inflammation in the body is linked to a host of ills: cancer, heart disease, obesity, autoimmune disorders, digestive diseases, to name some of the biggies.
But what does it mean? Edward Bullmore, professor of psychiatry at the University of Cambridge, UK, proposes that for some, depression is actually the direct result of inflammation-which helps explain why, for some, the typical treatments (medication, talk therapy, even deep brain stimulation for severe cases of depressive disorder). We asked Bullmore about his startling theory.
It's hard to overstate how pivotal-and potentially-controversial-this theory is.
I saw a patient with arthritis in 1
It sounds like you've got the arthritis and depression separately, rather than the inflammatory causing arthritis, leading to depression. How does that work?
Inflammation is established science. Following certain diseases, trauma, or stress, the body has a natural inflammatory response to it. Unchecked or long-lasting inflammation is dangerous. The theory is known as cytokines, which send an inflammatory signal to the brain. The brain's immune cells may begin to produce cytokines themselves, which interfere with the brain's ability to use serotonin.
Yes. SSRIs that are supposing to boost serotonin will not be effective.
Yes, but it's based on new knowledge about the relationship between the immune and nervous systems. In the 1980s, it was regarded as the fact that the blood-brain barrier protected the brain from inflammatory proteins and immune cells circulating in the blood. Through advancements in science and technology,
No one is experiencing any kind of inflammation. Not everyone who is inflamed is depressed, and not everyone is depressed is inflamed. Depression is the same thing for everyone, and there is only one treatment for it. That's the mindset we've been stuck in for 40 or 50 years.
What has this impacted on our understanding of depression?
19659004] It's clear SSRI's work moderately well, on average. The key phrase is "on average." What that conceals is that for some depressed people, they work really well.
How long do we have new depression drugs that target inflammation?
I am cautious about making predictions. The process is long and complicated. There are some clinical trials with people who have arthritis and other inflammatory diseases. For them, we're maybe five years away from seeing a treatment approved. For the broader group, it wants to take longer.
What is the ultimate goal? There are clear differences in how patients respond to treatment.
For now, what can we do with this knowledge?  Patients and physicians alike need to reconsider what "going to the doctor" looks like. Seeing one doctor for mental health and another for physical health, as they are are two completely different things.
And if he thinks they are?
Look at various things that can lead to inflammation: diet, exercise, and stress. Practicing stress-reducing techniques might also have an antidepressant effect.
The post The New Thinking on Depression first appeared on Men's Journal.