The relationship between diet, inflammation and depression

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A new study by the Centre for Addiction and Mental Health (CAMH) found that the measure of brain inflammation in people who were experiencing clinical depression was increased by 30 per cent. The findings, published in JAMA Psychiatry, have important implications for developing new treatments for depression.

A growing body of evidence suggests the role of inflammation in generating the symptoms of a major depressive episode such as low mood, loss of appetite, and inability to sleep. But what was previously unclear was whether inflammation played a role in clinical depression independent of any other physical illness.

More research has come out which supports the link between inflammation and depression. While this link hasn’t been confirmed my experience has piqued my interest in the topic. For about fifteen years I have been experimenting with Ayurveda which is a form of medicine which originated in India a thousand years ago. In Ayurveda the world is divided up into three different categories(doshas in human body), Vata, Pitta and Kapha. Vata is associated with air, Pitta with fire/water and Kapha with water/earth. In the human body the various categories govern certain functions and areas. Pitta governs metabolism, heat regulation and the immune system. It is located in the eyes and small intestine. Various tastes/qualities are said to balance the doshas. Pitta is said to be balanced by sweet, bitter, astringent and coolness.

For many years I have experimented with Ayurveda and discovered that balancing Pitta was very helpful, even more than balancing Vata which is associated in Ayurveda with the nervous system. Balancing Pitta is helpful especially in regards to anxiety, irritability and depression. Perhaps Pitta’s association with inflammation in Ayurveda might explain this. In addition, Ayurveda recommends a vegetarian diet for a Pitta type of imbalance, a vegetarian diet has been shown in western medicine to help with inflammation.

Balancing Kapha, which is said to be localized in the stomach, has been helpful in regard to lack of motivation and energy. Balancing a dosha can aggravate another. Whenever I balance Kapha I notice Pitta becoming imbalanced. Balancing or pacifying Kapha can increase irritability which is a Pitta imbalance. In Ayurveda there are different methods of balancing more than on dosha. One way is to balance Vata which is believed to govern the other doshas. The second method is to balance the two using the qualities that balance the two doshas. In the case of Pitta and Kapha they are both balanced by bitter and astringent tastes. While this balancing act can be consciously performed I think it is also subconsciously performed when we have desert after a meal that has had too much salty and sour taste to it.

Somewhat interestingly healthy food tends to be higher in bitter and astringent qualities while junk food is higher in salty, sour and sweet tastes. According to Ayurveda salty, sour and sweet all balance Vata which is associated with the nervous system and stress. Perhaps this preference is one reason why western cultures seem to have more problems with inflammation and depression.

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Do antidepressants cause weight gain?

Antidepressants have been associated with weight gain however a new study refutes that idea.

Yet according to a study published a few days ago in the online issue of JAMA Psychiatry, this should not have antidepressant-weight-gain-thinkstock-72919774-617x4161happened. Using electronic medical records to gather information on weight change among more than 19,000 patients on antidepressants, Dr. Roy Perlis and colleagues of the this hospital in Boston found only minimal changes in weight. Using electronic medical records to gather information on weight change among more than 19,000 patients on antidepressants, Dr. Roy Perlis and colleagues of the this hospital in Boston found only minimal changes in weight. ….. Conclusion: The researchers said that patients should not be scared of taking antidepressants because they think they will gain weight. [1]

Weight was gained among those who had depression, but according to the author, only among those who had what she described as atypical depression, a depression characterized by increased appetite.

The majority of my 50 pound weight gain started 4 years ago after I stopped taking Wellbutrin. Ten of the 50 pound weight gain could be due to taking Risperdone in the last year. I doubt the author’s speculation about an increase in appetite. My calorie intake was about the same over that four year period since I am rather rigid/consistent when it comes to eating. The fact that the weight gain could be related to atypical depression could be supported in my case however I didn’t gain much weight while on Wellbutrin. Atypical depressives can also gain weight independent of calorie intake.

