During normal times, depression is common. It is the leading cause of disability in the US for ages 15-43. During the pandemic lockdown, depression has been rampant, and the prevalence in the US was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. It is a cause for concern and those experiencing symptoms should seek help, however there are also steps people can take to lessen the likelihood of depression and make treatment more effective.
There is new and exciting information regarding the role of inflammation and cytokines in the cause and treatment of depression. Cytokines are chemical messengers that affect neurotransmitters, hormones, and your immune and nervous system. They are mood modulators and certain types make you feel depressed.
Think about when you have been ill. To fight the illness, your body generates inflammation and a cytokine response. This makes you feel tired and depressed. Depression is generally present in acute illness and higher levels of inflammation appear to increase the risk for the development of depression. Recovery from depression (and illness) is associated with a reduction to normal levels of cytokines. The good news is that this response can be modulated.
What are the symptoms of depression?
The definition of depression is: A period of at least two weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities, and had a majority of specified symptoms, such as problems with sleep, eating, energy, concentration, or self-worth.
Have you experienced any of the following for 2 or more weeks?
- Sleep issues such as either difficulty sleeping or sleeping too much on a daily basis)
- Decrease or increase in appetite nearly every day
- Weight increase or decrease by 5% in a month
- Decreased energy or fatigue almost every day
- Difficulty concentrating, making decisions, and thinking clearly
- Slow physical movements or unintentional or purposeless motions.
- Recurrent thoughts of death or suicide, a suicide attempt, or a specific plan for suicide
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
Take Control of Your Cytokines
Conditions or lifestyle factors that are associated with inflammation increase the risk of developing depression. Let’s explore these and how you can take control of your cytokines.
Dealing with Stress and Trauma
Psychosocial stressors old or new such as loss of a loved one, loss of health, a job, worry about finances, situations of overwhelm, loss, loneliness, confinement and even early exposure to childhood trauma increase the risk of developing depression and mood disorders. Different types of psychosocial stressors may stimulate cytokines that increase inflammation such as IL-6 and TNFα. Addressing these traumas is key to prevention and recovery. Consider some of the following techniques:
- Identify friends or family members for support.
- Face your feelings and processes them with a professional.
- Prioritize self-care.
- Be patient.
- Try various therapeutic techniques such as:
- Cognitive behavioral therapy
- Dynamic Neural Retraining
- EMDR- Eye Movement Desensitization and Reprocessing.
Some techniques are better for acute trauma while others may be more appropriate for chronic trauma. see a professional if your feelings are too much for you or go on for too long.
The Royal College of Psychiatrists recommends you ask for help if:
- you have no one to share your feelings with
- you can’t handle your feelings and feel overwhelmed by sadness, anxiety, or
- you feel that you are not returning to normal after six weeks
- you have nightmares and cannot sleep
- you are getting on badly with those close to you
- you stay away from other people more and more
- your work is suffering
- those around you suggest you seek help
- you have accidents
- you are drinking or smoking too much or using drugs to cope with your feelings.
Your diet can make or break inflammation. The Standard American Diet, otherwise known as the SAD diet, is higher in saturated fats and refined carbohydrates, trans fats, hydrogenated oils, and sugars and is associated with increased inflammation and inflammatory cytokine production. Individual nutrients are also related to depression. As an example, lowered availability of selenium in groundwater and lycopene contents in food are both associated with clinical depression.
- Eat more anti-inflammatory low glycemic fruits and vegetables.
- Eat more anti-inflammatory fats such as fish, olives, avocados, nuts, seeds and their oils.
- Take fish oil with high levels of EPA/DHA.
- Eat foods rich in selenium such as: Brazil nuts, yellowfin tuna, turkey and chicken.
- Eat foods rich in lycopene such as: Sun-dried tomatoes, tomato puree, guava, watermelon, fresh or canned tomato, papaya, pink grapefruit. Cooked tomatos have more lycopene than fresh.
- Take a multivitamin mineral formula with antioxidant vitamins and minerals
Exercise is an effective treatment strategy for depression. Regular exercise protects against the development of new depressive illnesses. Regular, moderate exercise decreases inflammation. It also reduces leptin which if elevated is also implicated in the development of depression. It is the most evidence-based management strategy for insulin resistance which if elevated leads to obesity which is an inflammatory condition.
An article in Psychology Today stated:
- Exercise 3 to 5 times per week, for 30 to 60 minutes at a time, and at a fairly high level of intensity, from 50 to 85% of maximal heart rate (220 minus your age in years).
- Exercising 45-60 minutes at a time may be better than shorter exercise periods.
- It can take 4 to 6 weeks to start working and can achieve maximal effect by around 10 weeks.
Exercising in nature has even more benefits, nature is calming.
Get a gut check and keep your microbiome healthy. The bugs in your gut outnumber the cells in your body and can regulate immune, nervous system and hormonal responses. Some bad bacteria harbored in your gut can produce LPS (lipopolysaccharides) which induce an immune response and inflammatory cytokines.
- Eat a healthy, nutrient dense, high fiber diet
- Eat more probiotic foods
- Take a probiotic
- Get 25 or more grams of fiber, gut bacteria digest this to produce butyrate.
- Take sodium butyrate which can alleviate the effects of LPS inflammatory response.
Insomnia is a risk factor for developing depression and can increase the risk of relapse in of people previously diagnosed with depression. Sleep deprivation increases the levels of the pro-inflammatory cytokines.
- Try 1- 5 mg of melatonin to induce sleep.
- Use L tryptophan 100- 300 mg to stay asleep longer than 3 hours.
- Block blue light from electronics 2 hours prior to bedtime.
- Sleep in a cool, dark, quiet room.
- Avoid stimulating foods (caffeine, alcohol) and activities close to bedtime.
- Try Somryst Sleep Training app.
Vitamin D has well documented modulatory effects on immunity. Supplementation robustly reduced the inflammatory markers most associated with depression in people with cystic fibrosis.
- It is generally safe to take 2,000 IU of Vitamin D3 daily.
- Be sure to take it with fat.
- Some may need higher levels and it is best to get a blood test for 25OH Vitamin D
- Many people need a supplement in addition to sunlight.
Allergen exposure, periodontal disease, gingivitis, obesity and smoking may also play a role in increasing inflammatory cytokine production leading to symptoms of depression. Take control of your cytokines and seek support. The team at Vibrance for life team can help with lifestyle, supplements, testing and gut, immune, and hormone health. For emotional and psychological support seek the help of a licensed therapist.