Inflammation and Mood

There has been a growing body of research around the idea that inflammation could be contributing to and/or causing mood disorders. Depression is commonly found in people who are also suffering from autoimmune diseases, gastrointestinal inflammation, cardiovascular diseases, type 2-diabetes, and cancer, all of which have chronic low-grade inflammation as a substantial contributing factor (Balacco, et al., 2011). Research suggests that dysfunction of the “gut-brain axis” may be the primary cause of inflammation, and that treating gastrointestinal inflammation with Vitamin B, Vitamin D, probiotics, and Omega-3 fats may improve depressive symptoms by lessening inflammation in the brain (Balacco, et al., 2011). Essentially, when you are experiencing chronic inflammation, it wreaks havoc on your body and can affect your brain as well.

Other sources suggest that not only does inflammation play a role in depression, but it may be its primary cause (Kendall-Tackett, 2007). Cytokines found in the blood, and inflammatory messengers such as IL-1, IL-6, CRP, and TNF-alpha have been shown to be linearly correlative (Howren, 2009) and predictive for depression (Cauley, 2012). It has been validated that in depression and bipolar, white blood cells called monocytes express genes that are pro-inflammatory leading to the release of cytokines. This simultaneously leads to decreased cortisol sensitivity, which is the body’s stress hormone and inflammatory buffer creating a harmful cycle (Bergink, et al., 2014). Once these inflammatory agents are triggered they transfer information to the nervous system, usually through stimulation of major nerves mainly the vagus, which connects the gut and the brain. Microglia are the specializes cells in the brain related to immunity and they are activated in inflammatory states (Cohen, 2002).

A number of trials have looked at the role of anti-inflammatory agents in reducing depressive symptoms. In a recent trial, patients who had been identified as resistant to antidepressant treatment and had serum levels of CRP >3mg/L were responsive to treatment with infliximab (Remicade), which is a TNF-alpha antagonist (anti-inflammatory) (Drake, 2013).

There was a recent case in 2015, where a patient who had recently received a gastrectomy developed their first manic episode. The researchers thought that this could be related to intestinal barrier dysfunction and altered gut microbiota. The patient was given activated charcoal, which absorbs inflammatory cytokines. It acts by neutralizing the effect of inflammatory mediators in the gut, and was thought to improve both manic symptoms and systemic inflammation. After the treatment began, 15 days later, the patient was asymptomatic for mania, and remained so at 8 months follow up. No psychiatric drugs were used (Boukouaci, 2015).

Given this information, what in our diet and lifestyles causes inflammation? Wouldn’t it make sense to identify and reduce these things in an attempt to alleviate psychiatric symptoms? One of the main contributors to inflammation is gluten intolerance, which has been shown to cause seizures, headaches, multiple sclerosis/demyelination, depression, anxiety, and ADHD. This is not just a concern with those who have celiac disease, as inflammation has been shown to occur in those who have gluten sensitivities and may not even be aware of it (Eaton, 2012; Ford, 2009).

Herbicides, such as the commonly used RoundUp, have been shown to kill beneficial bateria and promote inflammation in our gut. This has an affect on our micribiome every time we consume food that has been sprayed with this product (Samsel, 2013). NSAID’s have been shown to damage the gut lining and cause inflammation (Bjarnason, 1998). Insufficient sleep has also been shown to increase inflammation and cognitive impairment (Archer, 2013). Gluten, herbicides, NSAID’s, and lack of sleep could all be contributing to the amount of inflammation in a person’s body, and therefore their mood as well.

There are also many things that we can do to reduce inflammation in our bodies. Consuming probiotics have been shown to improve brain function by altering the intestinal microbiota (Ebrat, 2013). Consuming sufficient Omega-3 fats has also been shown to reduce inflammation, decrease anxiety (Andridge, 2011), and reduce depressive symptoms (Carlezon, 2005). Meditation has been shown to reduce inflammation (Davidson, 2013). The spice tumeric was shown in a study to improve depression more than Prozac (Goel, 2014), perhaps this is due in part to its powerful anti-inflammatory effects (Aggarwal, 2004).

Implementing anti-inflammatory measures into our lives can not only help to prevent future psychiatric disturbances, but it can also help in relieving current symptoms as well. Mental health professionals could help prevent and reduce psychiatric symptoms in their patients by informing them of things to avoid as well as things to bring into their lives to reduce inflammation. Clearly more research should be pursued in this, but reducing inflammation is a proven way to help relieve mood disturbances.