My arguments against antipsychiatry

My experience deviates from the experience of the depressed and psychotic people in Anatomy of an Epidemic. I would argue against Robert Whitaker (antipsychiatrists) by making the following points:

  • Robert Whitaker said that depression used to be thought of as cyclic and a limiting illness. My experience is that it is moreBobWhitaker chronic and that chronicity wasn’t due to medications . My depression was chronic for about eleven years prior to taking any medication. They don’t acknowledge atypical depression which is more chronic and less severe.
  • Whitaker believes that medication causes a more severe type of illness. This isn’t the case with me. The way depression expresses itself has changed over the years but I would necessarily say that medications made it more severe. Depression tends to be more atypical in younger people and more typical in older individuals.
  • Whitaker believes that psychosis is a fairly limited condition and consequently can be dealt with without medication. I experienced psychosis about four years ago and didn’t take medication until about a year ago. The psychotic episode didn’t seem to be resolving on it’s own.
  • Whitaker believes that most mental illness is resolved by time and alternative medicine such as diet, exercise and psychotherapy. Prior to experimenting with antidepressants and antipsychotics I tried quite a few natural therapies without much luck.
  • He believes that mental illness isn’t real, much like Thomas Szasz, due to a lack of pathology. There isn’t any test that doctors can run to diagnose someone as “mentally ill”. While this is true migraines don’t have any particular pathology either and yet are accepted as quite real. Why do antipsychiatrists assume that scientists know everything there is to know regarding mental illness. Antipsychiatrists seem to exist just in the present.
  • In many of his comparisons of nonmedicated vs medicated patients he never seems to discuss why the nonmedicated patients were nonmedicated. Did they possibly have a more limited illness or a less severe one?
  • Whitaker believes that medication interferes with people taking responsibility for their “illness”. Why is there a need to blame the patient with mental illness. Whitaker would like to take us back to the middle ages where mental illness was seen in the context of religion. It was seen primarily as a moral failing and not a physical one.

I agree with Whitaker that antidepressants aren’t particularly effective and many people are diagnosed incorrectly however there is still much that I don’t agree with him on.

Advanced paternal age associated with mental disorders

A new study has found that the increase in some mental illnesses could be due to the fact that child bearing is being delayed in modern culture.

 The effect of advanced paternal age at childbearing on the psychiatric morbidity risk of their children extends to several 8005762999_771a3cc7c1_opsychiatric disorders and particularly bipolar disorder, findings from a sibling-comparison study show.

Children born to fathers who were 45 years of age and older had a 24.70-fold increased risk for bipolar disorder, compared with those born to fathers aged 20 to 24 years. This was after all factors shared by siblings had been taken into account.

The team concludes in JAMA Psychiatry that the results support the theory that genetic mutations that occur during spermatogenesis as a man ages influence offspring morbidity.

It occurred to me that the association of Bipolar Disorder with affluence might fit with this study because more affluent people might wait longer to start families.

Evolutionary Origins of the Depression Epidemic

I recently read a book called “The Depth: The Evolutionary Origins of the Depression Epidemic“. Here is a summary of the book from Amazon:

Why are we losing the fight against depression? In this groundbreaking work, psychologist Jonathan Rottenberg depressionevol1explains that despite advances in pharmaceutical science, progress has been hampered by our fundamental misunderstanding of depression as a psychological or chemical defect. Instead, Rottenberg introduces a surprising alternative: that depression is a particularly severe outgrowth of our natural capacity for emotion; it is a low mood gone haywire. Drawing on recent developments in the science of mood—and his own harrowing depressive experience as a young adult—Rottenberg explains depression in evolutionary terms, showing how its dark pull arises from adaptations that evolved to help our ancestors ensure their survival.

For a good part of the book the author tried to make a case that mild depression is the same as major depression and  if mild depression( reactive depression) is the same as major depression( endogenous depression) then neither is a disease. According to him they both have the same causes, similar symptomatology, and respond to similar treatments, therefore they are the same. This didn’t seem like an air tight argument to me since there are some things that have similar causes, similar symptomatology, respond to similar treatments and yet are different. For example Subictal Mood Disorders (epilepsy) and Bipolar disorder are exacerbated by stress and can display similar symptomology( mood changes) but yet could have different pathology.

