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Dr. Andrew Weil

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The Depression-Inflammation Connection

Posted: 11/04/2011 8:25 am

The dramatic rise in depression diagnoses over the last two decades is a great challenge to modern medicine. I believe that part of the "depression epidemic" is false -- a creation of aggressive disease-mongering by pharmaceutical companies to promote antidepressant sales. However, it's equally clear that within that trend, there has been a real rise in depression rates.

The reasons for the increase are complex, but one important theory deserves special consideration, because I believe it offers new possibilities for prevention and treatment. At the center of this theory are cytokines -- proteins made by immune cells that govern responses to foreign antigens and germs.

Cytokines have varied effects. One type -- the interleukins -- controls inflammation and produces fever. Another type governs how red and white blood cells in the bone marrow mature. Because of such powerful effects, some cytokines have proved useful as medical treatments, though they can be quite toxic. In 1980, scientists succeeded in inserting a gene for human interferon into bacteria -- this made it possible to mass-produce and purify these proteins. Since then, synthetic, injectable forms of interferon have been in wide use as treatments for several cancers (skin cancers, some leukemias), chronic viral hepatitis and multiple sclerosis.

A commonly-reported side effect of interferon therapy is severe depression; in fact, some patients have committed suicide. Long-term activation of the immune system, as in autoimmune disease, also seems to go along with depression. The reverse is also true: Depression seems to involve changes in various aspects of immunity, particularly those having to do with cytokines. People with rheumatoid arthritis, scleroderma, systemic lupus (SLE) and other forms of autoimmunity are often depressed. And when proinflammatory cytokines are administered to animals, they elicit "sickness behavior": The animals become listless, lose interest in eating, grooming, socializing and sex, and show increased sensitivity to pain, changes strikingly similar to those in humans with major depression.

Loss of interest in food and ability to take pleasure in eating make sense as a short-term response to infection -- it frees up energy used for digestion and makes it available for immune defense. Once the immune system gains the upper hand, it can turn down the cytokines, allowing brain centers that control appetite and taste to resume normal activity. Malignant tumors, however, even when they are relatively small, often stimulate prolonged cytokine responses that do more harm than good. For example, they permanently suppress appetite. This leads to extreme wasting (cachexia) that all too many cancer patients suffer. Given that dramatic effect on the brain and body, consider the impact of prolonged cytokine responses on parts of the brain associated with thoughts and emotions.

The reason I find the cytokine hypothesis of depression so compelling is that it fits right in with my belief that doing everything we can to contain unnecessary inflammation -- by adhering to an anti-inflammatory diet, for example -- is the best overall strategy for attaining optimum health.

Inflammation is the cornerstone of the body's healing response. It is the process by which the immune system delivers more nourishment and more defensive activity to an area that is injured or under attack. But inflammation is so powerful and so potentially destructive that it must stay where it is supposed to be and end when it is supposed to end; otherwise it damages the body and causes disease. Cytokines are the principal chemical mediators of the inflammatory response. Anything you can do to keep them within their proper bounds will reduce your risks of chronic disease and also, it now appears, protect you from depression.

How to control inappropriate inflammation is a big subject, but dietary choices are perhaps the most important way to keep excessive cytokine production in check. The anti-inflammatory food pyramid consists of foods that can help control inflammation, as well as provide the vitamins, minerals and fiber required for optimal health. Prudent exercise regimes and stress-reduction techniques can also be helpful.

My new book, "Spontaneous Happiness," from which this article is adapted, provides detailed information about therapies and lifestyle changes that can control inflammation. It also explores other methods to improve mood states. Depression is a serious problem, but as our understanding of the mechanisms behind it improves, I believe we can make significant progress in developing simple, safe, effective therapies to treat it.

Andrew Weil, M.D., is the founder and director of the Arizona Center for Integrative Medicine and the editorial director of www.DrWeil.com. Become a fan on Facebook, follow Dr. Weil on Twitter, and check out his Daily Health Tips Blog.

 
 
 

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03:37 AM on 11/11/2011
Whatever the root cause of the inflammation, it's good to know it's not "all in your head!" And it's good to be able to treat this as a REAL disease process instead of a personal failure or character flaw. Having had p.p.d. that ballooned into this massive black emptiness, I can tell you that depression is not fun, and it's not funny. I lost about 2 years of my life to that, and was told I'd need meds the rest of my life.... so misunderstood was it back then.

