Depression is a Disorder of Inflammation in Many Cases

849 depression and inflammation

Depression is one of the most common mental disorders in the United States, affecting more than 16 million people. As such, antidepressant use has jumped by 65 percent in the last 15 years, with one in eight Americans over the age of 12 taking antidepressants.

These statistics are alarming considering the root causes of depression are going unaddressed. Like pain or injury anywhere in the body, depression is a warning flag from the body that the system is out of balance. Stamping out the root causes of depression is like removing the engine light in your car instead of investigating what’s wrong with the car.

In functional medicine we look at the body as an integrated whole, with all parts working together and influencing one another. If you understand human physiology, it doesn’t make sense to isolate and treat one part of the body — such as the brain in depression — without including the overall health of the body.

Many factors can play into depression, including blood sugar imbalances, hormonal imbalances, immune dysregulation, gut health, and gut microbiome dysfunctions.

All of these factors can lead to brain inflammation, which scientists are increasingly finding is the most common cause of major depressive disorder. This type of depression does not respond to antidepressants.

Antidepressants target brain chemicals. called neurotransmitters, that govern mood, motivation, behavior, and mental activity. Some natural remedies, such as 5-HTP or Saint John’s Wort, also target neurotransmitters.

However, this model does not take into account newer research that shows depression is usually due to inflammation. Inflammation in the brain disrupts brain function in several ways that leads to depression.

Brain inflammation slows firing between neurons

Your brain operates through communication, or firing, between neurons. However, when the brain becomes inflamed, the inflammation slows down conduction between neurons. Slowed firing between neurons in the frontal and limbic lobes of the brain leads to depression.

Brain inflammation prevents the production of neurotransmitters

Feeling happy and content instead of depressed depends on proper neurotransmitter production and activity in the brain. Brain inflammation has been shown to sabotage the synthesis of dopamine and serotonin, the two neurotransmitters most associated with depression.

Dopamine is called the “pleasure and reward” neurotransmitter. Symptoms of low dopamine include:

  • Inability to handle stress
  • Inability to self-motivate
  • Inability to start or finish tasks
  • Feelings of worthlessness
  • Feelings of hopelessness
  • Short temper over minor upsets
  • Isolating oneself from others
  • Unexplained lack of concern for family and friends

Serotonin is the “joy and well-being” neurotransmitter. Symptoms of low serotonin include:

  • Feelings of depression
  • Feelings of inner rage and anger
  • Difficulty finding joy from life’s pleasures and favorite activities
  • Depression when it is cloudy or when there is lack of sunlight
  • Not enjoying friendships and relationships
  • Not enjoying favorite foods
  • Unable to fall into deep restful sleep

As dopamine levels drop, you lose your motivation and drive. As serotonin drops, you lose your mood, sense of happiness, and satisfaction with things you used to love.

While this may look like a neurotransmitter problem, antidepressants typically have no effect because they do not address the brain inflammation causing it.

Brain inflammation prevents neurotransmitter receptor sites from working well

Brain inflammation also inhibits the function of receptor sites on neurons for neurotransmitters. Even if there is enough dopamine or serotonin in the brain, brain inflammation will prevent receptors from responding to them appropriately. This prevents neurons from communicating with one another efficiently and depression results.

Brain inflammation and depression are signs the brain is degenerating too fast

The brain is made up of two types of cells: neurons and microglia cells. Microglia cells are the brain’s immune cells and facilitate healthy neuron function, respond to foreign invaders, and clean up plaque and debris.

However, the brain’s immune cells don’t have an off-switch like the body’s. When they are triggered by a brain injury, an inflammatory food, unstable blood sugar, a chronic infection, poor gut health, infectious bacteria in the gut, chronic stress, alcohol abuse, and other insults, they become over-activated in an effort to protect the brain. Unfortunately, they don’t necessarily turn off afterward and can stay in a “primed” over active state indefinitely if constantly triggered by poor dietary and lifestyle choices. This is what causes brain inflammation and depression.

