Dear Eric!

I've been working on the problem of consciousness and its disorders during anesthesia and surgery for over 20 years.

The standard definition of postoperative psychosis or postoperative behavioral disorders in the literature I could not meet.

The reason for this is the lack of consensus among the experts and the unified theory of change of consciousness during anesthesia.

I managed to install some of the mechanisms in the brain that may explain such behavioral disorders.

In my experience and observation of patients with postoperative psychosis, often enough it was caused served several reasons:

1 Initial the general plight of the patient prior to surgery and anesthesia;

2 Do not adequate preoperative and small time limit for its implementation before the long and difficult operation;

3 The presence of acute injuries and concussion of the brain in patients who are undergoing urgent surgery;

4 Сoncomitant impact on the consciousness of the patient of acute poisoning toxins, alcohol, drugs and (or) the effects of psychotropic drugs.

5 Emergency accidents, disasters, wars and disasters.

But the main cause of postoperative mental disorders, which has always had a significant influence on the development of postoperative psychosis, was the lack of proper quality of the anesthesia care.

If general anesthesia is not performed adequately, the probability of postoperative complications and psychosis increased many times.

This situation could arise if:

- The level of analgesia and supportive intensive treatment in surgery did not match the severity of the initial state and the severity of the surgery, which caused further disruption of adaptive and compensatory mechanisms of the brain;

- Method of anesthesia did not match the individual typological characteristics of the patient;

- Anesthesia and surgery, for a number of external or internal causes, caused additional trauma to the patient, which is manifest in the form of postoperative psychosis.

The influence of general anesthesia is manifested not only deprivation of pain impulses, but also the influence on the organization of mental processes in the cerebral hemispheres.

The right and left hemispheres of the brain have a functional asymmetry. The mutual operations of the two hemispheres determines the behavior and psyche. In a state of clear consciousness in 98.3% of people have a moderate dominance of the left hemisphere of the brain. When anesthesia appears to change consciousness and a change of the dominant relationship between the hemispheres. The right hemisphere begins to dominate in the work and the regulation of the nervous processes. Against this background, there is a decrease the number of functional horizontal connections between the hemispheres (there is a functional block dissociation).

I called this phenomenon - an Adaptive inversion of the cerebral hemispheres. It has a large physiological, protective and adaptive significance.

When restoring the level of consciousness of the dominant relationship between the hemispheres becomes the source and consciousness becomes clear.

Under the psychosis and behavioral disorders is always a disorder between the initial level of dominance between brain hemispheres.

Therefore, one of the definitions of postoperative psychosis may be -

Psychosis - is a form of pathological hemispheric interaction that occurs under the influence of distress exposure over compensatory limits of physiological fluctuations in the brain and psyche.

In more detail, I described the phenomenon of adaptive inversion of the cerebral hemispheres in my monograph.

With best wishes for success Vadim Shanin

This is very interesting as the experience of psychosis is very much like a quieting of the right hemisphere of the brain and the much more multi-dimensional experience of the left hemisphere coming to the foreground of experience.

See the short movie of a neuroscience lecturer called  Jill Bolt-Taylor when she had a stroke. She lost her ability to speak as labels fell away, instead she was left with the wonder of seeing things as she had never seen them before. Every thing was metaphor and emotion, probably how a baby 'thinks/feels'.

Its only a 'disorder' when you need to function in a right minded world. The majority of people who experience this for short periods do so using recreational drugs. The spiritual emergence aspects are usually short lived crisis points and as you mention adaptive, perhaps to bring about increased balance and a re-aligning of personal consensus reality (Paris Williams). 

Also there has to be elements of post traumatic stress disorder that come into play during a medial emergency. As well as big drops in available Vit C and other antioxidants that get depleted during physically challenging events and healing processes. After all psychosis is a direct symptom of nutritional deficiency for 4 vital nutrients: Vit B3, folic acid, Vit B12 and Vit C (Patrick Holford).     

Opps , last sentence should not have said 'all' psychosis.... I believe there are many, many causes which pile on top of each other like the saying the last straw that broke the camels back... Medicine likes to blame the last straw rather than look at the whole body burden of negative influences. These include heavy metals, toxins, infections, parasites, diets, PH balance, allergies, poor nutrition, addictive substances, medications, metabolic disorders, over and under methylation, faulty thyroid function, blood sugar problems, high histamine production, serotonin deficiency, acetylcholine imbalance, essential fats deficiency and more....