Last Saturday whilst in a local coffee shop, my partner pointed to a headline on the front page of The Times magazine – What if depression isn’t all in the mind? Naturally I was curious to read the article inside.
It was by William Leigh and concerned the book “The inflamed mind” by Edward Bullmore, a British psychiatrist and university professor who believes, we may have unwittingly let some of those who suffer with depression down, as we're only just understanding the link between inflammation and its impact on the brain.
7 paragraph summary
1. The medical profession tends to separate the body from the mind. Doctors treat the body and psychiatrists treat the mind. This can be unhelpful in dealing with depression as it can be a product of both the mind and the body due to the continuous feedback loop between the mind, body and brain.
2. In medicine, generally blood tests are used to indicate issues and drugs are then prescribed against particular biomarkers. However, this is not the case for the prescription of anti-depressants. The level of serotonin is unlikely to be tested for pre-prescription so the outcome of taking these drugs is hit and miss.
3. Bullmore wanted to find a more effective treatment for depression so spent years looking at magnetic resonance imaging (MRI) brain scans of those who suffered with the disease at Addenbrooks. A unit funded by GlaxoSmithKline. A major issue with MRI scanning though is the technology just isn’t powerful enough for looking at the brain in detail as “the smallest things we can see is about 1 cubic millimetre. And that contains 100,000 neurons.” This led to the decision in 2010 by GSK and other major pharmaceutical companies to stop trying.
4. So Bullmore switched to studying the immune system (in another laboratory funded by GSK) and found others had begun to make a connection between inflammation (generated by the immune system) and depression as well as other diseases such as heart disease. The positive in this research area is you can use biomarkers to see what is going on in the body.
5. Today he is the lead scientist in a study of mood disorders. Research is finding “...if you take blood from people who say they are depressed, it shows a higher level of inflammation than samples from people who are not depressed,” suggesting the brain becoming inflamed may play a role in depression.
6. To prove that inflammation causes depression, experiments have been carried out on rats who display depressive behaviour when injected with proteins that signal inflammation. There is also a lot of anecdotal evidence that people who have been vaccinated feel low afterwards. This is especially true for almost everybody who is treated for hepatitis B with interferon which floods the body with inflammation, “around a third of these patients feel depressed for weeks”.
7. DNA research has found that many genes in common to depressed people “turn out to be genes for the immune function.” Indeed the mutation of olfactomedin 4 a gene linked to depression causes a strong inflammatory response to certain types of bacteria when they enter the gut.
Why this matters
Unlike traditional eastern medicine that considers health holistically, we don't tend to recognise ourselves as a connected system and instead think of our bodies like machines with independent parts. This can lead to believing that we do not need to take responsibility for our own health as we can not influence what occurs within us.
But it isn't only western medicine that separates our heads from our bodies. It is deep rooted in our culture to separate these two parts; consider Descartes' famous phrase "I think therefore I am" or our education system, geared to producing thinkers. The emphasis is on the head/brain rather than the whole human that we are.
The immune system’s inflammatory processes are not just triggered by injury to, or illness in, the body. The stress response (fight/flight/freeze) also floods the body with inflammation as the immune system switches on to prepare us for physical wounding (Slavich and Irwin, 2014). Additionally inflammation can be caused by the foods we eat - sugar, processed foods, fried foods, gluten (Harvard Medical School, 2014).
This makes me ask is the depression epidemic caused by a combination of stress, illness and the food choices we make?
Last month I heard about a friend of a friend who has been diagnosed with depression and been prescribed Prozac (fluoxetine). When this person shared this news with others they found that within that group 3 more were also on it and one had been for a decade. I hope that this kind of research results in a more personalised and relevant treatment programme than the current "take and wait", almost human experiment, approach.
And on a personal note, my last negative thinking ride and related time in the depression well coincided with recovering from the flu. I wonder now if the inflammation in my body that fought off that virus may have inflamed my brain in some way.
I have ordered and look forward to reading this book.
Bullmore, E. 2018 "The Inflamed Mind" Short Books, London
Harvard Medical School 2014, Foods that fight inflammation Harvard Health Publishing, Boston, Massachusetts.
Leigh, W. 2018, "The Depression Epidemic: We're on the cusp of a revolution" The Times Magazine, 21 April, pp 18-23
Slavich, G. M., & Irwin, M. R. 2014 From stress to inflammation and major depressive disorder: A social signal transduction theory of depression. NCIB, Bethesda, Maryland