I hope you can see now why so many people don’t respond to antidepressants and why it’s so important to address the root causes of depression. Failing to do so allows brain inflammation to continue unchecked, raising the risk of dementia, Alzheimer’s, Parkinson’s, and other brain degeneration diseases. Ask my office how functional medicine can help you tame brain inflammation and overcome depression.

How to Support Your Brain’s Happiness Chemical

836 serotonin basics

Many people take SSRI antidepressants for depression. However, it’s important to ask why you are feeling depression in the first place.

Many important research strides have been made linking chronic inflammation, poor gut health, gut bacteria, and general brain health with depression.

However, we still need healthy serotonin activity, the target of SSRIs, to feel good.

Do you have these symptoms of low serotonin?

  • No longer finding joy, pleasure, or enthusiasm in life
  • Rage and anger
  • Depression
  • Depression related to lack of sunlight
  • No longer enjoy hobbies, favorite foods, friendships, or relationships
  • Unable to sleep deeply or feel rested from sleep
  • Life looks good on paper but doesn’t feel good

Light. The brain depends on sufficient light to manufacture serotonin, so being indoors all the time or in chronically dark or grey weather can affect serotonin activity.

Estrogen. In women an estrogen deficiency can lead to poor serotonin activity. This can explain why some women who are perimenopausal or post-menopausal experience depression.

Although it’s important to use functional medicine to address the cause of low estrogen, such as blood sugar or adrenal imbalances, some perimenopausal or post-menopausal women may still need bioidentical hormone replacement. In these situations, estrogen therapy can deplete the methyl donors necessary for serotonin synthesis, making it important to supplement with them: methyl B-12, SAMe, or MSM (methylsulfonylmethane).

Diet. Some nutritional advice will tell you to address low serotonin activity with foods high in tryptophan, a precursor amino acid to serotonin. However, clinically we really don’t see this work.

Better nutritional advice is to eat a diet that keeps blood sugar stable and does not inflame the gut or the body. This means avoiding sugar and processed carbohydrates, avoiding foods that trigger an immune response, and eating lots of diverse vegetables to foster healthy and diverse gut bacteria.

Blood sugar and gut inflammation. Unstable blood sugar — blood sugar that is either too low or too high — can significantly impact serotonin activity, leading to depression. The same goes for a diet that inflames the gut and the body.

Iron. Additionally, an iron is deficiency can cause low serotonin production. Things that can cause iron deficiency include iron anemia, celiac disease, leaky gut, heavy periods, parasites, over exercising, low stomach acid, hypothyroidism, and uterine fibroids.

Nutritional cofactors for serotonin activity

In addition to iron, nutrients serotonin synthesis requires include P-5-P (pyridoxal-5-phosphate), an active form of B-6, niacin, methyl B-12, folic acid, and magnesium.

Deficiencies in these cofactors are widespread due to how poorly most Americans eat.

Additionally, magnesium deficiencies can arise in those taking diuretics or athletes who over train.

Methyl donors such as methyl B-12 are important for the conversion of the amino acid 5-HTP to serotonin; people who take SSRI antidepressants for long periods of time deplete their methyl donors and P-5-P.

Those considering weaning off SSRIs may need to supplement with these cofactors to cover deficiencies acquired during use of the medication.

Supplements that support serotonin activity

The amino acids 5-HTP or tryptophan are precursors to serotonin. Tryptophan has been shown to more easily cross the blood-brain barrier than 5-HTP. Others prefer 5-HTP because it is only one step away from being converted to serotonin, whereas tryptophan is two steps away. Therefore, 5-HTP has more potential to boost serotonin levels. However, both work and taking both can cover your bases.

Both 5-HTP and tryptophan have been shown to be helpful in addressing depression, persistent nightmares, fibromyalgia, chronic headaches, migraines, and mood disorders.

Botanicals that increase receptor site sensitivity, ensure the breakdown of used serotonin, and provide necessary cofactors for serotonin production include St. John’s wort, SAMe, P-5-P (a form of B-6), niacinamide, magnesium citrate, methyl B-12, and folic acid.

Ask my office how we can help you support your brain serotonin activity so it can help you feel happier and enjoy life more.