the freshly activated receiver circuits cause the person’s thoughts and emotions to shift accordingly, thus driving the “bipolar switch” [67]. With all of this abnormal electrical activity hijacking the cognitive-emotional system, it is not surprising that affected persons are so easily overwhelmed, so emotionally unstable, and so plagued with self-doubt. This raises the question of what really drives patients to seek treatment. The natural assumption is that they are driven to seek treatment by the factors that they say drove them to seek treatment. However, as one can see from the forgoing discussion, those factors can be abnormally amplified and distorted by poorly restrained discharges from the brain. Yet in actual practice, neither patients nor their healthcare providers have any reliable way of knowing this. In the 1900s, mild cognitive-emotional distortions were referred to as “neuroses,” and severe cognitive-emotional distortions are still referred to as “psychoses.” According to the MCNH hypothesis, various forms of psychosis are created when, due to the amplifying effect of neuronal hyperexcitability, the intensity of mentally-generated thoughts and emotions becomes as high or higher than the intensity of thoughts and emotions that would normally be driven by input from the eyes, ears, and other sensory organs. Hypothetically, the margin between internally-driven thoughts and emotions, which are normally of lower intensity, and externally-driven thoughts and emotions, which are normally of higher intensity, is what allows a person to distinguish internal from external reality. Of course, the distorting effect of neuronal hyperexcitability can easily be recognized in severely psychotic patients; but the distorting effect can be more difficult to recognize in patients whose complaints are less out-of-line with reality. If the therapist then begins to work with this distorted content in such patients, he or she would unwittingly be attempting to treat a neurological problem with a psychological intervention. By analogy, it would be like trying to correct impaired vision by talking about it. The difference, however, is that talking about a visual impairment cannot do further damage to the eye; whereas, talking about neurologically-distorted thoughts and emotions can cause further damage by continuing to stir the pot, particularly in a person whose hyperexcitable brain is continuing to distort everything that he or she thinks and feels. Most experienced psychotherapists can readily attest to the risk of regression when intensive psychotherapy is attempted with more severely disturbed patients (presumably those with higher levels of neuronal hyperexcitability), and the renowned Austrian psychiatrist Sigmund Freud, due to the same concerns, was careful to avoid psychoanalyzing psychotic-range patients [69]. In contrast to persons with hyperexcitable brains, those with normoexcitable brains would be relatively resistant to cognitive-emotional stress, and they would be even more resistant to developing psychiatric symptoms. That raises the possibility that most, if not all, persons who present for psychotherapy have hyperexcitable brains. Additional support for this idea comes from the observation that the vast majority of persons who initially seek the care of a psychotherapist rarely need to continue psychotherapy once, upon being referred to a prescriber, their neurological function is normalized with anticonvulsant drugs. Another observation that suggests that most persons who seek psychotherapy have hyperexcitable brains is that such persons are rarely satisfied with their treatment until they either become willing to accept medical therapy or they establish natural brain-calming habits and routines, such as stress-reduction, establishment of an early sleep schedule, regular exercise, avoidance of psychostimulants, and minimization of refined sugar. Consistent with this observation, the Royal Australian and New Zealand College of Psychiatrists is now, for the first time, recommending attention to diet, regular exercise, and 7 Year 2023 Global Journal of Medical Research Volume XXIII Issue III Version I ( D ) A © 2023 Global Journals Untangling Psychology from Biology in the Treatment of Psychiatric Disorders