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dr.michael c reedAccording to the American Academy of Pain Medicine (AAPM), pain affects more people in the United States than diabetes, heart disease and cancer combined, with an estimated 100 million Americans experiencing chronic pain.  Chronic pain is strongly associated with the development of other conditions such as depression, anxiety and substance abuse, with these three seen in more than half of patients with chronic pain.

Depression is a common, but serious illness that interferes with daily life. Each year about 6.7% of U.S. adults experience a major depressive disorder. Depression symptoms include: persistent feelings of sadness, anxiety, irritability and fatigue. However, diagnosing a patient with clinical depression can be difficult since depression is a complex illness that can be caused by one or a mix of many things, from environmental stressors to genetics.

It is estimated that, by the year 2020, major depression will be second only to ischemic heart disease in terms of the leading causes of disability in the world. But people with depression sometimes fail to realize (or accept) that there is a physical cause to their depressed moods.

A new study out of the Centre for Addiction and Mental Health (CAMH) has highlighted a link between clinical depression and brain inflammation that might be crucial in better understanding stress and depression’s physical impacts on the body, as well as in developing better treatments for these mental health issues.  In one of the most conclusive findings yet, a study in JAMA Psychiatry determined that brain inflammation was 30 percent higher in clinically depressed patients.

Since inflammation in the body can lead to inflammation in the brain we first need to understand what inflammation is. Inflammation is part of the immune system’s response to defend you against microbial infections.  It is the body’s first line of defense against invasion by microorganisms such as bacteria and viruses, and it is activated rapidly after infection.

During an inflammatory episode the body releases cytokines, which are small, cell-signaling protein molecules. These cytokines also induce acute phase proteins, such as C-reactive protein (CRP), which can activate the immune system. Significantly higher levels of inflammatory markers are associated with a range of depressive symptoms, which grants insight into disease severity and treatment response.

Current treatments for depression do not target inflammation.  Doctors suggest that future studies should investigate the possible impact of anti-inflammatory drugs on depression symptoms.  The best approach to treating depression should be personalized for each individual. Often, the combination of pharmacotherapy and psychotherapy is a very effective option for depression treatment.  It’s important to remember that a person with depression cannot simply “snap out of it.”  

Click here to see a visual presentation of Neuroinflammation & Depression.