Depression Is an Inflammatory Disease
I’m a big fan of the work Michael Maes, M.D., a Dutch biological psychiatrist
who now works in Australia. Dr. Maes has done much to establish the
biological correlates of mental illness, especially depression, and has shown
that inflammation and oxidative stress always accompany major depression.
Dr. Maes has also worked on the underpinnings of chronic fatigue syndrome
(known as myalgic encephalitis in other parts of the English-speaking world),
showing that it is “co-morbid’ with depression, that is, it shares many
signs, symptoms, and underlying pathologies.
Depression is an inflammatory disease
Dr. Maes is co-author of a recent paper, So depression is an inflammatory
disease, but where does the inflammation come from? From the abstract:
We now know that depression is associated with a chronic, low-grade
inflammatory response and activation of cell-mediated immunity, as
well as activation of the compensatory anti-inflammatory reflex
system… The obvious question this poses is ‘what is the source of
this chronic low-grade inflammation?’
A range of factors appear to increase the risk for the development
of depression, and seem to be associated with systemic
inflammation; these include psychosocial stressors, poor diet,
physical inactivity, obesity, smoking, altered gut permeability,
atopy, dental cares, sleep and vitamin D deficiency…
Most, but not all, of the above mentioned sources of inflammation
may play a role in other psychiatric disorders, such as bipolar
disorder, schizophrenia, autism and post-traumatic stress disorder.
The article goes on to discuss how these various factors raise levels of
inflammatory cytokines as well as levels of oxidative stress.
Lifestyle factors that can be modified to prevent
and treat depression
Of great interest is that of the ten factors listed above, at least eight are
amenable to change and/or manipulation. (The two that are not, at least in
part, are psychosocial stressors, particularly trauma or abuse in childhood,
and atopy, or a tendency to be hyperallergic.)
Poor diet: the authors point out that a high glycemic index diet devoid of
omega-3 fats and fruits and vegetables is associated with depression.
Fix: eat a diet low in refined carbohydrates, consider supplementing with
fish oil, and eat your veggies.
Exercise: “There is a substantive evidence base on the role of exercise as an
effective treatment strategy for depression.” The paper also notes that in
older people, sarcopenia (muscle wasting) is related to systemic
inflammation, and that resistance exercise ameliorates both sarcopenia and
inflammation.
Fix: exercise regularly, especially resistance training.
Obesity: ” With few exceptions, both clinical- and community-based crosssectional studies have consistently shown a relationship between obesity and
depression regardless of methodological variability. … Obesity is an
inflammatory state. Inflammatory cytokines have been found in abundance in
fat cells, are involved in fat metabolism and have been observed to be
positively associated with all indices of obesity, in particular abdominal
obesity.”
Fix: lose weight and/or maintain the lean state.
Smoking: “Cigarette smoke contains many thousands of chemicals, including
free radicals, metals, tars and other substances that induce inflammatory
responses in bodily tissues and increase levels of O&NS.”
Fix: don’t smoke.
Gut permeability: “A new potential pathway that may mediate depression
pathogenesis is increased immune responses against LPS [lipopolysaccharides]
of different commensal, gram negative bacteria.” What this means is that
increased gut permeability allows bacteria from the gut, or parts of their
cell walls, into the rest of the body, where they are carried by the
bloodstream everywhere. This causes an inflammatory response that may lead to
depression. This phenomenon is important in chronic fatigue as well.
Fix: this is a bit more difficult, but will involve a better diet, probably
of the low carb variety, high in saturated fats which will allow the gut to
heal. Coconut oil is beneficial here. Supplements to be considered for this
condition include n-acetylcysteine, probiotics, fish oil, and zinc.
Dental caries and periodontal disease: These are inflammatory, and gum
disease is related to heart disease, as well as depression.
Fix: an easy one: take care of your teeth and gums.
Sleep: Insomnia is related to depression.
Fix: get a good night’s sleep. Use of blue-blocking glasses and/or melatonin
may be helpful. Sleeping pills are bad news, and are related to a much higher
risk of death.
Vitamin D deficiency: Vitamin D reduces markers of inflammation, and its
deficiency is widespread.
Fix: get enough sun exposure, or supplement with vitamin D.
As we see, many factors associated with depression are quite modifiable, and
lifestyle factors appear to play a large role in depression.
PS: You can support this site by purchasing through my
Supplements Buying Guide for Men. No extra cost to you.
Subscribe and get my free book on fat loss