Identify The Invisible Links Of Depression

Depression is a complex condition. About 30 million Americans have had at least one occurrence of severe depression in their life time.

Depression can be linked to traumatic events in your life, such as loss of a loved one, stress and hormonal fluctuations, illnesses, specific drugs, or drug/alcohol abuse. Recent studies have shed new lights on different sources of depression.

Depression Is Associated With Inflammation.

Anyone who has experienced a viral or bacterial infection knows what it means to feel sick. Sickness leads to fever and nausea, lack of appetite and loss of interest in physical and social surroundings. Sick people exhaust easily, and have deprived sleep. In addition, they feel unhappy and prickly; suffer from shortened attention span and short-term memory loss.

Just as terror is normal in the face of a predator, sickness is a normal reaction to infection triggered by factors called inflammatory cytokines/markers created by body’s immune and inflammatory cells.

There is a growing evidence to implicate that inflammation is associated with depression. Here is some of the evidence:

• Augmented levels of inflammatory cytokines can stimulate depressive behavior.

• Inflammatory cytokines can enter the brain and change the levels of neurotransmitters such as dopamine and serotonin in the brain.

• Levels of inflammatory cytokines are much higher in people experiencing stress, anguish, depression, and other difficult emotions.

• Higher levels of inflammatory markers preceded the beginning of depressed mood in an elderly population with no psychiatric history.

• Depression is frequently associated with a variety of factors (e.g., psychosocial stress, medical illness, obesity, poor diet, diminished sleep, social isolation) that are known to give rise to an increase in inflammatory markers.

• Depression is a well-known complication of inflammatory and autoimmune diseases.

• Depression shares similarities with ‘sickness behavior’, a normal response to infection or inflammation.

• In cancer and hepatitis C patients receiving immunotherapy, depression appeared in up to 50% of patients.

• Neurochemical findings in autopsy studies suggest an inflammatory component to depression.

• Medications with an effect on the immune system can affect mood.

Inflammatory Cytokines Play A Key Role In Depression

Researchers do not know why inflammatory cytokine levels are higher in depressed and anxious people. They speculate that psychological trauma can alter blood pressure and heart rate. These stress-related changes can lead to the discharge of cell signaling molecules that encourage cytokine production. Other source of elevated inflammatory cytokines include smoking, high fat diet, and being overweight.

Various scientific observations suggest inflammatory cytokines have a key role in depression. Inflammation may initiate, worsen, and lengthen depression through:

• Hyper-responsiveness to acute stress

• Dampened immune system

• Neuronal damage and neuron death

• Reduced neuron renewal

• Increased neurotoxic end products

Links Connecting Depression And Inflammatory Disorders

Accumulating studies have revealed compelling relationships among depression and well-known inflammatory or autoimmune diseases such as heart disease, diabetes, cancer, Chronic Obstructive Pulmonary Disease (COPD), and Inflammatory Bowel Syndrome (IBS). Therefore, it is important to recognize inflammation as a shared factor that may trigger several health issues.

Depression is a recognized risk factor for the development of heart disease, as well as an independent forecaster of poor prognosis following a cardiac event. For example, patients with coronary heart disease are three times more susceptible depression than the general population.

Stress could be an underlying trigger that causes the development of both depression and heart disease. Stress can precipitate depression by stimulating the nervous system, disrupting heart rhythm, increased tendency for clotting of the blood, and intensified inflammatory responses, all of which negatively impact the cardiovascular system.

Inflammation that worsens both the disease and the tendency towards depression is observed in diabetes and cancer. While negative emotions may not increase the risk of advancing diabetes or cancer, they could intensify these illnesses.

There is evidence that once you have cancer, psychological stress and depression can aggravates the cancer through elevated levels of inflammatory cytokines. Research proves that inflammatory cytokines can cause challenge to chemotherapy, accelerating the transition of tumor cells into advanced cancer. Some cytokines seem to encourage the formation of new blood vessels that nourish tumors, the key process in tumor metastasis.

Several large studies demonstrated the evidence that patients with COPD are at an increased risk of developing depression. Despite advances in various treatments, the death rate associated with COPD has doubled in 30 years. The presence of anxiety and depression has been linked to increased death, weakened functional status, and decreased quality of life.