Then there was the stigma and shame of having been a mental patient. Being rejected for jobs, having to lie to even get hired.... The stigma of having had a depressive episode, even as legitimate as post partum, which should have been understood decades ago, has cost me dearly. Nobody should have to live this way. The more it's researched and understood, the less people will fear. It will be another MEDICAL condition. Not a SIN.
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yogini4
Think deeper!
04:34 PM on 11/14/2011
Pretired (love your handle); you have all the earmarks of having suffered traumatic stress which affects the hypothalamic-adrenal-pituitary axis giving rise to a host of problems including inflammation and depression. Sorry you have suffered so much! It is not a character flaw! Hope you get the healing you deserve!
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Carmen DA
07:32 AM on 11/10/2011
We are made with long legs for walking. Whatdo yout hink would happen to a cheetah if he was to sit down all day? He would be depressed and achy. Use your body or lose your body. Plain and simple.
http://www.bodybuilding-basics.com
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yogini4
Think deeper!
04:35 PM on 11/14/2011
A cheetah wouldn't sit down all day if he wasn't already depressed or achy. Careful how you attribute cause.
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Star2000dancer
Pay it forward, the movie..
07:15 PM on 11/09/2011
Since November 2009, CodexAlimentarius removed nutrients from our food, calling them toxic. Add to that the so called produce, meat, and poultry we get ex.FoodInc Documentary. And you've got a cocktail for immune system destruction.

Then the fear, the economy, the stress, and the poorest health care imaginable. Trickle down the bankrupted middle class into poverty. Well, frankly, I can not even count the number of people I've lost. The perfect storm.
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BeautifulOnDaOutside
I ♥ Huffington Post
05:45 PM on 11/08/2011
"People with rheumatoid arthritis, scleroderma, systemic lupus (SLE) and other forms of autoimmunity are often depressed."

Fancy that.
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farmilyman
everything is illusion
12:18 AM on 11/08/2011
The solution is simple - get vitamin D levels up.
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Silken17
Just a hare in your soup
07:59 PM on 11/09/2011
I'm afraid it ISN'T that simple. Increased levels of vitamin D are not going to do anything for mental depression or for most kinds of inflammation. The subject is vastly more complicated than the effects of a single vitamin.
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farmilyman
everything is illusion
03:34 AM on 11/10/2011
The Depression-Inflammation Connection That Makes Vitamin D Even More Important

http://articles.mercola.com/sites/articles/archive/2011/11/06/vitamin-d-for-depression.aspx
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Vinca
08:31 AM on 11/07/2011
Dr Andrew Weil is a very smart man!
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Terri Skau
Se... sotto una splendida luna piena...
07:47 AM on 11/07/2011
So many people with opinions. Well I suffer with depression and I don't eat sugar or bread and very little pasta. I also have hypoglycemia which is the opposite of a diabetic. I changed my diet over 25 yrs ago and still have depression and I do not take any meds...I've asked several shrinks and therapists instead of medicating me to help to understand and live with my disease, but they insist on medicating me so I won't take meds. What has always helped me is to be productive and right now I'm not. I've been unemployed for over 2yrs. but I keep plugging away with trying to find work...Yes I have good days and bad days but it's better than being all doped up on meds and wondering if my liver is gonna to be destroyed from the meds that all doctor's seem to want to perscribe....Well these are my thoughts on the subject.
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Star2000dancer
Pay it forward, the movie..
07:17 PM on 11/09/2011
I decided to raise my own and others endorphin levels. So, I started face painting. It took my pain away and put smiles on 1000's of faces. Nothing gives me more joy than making others happy.
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Silken17
Just a hare in your soup
08:02 PM on 11/09/2011
Actually, hypoglycemia is often a precursor to type II diabetes; it is not the opposite. Hypoglycemia is caused by an abnormal release of excess insulin when carbohydrates are eaten.
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Vinca
07:28 AM on 11/07/2011
Depression can weaken the immune system. The body reacts to our mind.
06:52 PM on 11/08/2011
That's why all women are DD's, all men have 9 inch appendages and are never bald, and no one wears glasses. There are many studies that over state the brain's ability to influence health. This is not to say that positive behaviors--eating healthy or exercising are not helpful, but they will not determine if the asbestos you inhaled will cause cancer. And, BTW, if dephttp://www.huffingtonpost.com/andrew-weil-md/depression-and-inflammation_b_1071714.html?ref=mostpopular#ression weakens the immune system, this would be a treatment for autoimmune diseases (which are treated by immune suppressors).
05:57 AM on 11/07/2011
This family says something about America and its problems.
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Star2000dancer
Pay it forward, the movie..
07:22 PM on 11/09/2011
You betcha'. It's the norm now days. It's hard to be the only one who wants to be happy and make everyone else happy. But, it's worth it. Keep the Golden Rule, and eventually people will be forced to follow by example.
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ckava3
05:25 AM on 11/07/2011
He's right, inflammation is a key to depression & disease in general. Drugs are NOT the answer, I can tell you from experience. But what's causing the inflammation??? Mainly the garbage we put in our bodies. Every passing year, food stuff has less nutrients. And of course we Americans luv junk food. As our diet has gotten worse, the rates of depression (and all disease) has skyrocketed. Drugs are NOT the answer, & make things worse in the long run. Yet they're pushed on us every where we turn. You'll never hear a Dr say 'get more vit c or b complex & omega 3's'. The real cure.
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cherrypie
unrevealed
11:26 AM on 11/07/2011
You also never hear a doctor to tell you to lose weight, and stop eating processed food. You don't want drugs? Don't eat that crap.
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Star2000dancer
Pay it forward, the movie..
07:23 PM on 11/09/2011
FoodInc. Documentary.
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Saijanai
Micro bio? We don't need no stinkin' micro bio...
03:17 AM on 11/07/2011
My favorite studies on Transcendental Meditation, just because they lend themselves to bad puns, are teh studies that claim that TMers emit less photons from their bodies. In theory, the chemical processes involved in free radical production can cause very weak photons to emit from the skin, and researchers hypothesized that meditation would lower free radical production, which would be detectable by measuring "ultra-weak photon emissions" in various groups and comparing the averages.

