Depression is categorized as a psychological disorder,
with the main treatment being talk therapy and selective serotonin reuptake inhibiters
(SSRIs) that mainly function in the brain to increase the neurotransmitter
serotonin (the happy drug). However, those that suffer from treatment-resistant
depression know that the pain is not always psychological. While it may be playfully
called a “heartache” or a “psych-ache”, the somatic symptoms felt by those with
persistent depressive disorder (dysthymia) is anything but in their heads.
The case for the physical-embodiment of the
crippling depression experienced by so many people may be coming to light with
a new type of depression treatment: anti-inflammatory drugs. “Within the recent
decades, comprehensive evidence has accumulated associating depression with
increased activity in the immune system,” (Kohler et. al. 2016). An increased immune
system is often a danger for those with physical abnormalities, such as those
with allergies and transplants. When the immune system is too high, the body
begins to attack its own cells violently, causing widespread inflammation and in
some cases, death. It is this property of immunity that may be the cause of
somatic pain in those with chronic depression.
“During
inflammation, the blood-brain barrier may become more permeable. Furthermore,
stimulation of peripheral nerves, in particular the vagus nerve, may represent
another pathway between the CNS and the peripheral immune system,” (Kohler et.
al. 2016). Both of these points are key to uncovering not only the reason for bodily
pain in depressed patients, but also a promising possibility for treatment. The
vagus nerve runs from the brain, through the chest (behind the heart), and down
into the abdomen. It is often associated with mood and truncal homeostasis, and
vagus nerve dysfunction can cause depression and anxiety, as well as increased
inflammation.
Luckily, many experiments
have been run using a mixture of SSRIs and non-steroidal anti-inflammatory
drugs (NSAIDs). The results are promising: “For NSAIDs, data indicate their
administration during a depressive episode to have positive effects on severity
and outcome, especially when combined with conventional antidepressants,” (Schmidt
et. al. 2016). With this in mind, the future for those suffering from chronic depression
with inflammation is brighter than it has been in a very long time.
Sources
Kohler,
O., Krogh, J., Mors, O., & Benros, M. E. (2016). Inflammation in depression
and the potential for anti-inflammatory treatment. Current Neuropharmacology, 14(7).
doi:10.2174/1570159X14666151208113700
Schmidt,
F. M., Kirkby, K. C., & Lichtblau, N. (2016). Inflammation and immune regulation
as potential drug targets in antidepressant treatment. Current Neuropharmacology, 14(7).
doi:10.2174/1570159x14666160115130414
This seems like a really interesting type of treatment. I like that this sort of treatment could help to diminish the stigma behind depression. I like that this would take some of the blame out of a diagnosis of depression giving a biological reason for it.
ReplyDeleteWhen you first mentioned this topic to me, it really got stuck in my brain. As someone with depression, it's crazy to think I could be "sick" because of inflammation somewhere in my body, even though it's not a nonsensical conclusion. Of course everything we do or eat or let come in contact with our bodies would have some sort of effect on us; why shouldn't inflammation cause so many chronic illnesses? I'm interested to see more research on the topic. Great job on this post!
ReplyDeleteThis is such an exciting treatment option and it makes a lot of sense. There’s so much stigma surrounding mental health, when in truth, it is just as much a physical ailment as anything else. It seems like this approach marks a new wave of thinking about mental health.
ReplyDelete