Health Update: Inflammation, Not Serotonin Levels…Linked to Depression
Hello again everyone:
Here is some interesting news about depression. The study below found the following data:
“The main areas of serotonin research provide no consistent evidence of there being an association between serotonin and depression, and no support for the hypothesis that depression is caused by lowered serotonin activity or concentrations. Some evidence was consistent with the possibility that long-term antidepressant use reduces serotonin concentration.” https://www.nature.com/articles/s41380-022-01661-0
So, if it is NOT serotonin, then what do you think has been found to correlate with depression? Well, if you know my area of research, then you know the answer is: inflammation. Please recall that almost all inflammation is related to, caused, aggravated, or perpetuated by the immune system. Here are some links to reveal the knowledge base about this critical topic:
“Depression represents the number one cause of disability worldwide and is often fatal. Inflammatory processes have been implicated in the pathophysiology of depression. It is now well established that dysregulation of both the innate and adaptive immune systems occur in depressed patients and hinder favorable prognosis, including antidepressant responses.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381373/
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. It is similarly accompanied by increased oxidative and nitrosative stress (O&NS), which contribute to neuroprogression in the disorder. The obvious question this poses is ‘what is the source of this chronic low-grade inflammation?’ https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-200
Bottom Line: In depression, as well as anxiety and brain fog (any brain issue), to reach optimal improvement requires finding and reducing or controlling all sources and drivers of inflammation. The last paper has a partial list:
“This review explores the role of inflammation and oxidative and nitrosative stress as possible mediators of known environmental risk factors in depression and discusses potential implications of these findings. 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 (insulin resistance), smoking (air pollution along with altered oxygen status such as anemia), altered gut permeability, atopy (allergies), dental cares (includes any latent infection such as mono or Lyme etc.), sleep and vitamin D deficiency. (One could also look at Omega-3’s, all B vitamins, Probiotics, and Magnesium)
The identification of known sources of inflammation provides support for inflammation as a mediating pathway to both risk and neuro-progression in depression. Critically, most of these factors are plastic (modifiable), and potentially amenable to therapeutic and preventative interventions. 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 best way to check out all these health issues and reduce or improve or get rid of them, is through a thorough functional neurologic and functional medicine evaluation in association with primary care providers treating mental health patients. In my opinion, when it comes to depression, we should not limit care to only medications, or only nutrition or exercise, but all tools should be appropriately evaluated and applied as needed. When the brain is inflamed it simply does not work right, and depression can be a symptom. Note that in the first quotation listed above that the efficacy of anti-depressants is less in those that are inflamed…a strong key to how important it is to identify and reduce inflammation sources. Finally, the last quotation and reference below summarizes how nutritional therapeutics should be important adjunctive care in depression and other mental health issues. It may also be that some anti-depressant meds have an anti-inflammatory effect that will be elucidated in future studies. And please note: if you are taking any prescriptions for depression, do not stop them without clearance and a schedule to wean off of them slowly with the prescribing physicians assistance.
“In summary, nutrition and nutraceuticals should now be considered as mainstream elements of psychiatric practice, with research, education, policy, and health promotion reflecting this new paradigm.”
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