This is potentially significant news for the 1 in 10 Americans who are suffering from major depressive disorders or mild depression with no apparent cause. Could some of those people be "fixed"? Cured even? Possibly without the use of SSRIs and other antidepressants whose side effects range from loss of libido (and pretty much no one welcomes that) and weight gain (again, not that charming) to gastrointestinal bleeding and suicidal thoughts (which pretty much negates the use of said antidepressant anyway).
As both a nurse and someone with bipolar disorder type two—which includes both depression and hypomania—let me pause here to break down this potentially momentous news.
Lesson One: Depression
First off, it's important to know that there are many types of depression, and that not all of them will be linked to inflammation. To wit:
Major depression is diagnosed when the patient experiences a loss of interest in previously enjoyed activities, and also involves weight gain, suicidal thoughts, and lack of energy. This is the type most likely to be associated with inflammatory processes. In fact, those suffering a major depressive disorder have a 30% increase in the inflammation markers in their brain.
There is also bipolar depression, the type I have, where the patient experiences depression coupled with bouts of mania or hypomania. This type of depression has a very strong genetic component and is unlikely to be related to other factors like inflammation.
Let's also not forget Seasonal Affective Disorder (shout out to my friends in the Midwest!), which occurs when people just never see the damn sun. A deficiency in Vitamin D coupled with the general dreariness of winter could explain this, but inflammation could be compounding the issue.
There's also postpartum depression, psychotic depression, and situational depression, none of which seem to have a strong link to inflammation.
Got it? Good. Now, you're probably asking: What's this inflammation thing all about?
Lesson Two: Inflammation
As a quick debrief, inflammation is in essence your body's response to some unwelcome stimuli, like the flu or a burn. Think of it this way: Any injury, even a simple cut or burn, sends a quick signal to your brain; a sort of fire alarm if you will. The brain responds in turn with a rush of blood and other goodies to the site of the injury. This sets into motion the wonder that is healing . . . the result of which is, you guessed it, inflammation. This type of response falls into the acute category of inflammation, meaning it happens quickly and usually resolves quickly.
In some cases, inflammation is a chronic issue (that link will direct you to a very comprehensive look at inflammation, and is basically third year medical school info, so feel free to skip). This includes things like autoimmune disorders. These are usually an unwelcome case of the aforementioned inflammatory response, and typically physicians and nurses (like me) will treat them with an anti-inflammatory medication (such as ibuprofen, sometimes steroids) or some other drug.
All of which leads us to the most pressing question: What is the cause of the inflammation that could be linked to depression? And wait a minute . . . what if I just take some Advil?
Sadly, it's not so simple.
Lesson 3: What It All Means
The inflammation immune response is designed to protect you. It's your bodyguard, so to speak. (Well, it's more like CPR, but you get the idea.) When you are chronically infected, however, your immune response gets sort of tired—because hey, everyone needs a nap sometimes, even your immune system. And it seems like maybe this prolonged inflammation, and exhausted immune system, is connected to the non-genetic, non-situational type of depression.
Some of the known triggers of this type of inflammation include: excess weight, prolonged levels of anxiety, and smog. So pretty much everyone in America is at risk. Encouraging news. Thanks for nothing, scientists!
There has been a lot of buzz in recent years about gluten being an inflammatory offender, which would also implicate the paleo diet that seems still to be all the rage. (Count me out; I like cake. Made with flour that is not rice or almond.)
A bunch of other awesome foods are also included on the list of inflammation triggers, like sugar (say it ain't so!), trans fat (goodbye beloved Oreos—though to be fair they don't have trans fat anymore), and milk (oh ice cream, how I'll miss you!)
It can also be caused by an imbalance of omegas, which means more fish, less burgers are in order.
And wait, what's this? Even alcohol is bad? Well, forget that. That's just going too far . . .
We are only just beginning to understand the far-reaching effects of these processes and their causes. But this is promising news for sufferers of chronic depression who may find that they can affect change in their own body simply by altering a few habits. This could be a game changer for people who have negative reactions to SSRIs (so pretty much everyone) or those who just don't want to deal with their super-fun (not!) side effects.
Until further research is conducted, though, you'll find me huddled in a corner with a slab of chocolate cake and a glass of wine, pretending I never wrote this.