Researchers Study Relationship Between Inflammation and Depression

Anti-inflammatory medications and supplements are being studied as possible treatments for depressive symptoms

Systemic inflammation is a factor for many conditions, such as cardiovascular disease, cancer, and autoimmune disorders like rheumatoid arthritis. But there is increasing evidence that inflammation may play a major role in depression, too.

A recent study by researchers from Massachusetts General Hospital and other facilities, published in Psychotherapy and Psychosomatics, found that the anti-inflammatory psoriasis medication ixekizumab helped reduced depressive symptoms in people with moderate-to-severe psoriasis. Scientists believe that inflammation causes the red, flaky skin rash of psoriasis, as well as the depression that often accompanies this common skin condition.

Mass General is also studying the anti-inflammatory effects of omega-3 supplements as depression treatment for certain obese patients. Psychiatrist Maurizio Fava, MD, director of the Division of Clinical Research of the MGH Research Institute, suggests that because chronic inflammation may be at the root of depression in some individuals, anti-inflammatory treatments could have a significant role in depression treatment. He adds that this approach may be particularly effective with depressed patients who have elevated levels of proinflammatory cytokines. These are molecules excreted by certain cells in your immune system that promote inflammation.

“Inflammation and depression is a complex relationship,” Dr. Fava says. “In some cases, chronic inflammation may lead to depression; in other cases, it may be the other way around.”

Inflammation-Depression Link

Researchers have found that blood inflammatory biomarkers, including inflammatory cytokines, appear to access the brain and interact with the health and function of neurons (nerve cells), Dr. Fava explains. He adds that the activation of inflammatory pathways within the brain is thought to lead to decreased support for the health and growth of neurons and to greater oxidative stress, a condition that decreases cell function.

In a separate study also published in 2017, researchers found that in a group of more than 14,000 people, those who had depression had, on average, 46 percent higher levels of C-reactive protein, another biomarker of inflammation. That study could prove only an association between depression and inflammation, and not causation, but it added to a growing body of evidence that treating inflammation could have a profound effect on people also battling depression.

Health and Depression

The onset of depressive symptoms is common after the diagnosis of a chronic illness. The news that a person has cancer, heart disease, or another serious condition can trigger a cascade of emotions. Cardiologists, for example, should take careful note of a heart attack survivor’s emotional state after the event. Depressed individuals are less likely to take their medications as prescribed, follow a healthy diet, and exercise to help prevent further heart trouble.

Even if a physical ailment can be managed successfully, it isn’t always enough to relieve depressed feelings. Dr. Fava notes that in his study, another anti-inflammatory medication called etanercept (Enbrel) improved the psoriasis, but did not reduce symptoms of depression.

The interaction between inflammation and depression is still something of a mystery, though researchers are learning more every year. Even though there is still much to discover, there are several things you can do that may help reduce inflammation and depressive symptoms, while boosting your overall health. Among them are:

Manage your stress through exercise, yoga, meditation, better sleep, breathing techniques, and the avoidance of everyday stressors. Chronic stress can worsen inflammation and contribute to feelings of depression, anxiety, and irritability.

Avoid foods that contribute to inflammation, while consuming more foods that can help lower inflammation. Pro-inflammatory foods include fried foods, soda, red meat, and foods made with enriched white flour, such as white bread and pastries. Anti-inflammatory foods include leafy green vegetables, fish, nuts (almonds and walnuts), and a little olive oil.

Exercise most, if not all, days of the week for at least 30 to 40 minutes. Research shows that exercise can help fight the effects of age-related inflammation.

Don’t Wait to Get Help

It’s not uncommon to display depressive symptoms but not be consciously aware that anything has changed. You might blame feelings of sadness on the holidays, money troubles, the news, or some other external cause. But it’s possible that what is affecting your mood is something going on inside.

Dr. Fava says people who have been diagnosed with an autoimmune disease, such as psoriasis, or an inflammation-related condition, such as cardiovascular disease, should be aware that a change in mood may be something that can be addressed with medications, supplements, or lifestyle changes. “They should consult their doctor and perhaps obtain a referral to a mental health specialist,” Dr. Fava says. Seeing a therapist may help you cope better with depression, which in turn may make you more proactive toward other health challenges. MMM

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