Participants from several different meditation traditions were measured and the TMers showed the lowest levels of emissions.

Insomuch as inflammation tends to go hand in hand with free radical production, one could claim that there is [literally] visible (sorry) evidence that TMers tend to be less inflamed (again?) than others. IOW, they were less "enlightened" than the other groups (told you it made for bad puns).

http://www.ncbi.nlm.nih.gov/pubmed/18399758
http://www.ncbi.nlm.nih.gov/pubmed/16086532
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cherrypie
unrevealed
11:30 AM on 11/07/2011
To hopefully add to this. After learning to meditate, meditators actually have control over their breathing and heart beat; to slow them down enough to relax. It's mind/body connection getting more tuned.
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Saijanai
Micro bio? We don't need no stinkin' micro bio...
07:27 PM on 11/07/2011
with TM there is no control. Whatever level of relaxation occurs happens spontaneously as a side-effect of doing the technique. Even the deepest level of TM, pure consciousness, where breathing sometimes seems to stop, is a spontaneous event. In fact, since pure consciousness involves no thought, it couldn't possibly be anything other than spontaneous and in fact, pure consciousness is no more important an event than any other during meditation. If it were not so, you wouldn't really be relaxing because you would be setting a goal for yourself.
01:57 AM on 11/07/2011
my brain has worked right since i was 26 in 1991...it is like having overused wiring in house and circuits get worn out
11:56 PM on 11/06/2011
Ive read that consuming legumes beans , peas etc reduces inflammation at least in the gut ? So the old " beans beans the magical fruit, the more you eat the more you toot, the more you toot the better you feel so eat your beans at every meal" is not really off the mark at all ? Beans and peas by reducing an enflamed gut merely " allow" you to " toot"?
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yogini4
Think deeper!
11:33 PM on 11/06/2011
Depression rates have not gone up because of food choices. It has gone up as the rates of child abuse have gone up and our society has become ever uncaring, disconnected and unkind. These lead to disturbances in the HPA axis resulting in inflammation. Fix these problems, and I promise you, we can all celebrate an impending end to depressive disorders, and we'll have good food as we all come back into balance. Our bodies will no longer experience the craving for the fats and sugars brought on by extreme stress.
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ckava3
05:14 AM on 11/07/2011
Are you serious???!!! You're welcome to your opinion, but don't spout off inaccuracies. Depression, as well as disease in general, HAS gone up because of food choices. Also because no matter what food we choose today, it has less nutrients than it did 20, 30, 50 yrs ago. These are FACTS m'am, not my opinion.
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Star2000dancer
Pay it forward, the movie..
07:25 PM on 11/09/2011
True story. Apparently the poster is not aware of the FoodInc.Documentary yet.
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yogini4
Think deeper!
12:34 PM on 11/10/2011
I'm serious. Check out the Adverse Childhood Events study out of San Diego, which looked at 17,000 patients over many years. The evidence is in. Stress makes you depressed, fat, tired, gives you heart disease and makes you crave carbs among many other things. This is not my opinion. It is hard core research. You are still describing symptoms, not cause.
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Silken17
Just a hare in your soup
08:14 PM on 11/09/2011
Depression rates have gone up with the popularity of low fat, high carbohydrate diets.
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10:00 PM on 11/06/2011
I take Weil Juvenon and it is Awesome !!! This guy is a terrific asset to health in this country and a wonderful example as well , thank you Doctor for impacting my life in a positive manner , I appreciate it Sir !!!