Of people who suffer from Inflammatory Bowel Syndrome (IBS), more than 20% have depression. Evidence also suggests depression can aggravate IBS.

Links Between Depression And Inflammatory Skin Conditions

Depression is commonly associated with inflammatory skin conditions such as psoriasis, acne and rosacea.

Psoriasis is a hyper-proliferative inflammatory skin disease that often occurs as thick, red, scaly lesions. Multiple studies have established that depression is a common challenge among psoriasis sufferers, which can change the progress of psoriasis as well as the effectiveness of treatments.

The association between depression and acne has long been documented, especially in teenagers. Acne raises the risk of depression and suicide attempt. Depression can also aggravate acne.

Control Of Inflammation Represents A Novel Approach To Relieve Depression

Evidence shows that inflammatory cytokines induce not only signs of sickness, but also true disorders in susceptible individuals and physically ill patients despite the fact that they have no previous history of mental disorders.

The findings that inflammation can essentially initiate depression and various chronic disorders suggest that targeting inflammatory responses could be an innovative approach to treat depression and associated health concerns. Various studies are under way to treat symptoms of depression with anti-inflammatory drugs including non-steroidal anti-inflammatory drugs (NSAIDs). Encouraging results have been achieved by blocking inflammatory cytokines in psoriasis and from the treatment of COX-2 inhibitors in patients with depression.

Herbal Treatments For Relief of Inflammation And Depression Symptoms

For decades, NSAIDs have been widely suggested for various aspects of flu-like symptoms or sickness-related behaviors. Unfortunately, 25% of NSAIDs users encounter severe and sometimes deadly complications such as stomach ulcers and gastrointestinal bleeding. The newer NSAIDs such as selective COX-2 inhibitors (Vioxx and Celebrex) have been associated with an increased risk of severe adverse cardiovascular events including heart attack and stroke.

In this scenario, the good news is that safer treatments are available. You can fight depression and anxiety without the side effects of antidepressant drugs or NSAIDs! Nutrients, anti-inflammatory herbs and herbal remedies have been demonstrated to alleviate depression symptoms.

By keeping inflammation under control, anti-inflammatory therapies may:

• Improve sleep and ease headaches and anxiety

• Help restore the balance of nitric oxide and prostaglandins, which influences the severity of depression, anxiety, and sexual dysfunction

• Repair the body’s antioxidant defense

• Boost the vascular healing and repair

• Reestablish vascular cell function and integrity

Millions of people go undiagnosed or untreated for depression. Without treatment, depression may linger for 6 months or longer, with increased occurrence and severity of episodes.

If you feel the pain from depression, or your symptoms of depression continue despite the treatment of anti-depressant drugs, or your anti-depressant drugs become less helpful, you may need to recognize inflammatory sources and seek for anti-inflammatory remedies.

References:

1. Inflammatory mechanisms in major depressive disorder. Raedler TJ. Current Opinion in Psychiatry. 24(6):519-25, 2011

2. Inflammatory cytokine levels and depressive symptoms in older women in the year after hip fracture: findings from the Baltimore Hip Studies. Matheny ME. et al. Journal of the American Geriatrics Society. 59(12):2249-55, 2011

3. Association between social isolation and inflammatory markers in depressed and non-depressed individuals: results from the MONICA/KORA study. Hafner S. et al. KORA Study Investigators. Brain, Behavior, & Immunity. 25(8):1701-7, 2011

4. Cytokines mediated inflammation and decreased neurogenesis in animal models of depression. Song C. Wang H. Progress in Neuro-Psychopharmacology & Biological Psychiatry. 35(3):760-8, 2011

5. Glucocorticoids, cytokines and brain abnormalities in depression. Zunszain PA. et al. Progress in Neuro-Psychopharmacology & Biological Psychiatry. 35(3):722-9, 2011

6. Inflammatory biomarkers in depression: an opportunity for novel therapeutic interventions. Li M. Soczynska JK. Kennedy SH. Current Psychiatry Reports. 13(5):316-20, 2011

7. Altered expression of genes involved in inflammation and apoptosis in frontal cortex in major depression. Shelton RC. et al. Molecular Psychiatry. 16(7):751-62, 2011