 

Works Cited:

Aggarwal, B. B., et al., (2004), Nonsteroidal anti-inflammatory agents differ in their ability to suppress NF-kappaB activation, inhibition of expression of cyclooxygenase-2 and cyclin D1, and abrogation of tumor cell proliferation, Oncogene, 23(57):9247-58, doi: 10.1038/sj.onc.1208169

Andridge, R., et al., (2011), Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial, Brain, Behavior, and Immunity, 25(8):1725-34, doi: 10.1016/j.bbi.2011.07.229

Archer, S. N., et al., (2013), Effects of insufficient sleep on circadian rhythmicity and expression amplitude of the human blood transcriptome, PNAS, 110 (12): 1132-1141, doi: 10.1073/pnas.1217154110

Balacco, G., et al., (2011), Role of gastrointestinal inflammations in the development and treatment of depression, Orvost Hetilap, 152(37): 1477-85, doi: 10.1556/OH

Bergink, V. et al., (2014), Inflammatory activation is associated with a reduced glucocorticoid receptor alpha/beta expression ratio in monocytes of inpatients with melancholic major depressive disorder, Translational Psychiatry, 4, e344, doi: 10.1038/tp

Bjarnason, I, et al., (1998), Intestinal permeability and inflammation in patients on NSAIDs, Gut, 43(4):506-11, doi: 10.1136/gut.43.4.506

Boukouaci, W., et al., (2015), Resolution of a manic episode treated with activated charcoal: Evidence for a brain–gut axis in bipolar disorder, Australian and New Zealand Journal of Psychiatry, 1-3, doi: 10.1177/0004867415595873

Carlezon Jr., W.A., et al., (2005), Antidepressant-like effects of uridine and omega-3 fatty acids are potentiated by combined treatment in rats, Biological Psychiatry, 57(4): 343–350, doi: http://dx.doi.org/10.1016/j.biopsych.2004.11.038

Cauley, J. A., et al., (2012), How predictive of dementia are peripheral inflammatory markers in the elderly?, Neurodegenerative Disease Management, 2(6): 609–622, doi: 10.2217/NMT.12.68

Cohen, H. J., (2002), Cytokines and Cognition—The Case for A Head-to-Toe Inflammatory Paradigm, Geriatric Bioscience, 50:2041–2056, Retrieved January 30, 2016, from http://www.usc.edu/projects/nexus/faculty/dept-ldsg/finchcaleb/388%20Finch%20Cytokines%20and%20Cognition.pdf

Davidson, R. J., et al., (2013), A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation, Brain Behavior and Immunity, 27(1):174-84, doi: 10.1016/j.bbi.2012.10.013

Drake, D. F., et al., (2013), A randomized controlled trial of the tumor necrosis factor antagonist infliximab for treatment-resistant depression: the role of baseline inflammatory biomarkers, JAMA Psychiatry, 70(1):31-41, doi: 10.1001/2013

Eaton, W.W., et al., (2012), Neurologic and psychiatric manifestations of celiac disease and gluten sensitivity, Psychiatric Quarterly, 83(1): 91–102, doi: 10.1007/s11126-011-9186-y

Ebrat, B., (2013), Consumption of fermented milk product with probiotic modulates brain activity, Gastroenterology, 144(7):1394-401, doi: 10.1053/j.gastro.2013.02.043

Ford, R. P., (2009), The gluten syndrome: a neurological disease, Medical Hypotheses, 73(3):438-40, doi: 10.1016/j.mehy.2009.03.037

Goel, A., et al., (2014), Efficacy and safety of curcumin in major depressive disorder: a randomized controlled trial, Phytotherapy Research, 28(4):579-85, doi: 10.1002/ptr.5025

Howren, M. B., (2009), Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis, Psychosomatic Medicine, 71(2):171-86, doi: 10.1097/PSY

Kendall-Tackett, K., (2007), A new paradigm for depression in new mothers: the central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health, International Breastfeeding Journal, 2: 6, doi: 10.1186/1746-4358-2-6

Samsel, A., (2013), Glyphosate’s Suppression of Cytochrome P450 Enzymes and Amino Acid Biosynthesis by the Gut Microbiome: Pathways to Modern Diseases, Entropy, 15(4), 1416-1463, doi: 10.3390/e15041416

 

 

 

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