Womblife and Serotonin. The Origins of Mental Illness

(Originally published July 9, 2008)

Let’s begin with the poor lonely mouse. Regarding its womb-life: it is only after several months of gestation that the fetus produces adequate amounts of inhibitory/repressive chemicals such as serotonin. A mouse fetus does not make its own serotonin until close to the third trimester. It seems like the mother supplies what is needed until the baby can take over. But when the mother is low on supplies, she cannot fulfill what the developing baby lacks. Now if we extrapolate a bit to human mothers. But first a caveat: it seems to me that the principles or laws of biology apply pretty much across many species so that what is true in the physiologic evolution of mice might also be true in our own biologic evolution, as well, and as the following discussion indicates, it is true; the lag between the ability to experience pain and the ability to repress it can be considerable. 

Whereas the beginnings of serotonin production in mice are sometime in the third trimester, in humans it seems to begin slightly earlier. Research on a fetus seems to indicate that it can experience pain after thirteen weeks from conception but that it really fully experiences pain after 20-24 weeks of gestation--bout five months of life in utero. It is fully sensitive to adverse events at this time. (see Paul Ranalli, “The Emerging Reality of Fetal Pain in Late Abortion.” www.nrlc.org) My guess is that it begins even earlier. What is critical here is there is a time during gestation when the fetus can not produce repressive/ inhibitory chemicals and must “ask” for help physiologically from his mother. When the fetus does begin manufacturing is own neuro- chemicals it sends some of it to the mother. It says, “I can soothe myself now. Thanks for the help.” Above all, serotonin is a soother. 

Allthough the pain-killing aspects of serotonin are well known, less is known about its role in affecting appetite, gastric symptoms and heart function. In short, it has a role in normal development and evolution. In particular, new evidence points to its role in actually shaping some brain structures early in fetal life. (see Cote. F. et al. “Maternal Serotonin is Crucial for Murine Embryonic Development.” 2006 National Academy of Science.) Traumas very early on, before the secretion of serotonin is evident in the fetus, impact later serotonin output and can change who and what we are significantly. One reason we see serious mental illness arising during adolescence is that the hormonal turmoil going on and the weakening of defenses permits some of the fetal pain to rise and affect thought processes. Hence delusions and hallucinations. 

Interestingly, in its early secretory life serotonin functions to control and shape anatomic structure. Later on, it carries on as a pain controller. It too evolves and changes. Thus, we as humans may have a significant delay in secreting serotonin during gestation. And we rely on our mother to pitch in before we start making our own. She needs to have an adequate supply for both herself and her baby. If she is chronically depressed she is apt to have low levels of serotonin, used up in the fight against her pain. In this way the mother cannot fulfill the fetal needs for a way to blunt the impact of adverse events; i.e,. of pain. Thus, the fetus has developed a residue of unblocked, free floating pain and terror early in his gestation. This makes him much more vulnerable to trauma at birth and in infancy. He is defective in coping mechanisms. Any later trauma can have double the impact on the relatively undefended system. 

The low serotonin output is an imprint that remains pretty much the same throughout our life, making us not up the task of everyday living. That is why we so desperately need serotonin enhancing medication later in life. (Prozac. Zoloft) The medication is blocking pain that happened before we set foot on this planet. 

We know from current research that an imprint during gestation remains pristine pure for all of our lives, whereas an imprint from after birth can produce compensating secretions that blunt the impact of trauma during infancy. My very notion of the imprint means events that they create irreversible dislocations of function in the neurobiologic sysems. The only way it can change is if we return to the origin of the dislocation and right the ship. It needs a push from below not a cry from above. 

It seems to be another biologic law that whatever happens during gestation can alter basic physiologic set points, which is rarely the case after birth where there can be compensatory mechanisms to make up for the dislocation of function associated with the original trauma. 

