Depression can be debilitating and self-perpetuating. When depression symptoms are very severe, those affected may struggle with difficulty eating, sleeping and exercising and may isolate themselves from their loved ones. Unhealthy lifestyle habits only serve to make depression symptoms more intense and longer lasting. Sometimes medication can serve as a bridge back to health by giving patients enough symptomatic relief to allow them to carry out their daily activities, which further improves symptoms.
Unfortunately, not every person responds to medical therapy, and it can take a long time for psychiatrists and their patients to find the right dose of the right drug. Pharmacogenetic testing offers health care providers with genetic information on their patients that can aid in the process of finding the right drug for each patient. However, treatment-resistant depression is still a problem for many.
Researchers find link between inflammation and depression
Researchers continue to look for new avenues to help those with persistent depression symptoms. Recent findings have suggested that inflammation may play a role in the development of depression. Inflammation results from a cascade of biochemical reactions that are triggered when cells in the body are damaged for any reason, including trauma, disease, toxins and infection. Chronic, low-grade inflammation has been linked to dysfunction in the neuronal networks causing depression.
A recent analysis of 20 clinical trials of medications used to treat inflammatory conditions focused on depressive symptoms of patients as they were given these drugs. (Depressive symptoms are often measured as a secondary outcome during clinical trials to make sure that new medications being tested do not have mental side effects.) Participants were being treated for conditions such as rheumatoid arthritis, psoriasis and Crohn’s disease. Medications included either placebo or anti-cytokine drugs, such as adalimumab, etanercept, infliximab and tocilizumab.
The researchers found a significant difference between the medication group and the placebo group, in that those taking the medication had a small to moderate but significant improvement in their depression symptoms. This improvement was not statistically related to their clinical improvement in their underlying inflammatory disease symptoms.
The authors concluded that their findings suggest that cytokines may be the link between inflammation and depression symptoms, and that anti-cytokine therapy may emerge as a new approach to the pharmacological management of depression.
The role of stress
Peter B. Jones, M.D., Ph.D., is a professor of psychiatry and deputy head of the School of Clinical Medicine at the University of Cambridge and co-author of the study. He advised that clinicians should not start using these medications to treat primary depression just yet, stating, “We will need clinical trials to test how effective they are in patients who do not have the chronic conditions for which the drugs have been developed … On top of this, some existing drugs can have potentially serious side effects, which will need to be addressed.”
While more study of anti-cytokine therapy for depressed patients is warranted, researchers and clinicians mustn’t lose sight of the complex nature of depression. Ashish Bhatt, M.D., is an internationally recognized psychiatrist and addiction medicine specialist and the Chief Medical Officer for Sovereign Health. Dr. