Presented is the case of the fifty-six year-old asthmatic woman, with a six-month history of a Major Depressive Episode. Following an acute respiratory crisis, requiring assisted ventilation, the depressive symptomatology resolved. The historical administration of treatments of the mentally ill, incorporating acute physiological stress, are commented upon, and hypotheses discussed concerning the possible mechanisms of action of such treatments. The induction of a delirium may be the significant therapeutic event experienced by this patient, and the common event induced by physiologically stressful treatments administered by our psychiatric forbearers.
JonesW. L., Ministering to Minds Diseased, William Heinemann, London, 1983.
2.
ZilboorgG., A History of Medical Psychology, W. W. Norton and Company, New York, p. 337, 1941.
3.
Cervantes, Don Quixote, Penguin Books, Hammondsworth Middlesex, pp. 934–940, 1952.
4.
FreudS., Beyond the Pleasure Principle, The Standard Edition of the Complete Works, Vol. XVII, Hogarth Press, London, p. 33, 1954.
5.
RossD. R.LewinR.GoldK.GhumanH. S.RosenblumB.SalzbergS.BrooksA. M., The Psychiatric Uses of Cold Wet Sheet Packs, American Journal of Psychiatry, 145:2, pp. 242–245, 1988.
6.
JohnstoneE. C.DeakinJ. R. W.LawlerP.FrithC. D.StevensM.McPhersonK.CrowT. J., The Northwick Part ECT Trial, Lancet, ii, pp. 1317–1320, 1980.
7.
AkiskailH. S., A Proposed Approach to Chronic and “Resistant” Depressions: Evaluation and Treatment, Journal of Clinical Psychiatry, 46, pp. 32–36, 1985.
8.
DelahuntJ. W.MellsopG., Hormone Changes in Stress, Stress Medicine, 3, pp. 123–124, 1987.
9.
PerkoffG. T.SandbergA. A.NelsonD. H.TylerF. H., Clinical Usefulness of Determination of Circulating 17-Hydroxy-Corticosteroid Levels, Journal of the American Medical Association, 93, pp. 1–8, 1954.
10.
BreierA.AlbusM.PickarD.ZahnT. P.WolkowitzO. M.PaulS. M., Controllable and Uncontrollable Stress in Humans: Alterations in Mood and Neuro Endocrine and Psychophysiological Function, American Journal of Psychiatry, 144:11, pp. 1419–1425, 1987.
11.
LewisD. A.SmithR. E., Steroid-Induced Psychiatric Syndromes, Journal of Affective Disorders, 5, pp. 319–322, 1983.
12.
McEwenB. S., Glucocorticoid-Biogenic Amine Interactions in Relation to Mood and Behaviour, Biochemical Pharmacology, 36, pp. 1755–1763, 1987.
13.
BortzW. M.AngevinP.MeffordI. N., Catecholamines, Dopamine, and Endorphin Levels during Extreme Exercise, New England Journal of Medicine, 305, pp. 466–469, 1981.
14.
Van Der KolkB., Psychological Trauma, American Psychiatric Press, Washington, D.C, 1987.
15.
AnismanH. K.RitchM.SklarL. S., Noradrenergic and Dopaminergic Interactions in Escape Behaviour, Psychopharmacology, 74, pp. 263–268, 1981.
16.
SulserF.VentulaniJ.MobleyP. L., Mode of Action of Antidepressant Drugs, Biochemical Pharmacology, 27, pp. 257–261, 1982.
17.
CanonJ. T.LeibeskindJ. C.FrenkH., Neural and Neurochemical Mechanism of Pain Inhibition, in The Psychology of Pain, SternbachR. A. (ed.), Raven Press, New York, 1978.
18.
ChristieM. J.ChesterG. B., Physical Dependence on Physiologically Released Endogenous Opiates, Life Science, 30, pp. 1173–1177, 1982.
19.
CarrD. G., Endorphins at the Approach of Death, The Lancet, 1, p. 390, 1981.
20.
GreyM., Return from Death, Arkana Publishing Company, London, 1985.
21.
GrossoM., Nurses' Views of Near Death Experiences, American Journal of Nursing, 86:4, pp. 417–421, 1986.
22.
GernerR. H.CatlinD. H.GorelickD. A.HuiK. K.LiC. H., B-Endorphin: Intravenous Infusion Causes Behavioural Change, Archives of General Psychiatry, 37, pp. 642–647, 1980.
23.
BorchardtC. M.PopkinM. K., Delirium and the Resolution of Depression, Journal of Clinical Psychiatry, 48:9, pp. 373–375, 1987.
24.
AdamsF., Emergency Intravenous Sedation of the Delirious, Medically Ill Patient, Journal of Clinical Psychiatry, 49:12 (Suppl.), pp. 22–27, December 1988.
25.
BleulerM.WilliJ.BuhlerH. R., Akute Psychische Begleiters-Cheinungen Korperlicher Krankheiten, Thieme, Stuttgart, 1966.
26.
GormanJ. M.AskanaziJ.LeibowitzM. R.FyerA. J.SteinJ.KinneyJ. M.KleinD. F., Response to Hyperventilation in a Group of Patients with Panic Disorder, American Journal of Psychiatry, 141, pp. 857–861, 1984.
27.
WoodsS. W.CharneyD. S.LokeJ.GoodmanW. K.RedmondD. E.HeningerG. R., Carbon Dioxide Sensitivity in Panic Anxiety, Archives of General Psychiatry, 43, pp. 900–909, 1986.
28.
WoodsS. W.CharneyD. S.GoodmanW. K.HeningerG. R., Carbon Dioxide Induced Anxiety, Archives of General Psychiatry, 45, pp. 43–51, 1988.
29.
LagercrantzH.SlotkinT. A., The “Stress of Being Born,”Scientific America, 254:4, pp. 100–107, April 1986.
30.
WeissmanM. M., The Psychological Treatment of Depression: Evidence of the Efficacy of Psychotherapy Alone, in Comparison With, and In Combination With Pharmacotherapy, Archives of General Psychiatry, 36, pp. 1261–1269, 1979.
31.
BoswellJ., The Life of Samuel Johnson, Penguin Books, Harmondsworth, Middlesex, p. 231, 1979.
32.
WitzelL., Behaviour of the Dying Patient, British Medical Journal, 2, pp. 81–82, 1975.
33.
KohutH., Self Psychology and the Humanities, W. W. Norton, New York, pp. 16–21, 1985.
34.
PostR. M.KopandaR. T., Cocaine, Kindling, and Psychosis, American Journal of Psychiatry, 133, pp. 627–634, 1976.
35.
FinkM., Theories of the Antidepressant Efficacy of Convulsive Therapy (ECT), in Neurobiology of Mood Disorders, PostR. M.BallencerJ. C. (eds.), Williams and Wilkins, Baltimore, 1984.
