The Anxiety - Depression - Inflammation Connection
by Dr. Mitchell Rasmussen, DC, CFMP, FRC-ms
Patients themselves often tell me how they are inflamed. They say this word; but they don't fully understand what that even means or why that matters with respect to whatever condition they are currently dealing with.
Inflammation is at the center of every single chronic condition we suffer from. If not the primary driver; it is certainly a reinforcer of the metabolic dysfunction associated with conditions that don’t seem to improve. Whether it be chronic mood issues, weight issues, brain fog, skin conditions, Multiple Sclerosis, type 2 diabetes, Hashimoto’s disease, chronic joint or muscle pain, fatigue, or any other thing that you might ‘have’ and which doesn’t seem to improve over time. The higher the background level of inflammation, the more your condition will cause you strife.
Enter: Neuroinflammation "Brain on Fire"
Finally mainstream media (re: social media) is catching up to the principle that depression and anxiety are neuro-inflammatory conditions; much less about chemical imbalance and more about the state of the system.
We’ve talked about this for years, including the gut-brain connection and lifestyle habits that contribute to inflammation. Now, we’ll dive deeper into the Inflammation-Mood Disorder connection from the lens of Functional Medicine.
There are a range of factors that appear to increase the risk for depression – and all of them are associated with systemic inflammation:
Stress
Poor diet
Physical inactivity
Obesity
Smoking
Leaky gut
Skin conditions
Dental issues
Poor sleep quality
Vitamin D deficiency
Nothing on that list should surprise us.
When a person is chronically inflamed, they often become depressed or anxious.
An article from Biology and Psychiatry states,
“Recognition that inflammation may represent a common mechanism of disease has been extended to include neuropsychiatric disorders including major depression. Patients with major depression have been found to exhibit increased peripheral blood inflammatory biomarkers, including inflammatory cytokines, which have been shown to access the brain and interact with virtually every pathophysiologic domain known to be involved in depression, including neurotransmitter metabolism, neuroendocrine function, and neural plasticity. Indeed, activation of inflammatory pathways within the brain is believed to contribute to a confluence of decreased neurotrophic support and altered glutamate release/reuptake, as well as oxidative stress, leading to excitotoxicity and loss of glial elements, consistent with neuropathologic findings that characterize depressive disorders.”
Key Takeaway: Inflammation interferes with the metabolic integrity of our neurons.
If a neuron’s metabolism is impacted, then it can’t make energy (ATP) efficiently. If this is the case, now the neurons can’t fire as rapidly as they should. Your prefrontal cortex firing output becomes dampened overall. Now you can’t think crisply or feel fully present and awake.
Our neurons need fuel (ATP), oxygen, and stimulation.
Inflammation, poor blood sugar control, hypoxia from any number of causes, neuron-microglia dysfunction, autoimmunity, infections like gut dysbiosis or any number of other infectious pathogens are all reasons for impaired neuronal integrity.
And we know now that impaired neuronal integrity is a driver of major depression.
Midbrain Neural Plasticity ?
In the article, they mentioned ‘neural plasticity’. Unfortunately for our midbrain, plasticity here is what we’d call ‘hard plasticity’.
Let me explain… Imagine baking a cake. Once it’s been baked, you can’t unbake it. Similarly, once our midbrain is activated, it doesn’t ‘inactivate’.
Our midbrain is the area of the brain that lights up in such a way that drives our sympathetic nervous system into high gear – (fight/flight).
Visual and sound stimuli arrive in areas of the mid-brain and drive its activation.
This is why we often see midbrain activated patients who present with light or sound sensitivity. Your midbrain is already active – now we are further pushing the button with light or sound. (This is a clinical clue that the patient may be dealing with midbrain over-activity as part of their complex picture..)
The midbrain will start to hard wire its firing over time, and this leads to increased efficiency with which it reacts. It gets ‘better’ at firing our fight/flight responses.
We know that chronic inflammatory activation drives this efficiency.
Inflammation > stress chemistry > inflammation
KEY TAKEAWAY:
If you’re depressed or anxious, then it is of the utmost importance for us to inventory and address your inflammatory drivers. And if we do so with enough breadth and depth and time investment, you will undoubtedly begin to improve regarding many aspects of your health.
Mental health included.
ABOUT THE AUTHOR:
Dr. Mitchell Rasmussen, DC, CFMP serves as Director of Functional Medicine at The Facility in Denver, CO. He sees patients in-person and via Telehealth to get to the root cause of dysfunction and restore a state of well-being using nutritional intervention, supplementation, and lifestyle change.
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(BMC Med. 2013 Sep 12;11:200. Berk M, Williams LJ, et al.)
(Biol Psychiatry. 2009 May 1;65(9):732-41. Miller AH, Maletic V, Raison CL.)
