For decades we've been told in pharmaceutical commercials that depression is simply a chemical
imbalance in the brain, and while that was perhaps an improvement on the previous idea
that depression was a moral failing, it isn't the full truth. Depression is an umbrella diagnosis;
it's a cluster of symptoms. When you get a depression diagnosis, your doctor or therapist
has no way of telling you what is causing your depression. All they can tell you is that you
currently have at least five out of nine symptoms. New research is demonstrating that depression,
far from being one disorder, is most likely rooted in a variety of physical and psychological and
social causes. And research is starting to show evidence that for some people with depression,
the contributing biological cause may actually be inflammation. And this new understanding
can give you a new tool to fight depression. Inflammation may also play a big role in other
mental health disorders like bipolar, anxiety, schizophrenia, OCD, autism, and PTSD. So let's
talk about what inflammation is, how it impacts mental health, and what we can do about it.
Have you ever caught a bad cold that made you extra sad or irritable or unmotivated?
When you're sick, your immune system creates an inflammatory response that makes you feel
this way. But feeling down serves a function: to keep you in bed so that your body can devote
its resources to fight off the virus and heal. And when the inflammation is gone,
your mood bounces back and you get your energy back and you start feeling more cheery. It's long
been known that inflammation causes a depressed mood. People with high inflammation due to
rheumatoid arthritis or cancer seemed to have good reasons to be depressed. Scientists assumed that
it was a psychological response to the stress of being sick that was causing the depression. But as
research progressed, it seems that inflammation, stress, and mental health disorders all play into
each other. Stress causes inflammation, being inflamed causes mood disturbances,
and mood disturbances can lead to more stress - which creates a vicious cycle. So for example,
when patients with rheumatoid arthritis, which is an inflammatory disease,
began taking anti-inflammatory drugs, their mood lifted to the point of being euphoric. It
was such a remarkable side effect that the nurses fought over who got to administer the medication.
Now, depression and other mood disturbances aren't just a psychological side effect of being sick;
being sick and inflamed actually contribute physically to being depressed. So what is
inflammation? It's our immune system's reaction to protect us from threats. When our immune system
senses a threat, whether it's a sprained ankle a cut or a virus, it sends inflammation to the
area. Your immune system sends macrophages and lymphocytes to attack pathogens, and it makes
the area heat up and swell. If the bacteria or other invader is spreading, the immune system
communicates through the lymph nodes to heighten the inflammation response throughout the body,
And this is one way that your body protects itself from threats and it heals and it stays safe. It's
a pretty incredible life-saving reaction. But when you're chronically inflamed, your immune system
remains in an activated state, and this can damage healthy tissues and interfere with healings.
When inflammatory cytokines in the body reach a certain threshold, the vagus nerve sends a message
to the brain to initiate its own inflammatory response, and this makes the macrophages get more
angry and start to pump out cytokines. Now, these cytokines not only attack invaders like germs,
but they can harm healthy tissues throughout the body and the brain. And this may be one
explanation for the memory loss and cognitive impairment that come with chronic inflammation.
Inflammation also lowers levels of serotonin, which can impact sleep and appetite and mood.
But the awesome thing about the vagus nerve is that it sends information in both directions. It
can send messages from the body to the brain to be inflamed, but it can also send messages from the
brain to the body to lower inflammation. Numerous studies have linked depression and inflammation.
One Danish study with over 70,000 participants showed that higher levels of CRP - which is an
inflammation protein marker - the higher the levels of CRP in a person's blood,
the more likely it was that they were to have self-critical and negative thoughts.
Another study with over 15,000 children showed that kids with higher levels of inflammation were
50% more likely to be depressed by the time they turned 18. Another study showed that 45% of people
with depression who did not respond to antidepressants had CRP levels higher than
three milligrams per liter. So what causes chronic inflammation? Infection, autoimmune disorders,
diabetes, obesity, genes, and age are all things that can cause chronic inflammation,
but stress is the biggest cause of inflammation. Your body interprets mental or emotional threats
in the same way it does physical threats. 80% of depressive episodes are preceded by a
stressful event like divorce or the death of a loved one. But it doesn't have to be like this
huge event to create an inflammatory response. Things like public speaking, peer rejection,
or tight deadlines can all lead to a short-term elevated stress and inflammation response. Now
again, stress and inflammation aren't inherently bad. This reaction protected our ancestors from
germs when they had no medicine, and our ancestors with the strongest inflammation response may have
been more likely to survive injuries and illness, at least in the short term. And if someone felt
sick and they felt down and discouraged and moody and they felt like withdrawing from the group,
that may have protected others in their group from getting sick too. So inflammation and the
depressive symptoms may have served a function. But in our modern day, the inflammatory response
is very sensitive to things like public speaking, and that can lead to more suffering and depression
and actually shorter life spans. Now, if you look at the list of things that cause inflammation,
um it seems especially relevant that things like abuse and trauma contribute to inflammation.
So how does this help us treat depression? When it comes to depression, we need more treatment
options that are more targeted and more effective than what we currently have. So that has led
scientists to look at decreasing inflammation as one option. Now, right now treatment options
are limited. Your doctor could test you for inflammation by checking CRP in a blood test,
and if your levels are repeatedly over three milligrams per liter, it could be a sign of
chronic inflammation. Findings suggest that people with a CRP greater than one, which is the cutoff
for moderate inflammation, were less likely to benefit from SSRIs. And for these people,
they may respond better to treatments that target inflammation rather than serotonin,
or they may benefit from a tricyclic medication like nortriptyline. Now, some studies have shown
that anti-inflammatory drugs used for rheumatoid arthritis, psoriasis, and asthma have mild
antidepressant effects. Anti-inflammatory drugs are still not approved for depression treatment.
Edward Bullmore, the author of The Inflamed Mind, where I learned much of this information,
estimates that the first anti-inflammatory drugs for depression may come to market within the
decade. Now, there are a lot of other things you can do to decrease inflammation. The first is,
of course, is managing your stress levels. Eating a healthy diet and exercise can also make a big
impact. Omega-3 fatty acids can decrease the inflammation response for some people.
And there's also some evidence that vagus nerve stimulation using an implanted device
that essentially calms the stress response, that that can help lower inflammation. But you can also
train yourself to stimulate the vagus nerve with some activities that I teach in many of my videos,
and that can also help in a big way with long-term stress. Long story short,
inflammation may play a key role in mental health. The science behind it is just beginning to emerge.
Getting your CRP levels tested may inform your treatment options, and learning to reduce
stress and inflammation may be really helpful at treating depression and improving mental health
in general. Okay. I hope you found this video helpful. Thank you for watching, and take care.
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