Additionally, one person has argued that the term major depression includes too many people who might not necessarily have endogenous depression. What the author should have possibly been comparing is mild depression to melancholic depression in order to make his case. Melancholic is considered by many to be more endogenous in nature than major depression which might include more of the neurotic/reactive variety.

Another argument that he makes is that depression could be evolutionarily favorable. He makes a better argument here except severe depression doesn’t seem to be for the most part evolutionarily favorable. He specifically mentions an experiment where severely depressed people were a better judge of character than controls however this was just one experiment.

The author argues that depression is evolutionarily favorable since it causes people to stop pursuing impossible goals which are causing unnecessary stress. This seems plausible for mild depression which appears to make people more realistic but not so much for severely depressed people since they often have a distorted view of reality.

In conclusion his evolutionary theory in relation to mild depression was quite interesting  and gives depression a more positive image but the inclusion of severe depression needs a stronger argument.

Green tea improves symptoms of depression

some of that tea
some of that tea (Photo credit: Wikipedia)

A just came across a recent study that demonstrated that green tea could significantly improve depression symptoms, in particular anhedonia.

Green tea (Camellia sinensis) extracts, as well as their main component, the polyphenol
epigallocatechin-3-gallate (EGCG), reportedly have antistress, anticancer, and
antioxidant effects. Recent studies suggest a beneficial association between green tea
consumption and symptoms of depression; however, the underlying mechanism behind
that association is unclear. Anhedonia, the inability to experience pleasure, is a
characteristic of depression, marked by reduced pleasure, altered motivation, and
disturbed reward learning.1,2 A reduced reward-learning function has been linked to
persistent anhedonia in depressed patients.3

“It has been evidenced that reduced dopamine neurotransmission might
contribute to the anhedonia and loss of behavioral incentive in depressive disorder,
therefore it is important to examine the regulatory role of green tea on the brain circuitry
activated by reward learning,” write the authors.

Compared with the control treatment, the green tea produced significantly greater
improvements in the MADRS (P<0.01) and HRSD-17 (P<0.001) total scores.

I’ve been drinking green tea occasionally and noticed that it seemed more stimulating than regular tea. This seemed odd to me since green tea has approximately half the amount of caffeine compared to black tea. According to this study and others the stimulating effects could be due to an increase in dopamine activity in the reward center of the brain.

Green tea is recommended for Pitta and Kapha types in Ayurveda. Pitta types are said to have more problems with inflammation so green tea, which has an astringent quality to it, would be recommended. Inflammation has been shown to in turn to be associated with depression. I found one recent journal article in addition that supports the idea that tea, black or green, has anti-inflammatory properties.

Diet could possibly affect mood via bacteria in gut

Lord of Ayurveda,Dhanvantari
Lord of Ayurveda,Dhanvantari (Photo credit: Wikipedia)

I have tried a number of diets in order to improve my mood and one that seemed to help the most was the Pitta diet of Ayurveda. This diet consists mainly of food that has the flowing qualities: bitter, astringent,  and sweet. Additionally the diet specifies eating little to no meat,no eggs, and avoiding certain oils. The Pitta dosha is associated with inflammation in Ayurveda.

Recently I read in NPR that a diet consisting of just meat, eggs and cheese increases a type of bacteria your gut that could lead to inflammation and inflammation has in turn been associated with depression. A vegetarian diet on the other hand increased other types of bacteria which haven’t been associated with inflammation.

Scientists are just beginning to learn about how our decisions at the dinner table — or the drive-through — tweak our microbiome, that is, the communities of bacteria living in our bodies. But one thing is becoming clear: The critters hanging out in our intestine influence many aspects of our health, including weight, immunity and perhaps even behavior.

“The relative abundance of various bacteria species looked like it shifted within a day after the food hit the gut,” David says. After the volunteers had spent about three days on each diet, the bacteria in the gut even started to change their behavior. “The kind of genes turned on in the microbes changed in both diets,” he says.