So we have a developing fetus who has no effective repressive mechanisms trying to borrow some of mother’s serotonin to help out, but to no avail. A completely naïve physical system has no frame of reference that tells it that basic physiologic processes are deviated. During gestation the system deviates and then considers that deviation as normal. So the baby is born with inadequate serotonin/gating capacity, and that deficiency follows him throughout life. But it is an already wounded organism, a wound that almost no one can see or even imagine. He will grow up chronically anxious, unable to concentrate or focus. He may well be ADD and be unable to sit still because the activation goes on incessantly. It shows itself in the panic attacks that happens when the system is vulnerable and gating weak; the imprint from gestation rises to the top and shouts out its message which almost no one can decipher. It is such a mystery because its origins are so arcane. 

An example: a girl is born in wartime to a mother who is chronically anxious because her husband has been sent to war and left her all alone. The anxious mother transmits some of that to her baby who is then considerably weakened. He cannot fully repress to hold down pain. By the time infancy happens there is already a weak, vulnerable baby who is chronically agitated. This may be the beginnings of serious mental illness. It is not obvious to the human eye but the damage is done. 

Too often this is ascribed to heredity because no one can imagine what has already happened in the womb. It is kind of a free- floating anxiety that seems to have no specific time of origin. Remember, this is a purely physiologic reaction originated at a time when there was no higher brain centers to process the event. To recapture it we must retreat to that primitive brain. 

What we may see many decades later are panic and anxiety attacks, and then much later a cerebral stroke. This imprint would militate against cancer because for cancer to develop we often need massive repression; and for that we need massive secretions of neurojuices such as serotonin. What would exacerbate the risk of cancer is events later in infancy and childhood with unloving, stern parents. The result is a person who never had outlets for his pain. What further shuts down the person is growing up with a violent father or mother, a strict religious household, and no one to turn to. The force of the imprint may well affect the brain when the person is in his sixties. How on earth can we access such remote experiences, a time when there were no ideas to help out? 

We do know that each high level of brain function can incorporate the previous lower level. That is, early memories become elaborated on higher levels of brain function and are incorporated into those levels. So when we relive a non-verbal pain or trauma in infancy we are at the same time reliving the residue from earlier in womb-life. The events are united under a resonance factor that makes a higher level of brain function trigger off a deeper and more remote feeling. To put it differently, each early preverbal imprint is ramified on higher levels so that feeling fully on the higher level automatically has us feeling the earlier aspects of the feeling. Because of this we can over-react to events in adult life. As we see in our therapy, it may be one cause of erectile dysfunction—the feeling of being overwhelmed because of even slight pressure to function in the present. Or the inability to get going at work. 

So to summarize: there seems to be a time in gestation when pain or noxious stimuli impinge, but we are not yet able to produce our own gating chemicals, such as serotonin and endorphin, resulting in un- gated pain. When I refer to gating, I refer to electrochemical process that blocks the transmission of the pain message across the synapse. This residue will continue and may lead to bouts of anxiety later on in life. It becomes free-floating, unbound fear or terror. It can then be focused on elevators and a phobia is born. This is not due to heredity but rather to experience in the womb. Part of our in-utero life, therefore, takes on hurt at a time when the system can do nothing about it; nevertheless, it affects all later development. At 30, we may suffer from panic attacks that began its life in the very early months of our mother’s pregnancy. It is pristine, ready to spring forth whenever we are vulnerable. No talk therapy can make a dent in it because it involves a vegetative primitive nervous system which was adequate to register pain and terror during womb-life. This is a nervous system impervious to words; it doesn’t understand them and does not respond to them. So insights leave it absolutely indifferent. The womb experience leaves us fragile for a lifetime so that any insult or lack of love in infancy and childhood weakens us all the more. That is why we need drugs that work on lower brain centers below the intellectual in order to suppress these imprints for a time.

So much severe mental illness has its causes so early in our lives; and then nature later provides us with useless intellectual tools to address them. When all we have to do is let the primitive nervous system take charge and lead the way. It knows the path to liberation.