Inflammation and Depression
There is plenty of research evidence pointing to a link between inflammation and depression and maybe enough to even say that inflammation causes depression. Getting depressed while inflamed had a purpose in human evolution. If you had a cut a few thousand years ago, it likely made sense to retreat to your cave and let your wound heal, rather than to expose that wound to lots of germs found in the environment.
The inflammation that plays a role in depression is different. We are talking about chronic low-level inflammation caused by a pro-inflammatory diet, sedentary lifestyle, chronic infections, obesity, and many other lifestyle factors.
Inflammation can be measured in many different ways, and a simple lab test called the c reactive protein (CRP) is a good starting point. CRP is a readily available and inexpensive blood test that any lab can perform. Higher levels of CRP are associated with higher severity of depressive symptoms, higher risk of hospitalization, and greater likelihood of completed suicide (2). Inflammation in the brain causes a certain type of inflammatory depression with decreases in motivation and movement and increases in anxiety, arousal, and alarm (3). It is clinically useful to know if a depressed individual has elevated inflammatory markers because this will affect their treatment plan. Different medications may be effective with those with low versus high inflammation levels (4), and anti-inflammatory agents such as omega 3s, probiotics, and exercise, may be helpful (5).
This complex interplay of genetics with lifestyle and exposure determines whether someone will tip into depression or will remain well. I explore many other factors that contribute to the development of depression and other mental health conditions in my other blogs.
REFERENCES
Howard DM, Adams MJ, Clarke T-K, et al.: Genome-wide meta-analysis of depression identifies 102 independent variants and highlights the importance of the prefrontal brain regions. Nat Neurosci 2019; 22:343–352
Batty G., Bell S., Stamatakis E., Kivimäki M. Association of systemic inflammation with risk of completed suicide in the general population. JAMA Psychiatry. 2016;73:993–995. doi: 10.1001/jamapsychiatry.2016.1805.
Miller, A., Raison, C. The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nat Rev Immunol 16, 22–34 (2016). https://doi.org/10.1038/nri.2015.5
Jha MK, Minhajuddin A, Gadad BS, Greer T, Grannemann B, Soyombo A, Mayes TL, Rush AJ, Trivedi MH. Can C-reactive protein inform antidepressant medication selection in depressed outpatients? Findings from the CO-MED trial. Psychoneuroendocrinology. 2017 Apr;78:105-113. doi: 10.1016/j.psyneuen.2017.01.023. Epub 2017 Jan 24. PMID: 28187400; PMCID: PMC6080717.
Suneson K, Lindahl J, Chamli Hårsmar S, Söderberg G, Lindqvist D. Inflammatory Depression-Mechanisms and Non-Pharmacological Interventions. Int J Mol Sci. 2021;22(4):1640. Published 2021 Feb 6. doi:10.3390/ijms22041640
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