What Does New Research Show About Treating Depression Through the Immune System?
by Lisa DiFalco
Depression is the diagnosis for 350 million people worldwide. There are treatments available, including antidepressant drugs and cognitive behavioral therapy. However, one-third of patients do not respond well to existing therapies. The BBC reports of how scientists are now exploring the relationship of the immune system and depressive symptoms as part of The Inflamed Mind on BBC Radio 4. What started as an unusual response to anti-inflammatory drugs on those with rheumatoid arthritis may just open the door to a new approach and alternative therapies that can allow those with depression to break free from their condition. This might make a world of difference to those suffering from depression and provide them with additional options.
Professor Carmine Pariante, professor of biological psychiatry at King’s College in London, shared how important the new findings are to developing a new understanding of depression. Pariante said:
“It is groundbreaking because, for the first time, we are demonstrating that depression is not only a disorder of the mind, in fact it is not even only a disorder of the brain, it is a disorder of the whole body.”
New surprising findings may help healthcare professionals, case managers and families provide depression sufferers with alternative treatment and understand the implications of the emerging developments linking depression to the immune system.
Scientists Ready to Think Differently
The new approach to depression focuses on the how an errant immune system can result in inflammation in the body and change mood. Scientists are seeking new ways to tackle depression. Professor Ed Bullmore, the head of psychiatry at the University of Cambridge, said:
“Recent history is telling us if we want to make therapeutic breakthroughs in an area which remains incredibly important in terms of disability and suffering, then we’ve got to think differently.”
“Depression and inflammation often go hand in hand, if you have flu, the immune system reacts to that, you become inflamed and very often people find that their mood changes too.”
Inflammation is necessary for the body as it prepares to fight off illness. Damage can occur when inflammation is too high and, interestingly enough, one-third of patients with depression also are found to have consistently high inflammation levels. Evidence now suggests that inflammation may be the cause of depression in some patients with the immune system altering how brains work.
Starting with Arthritis
Doctors first noticed this new relationship at arthritis clinics like the Glasgow Royal Infirmary. Patients came in suffering with rheumatoid arthritis. They were given specific anti-inflammatory drugs that reduced their inflammation and calmed related parts of the immune system, but also inadvertently improved their mood to a noteworthy degree. Professor Iain McInnes, a consultant rheumatologist, shared:
“When we give these therapies, we see a fairly rapid increase in a sense of well-being, mood state improving quite remarkably, often disproportionately, given the amount of inflammation we can see in their joints and their skin.”
The results are not only skin deep. The team then decided to scan the brains of patients with rheumatoid arthritis before and after giving them an immune-targeted therapy. The results were startling. McInnes said:
“What we are starting to see when we give anti-inflammatory medicines is quite remarkable changes in the neuro-chemical circuitry in the brain.”
“The brain pathways involved in mediating depression were favorably changed in people who were given immune interventions.”
McInnes and his team are not alone in showing interest in this potential link suggesting that anti-inflammatories can positively impact brain circuitry and alter mood.
Professor of biological psychiatry at King’s College London, Professor Carmine Pariante, has been gathering evidence on the subject for two decades. Pariante said:
“Nearly 30% to 40% of depressed patients have high levels of inflammation and in these people we think it is part of the causal process.”
“The evidence supporting this idea is that high levels of inflammation are present even if someone is not depressed, but at risk of becoming depressed.”
“We know from studies that if you have high levels of inflammation today, you’re at higher risk of becoming depressed over the weeks or months, even if you are perfectly well.”
His research has shown that those that are depressed have an increased likelihood of having high inflammation levels and that depressed patients with overactive immune systems usually do not respond as well to antidepressants. Even if this new approach to depression is effective, it does not mean that everyone with depression would be a candidate. A blood test may be necessary to help identify potential candidates for immune-based therapies.
Why is This Emerging Body of Research of Interest?
Those with depression can’t simply “pull themselves together” or “snap out of it.” Yet, comments such as these are commonly said by those that do not understand the condition. If depression were seen as a physical problem, it might make a difference to how those with depression are commonly treated and provide more validation to help those with their diagnosis. Physicians and the medical community want to understand more about alternative treatments to help those suffering with depression that do not respond well to current therapies.
Depression impacts children to the elderly, and no age group is immune. As we read in Unusual Factors Producing Depression in the Elderly, depression can be difficult to identify. In How to Support Senior Citizens with Depression, additional resources and awareness are given to help vulnerable populations. Individuals that believe that they or someone they know could be depressed or need more options for treatment can turn to NHS Choices for more information or call one of the helplines provided by PsychCentral®.