Inflammation & The Brain: A New Approach To The Cause And Treatment Of Depression

Major Depressive Disorder (MDD) or clinical depression, is a common mood disorder that can affect anyone. Its most prevalent symptom can include persistent sadness or irritability, loss of interest in previously pleasurable activities, difficulties concentrating and disturbed appetite and sleep habits. It is estimated that one-in-three women and one-in-five men have an episode of major depression by the age of 65. The World Health Organization recently reported that MDD is now the major cause of disability and affects over 300 million people. The conventional drug treatments for depression often fall short of providing effective results. 

Researchers are now starting to approach depression as a whole-body problem that requires a whole-body approach to solving it;

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“I think we need to think outside the box, which is the brain and the neurons…When you’re stressed, you feel it all over your body, you don’t feel it only in your brain.” — Caroline Ménard, assistant professor of psychiatry and neuroscience at Université Laval and CERVO Brain Research

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The Limitations of Current Treatments

Antidepressants, a standard treatment for most depressive disorders, are designed to modulate the transmission of certain neurotransmitters — serotonin, dopamine and norepinephrine — but this only works for some patients, others are resistant to these treatments. The current state of available treatments for depression highlights the clear requirement for a fresh approach, given that most of the treatments are derived from chance discoveries made over 60 years ago.

After an analysis of over 30 studies, comprising of 13,541 depressed patients and 155,728 controls, a study published the Cambridge University Press, concluded that about 25% of patients with depression show evidence of low-grade inflammation, whilst over 50% of patients show mildly elevated CRP levels - a biomarker used to indicate inflammation. There are significant differences in the prevalence of low-grade inflammation between patients and matched healthy controls. These findings suggest that inflammation could be relevant to a large number of patients with depression.

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Inflammation As Part Of A Toolkit Approach For Depression

Depression is not an inflammatory disorder and not every patient with depression has increased inflammation. Although a multitude of studies have demonstrated increased mean concentrations of a variety of inflammatory markers in depressed patients. In certain patients, research indicates that depressive behaviours may be driven by the inflammatory process rather than solely by neurotransmitter imbalances.

The biomarker C-reactive protein (CRP) when elevated in the bloodstream can disrupt the body-brain barrier, leading to neuro-inflammation. In the study, CRP was elevated in patients with depression, and even more so in treatment-resistant patients suggesting a crucial link to explore for future approaches to the treatment of depression.

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Can Treating Inflammation Impact Depression?

Studies exploring the correlation between inflammation and depression are shedding light on how targeting and treating inflammation can potentially unlock a more precise approach to depression care, offering renewed hope for individuals whose depression is resistant to anti-depressants.

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“We’ve come to the tipping point…we know enough at this point to begin to target the immune system and its downstream effects on the brain to treat depression. We are there.”  — Andrew H. Miller Professor of Psychiatry and Behavioural Sciences at the Emory University School of Medicine

Further research is being called for to address the need for a new approach to treatment. If inflammation can induce or exacerbate depression and its symptoms, then reducing inflammation could provide, if not a complete remission, maybe a relief for many people with depression. 

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How to proactively manage inflammation?

Main signs of inflammation

• Persistent Joint Pain: Frequent or chronic joint pain, stiffness, and swelling can be a sign of inflammation, especially in conditions like arthritis.

• Fatigue and Low Energy: Experiencing constant fatigue, lack of energy, and difficulty in recovering from physical or mental exertion may be linked to elevated inflammation levels.

• Digestive Issues: Inflammation in the digestive system can lead to symptoms such as abdominal pain, bloating, diarrhoea, or constipation.

• Skin Problems: Inflammatory skin conditions like acne, eczema, psoriasis, or rashes that persist or worsen could be related to underlying inflammation.

• Frequent Infections: A weakened immune system due to high inflammation can result in recurring infections, such as respiratory or urinary tract infections.

• Mood and Cognitive Changes: Inflammation may affect mental health, leading to mood swings, depression, anxiety, memory problems, or difficulties with concentration.

Chronic inflammation is a persistent, long-term state of inflammation in the body. Unlike acute inflammation, which is a normal response to injury or infection (and settles once the underlying issue is resolved), chronic inflammation can persist for months or even years. It occurs when the immune system triggers an inflammatory response continuously or repeatedly, even when there is no immediate threat or injury.

Common non-dietary inflammation triggers

• Chronic Stress: Prolonged stress activates the body's stress response, leading to the release of stress hormones that can promote inflammation.

• Lack of Physical Activity: Sedentary lifestyles can contribute to low-grade inflammation. Regular exercise helps reduce inflammation and promotes overall health.

• Environmental Toxins: Exposure to pollutants, chemicals, and toxins in the environment can trigger an inflammatory response in the body.

• Lack of Sleep: Inadequate or poor-quality sleep disrupts immune function, leading to increased inflammation.

• Chronic Infections: Persistent infections, such as viral or bacterial infections, can cause chronic inflammation.

• Smoking and Alcohol Consumption: Smoking and excessive alcohol intake contribute to inflammation and increase the risk of developing chronic inflammatory conditions.
  

Strategies for reducing inflammation

• Follow an Anti-Inflammatory Diet: Consume plenty of fruits, vegetables, whole grains, fatty fish, nuts, and seeds while minimising processed foods, gluten, refined sugars, and unhealthy fats.

• Regular Exercise: Engage in moderate-intensity exercise most days of the week to help lower inflammation and promote overall well-being.

• Manage Stress: Practice stress-reducing techniques like meditation, deep breathing, yoga, or engaging in hobbies to minimise chronic stress and its inflammatory effects.

• Get Adequate Sleep: Aim for 7-9 hours of quality sleep each night, as insufficient sleep can contribute to inflammation.

• Maintain a Healthy Weight: Excessive weight can trigger chronic inflammation due to the increased production of pro-inflammatory molecules by adipose (fat) tissue. Adipose tissue secretes hormones and cytokines that promote inflammation, leading to a state of low-grade chronic inflammation in the body. 

• Limit Alcohol and Tobacco: Minimise alcohol consumption and avoid smoking, as both can contribute to inflammation and worsen its effects.
  
  

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Wondering about your current inflammation levels?

Understanding inflammation and its effects on the body enables you to take action and improve your overall health now to help you age well into the future. The WellBeing Test is a private blood test that delivers a health report by analysing multiple blood biomarkers. Discover what your blood is telling you and receive actionable insights into the core health areas of energy, sleep, stress, inflammation, fitness and body fat composition.

Learn more about The WellBeing Test.

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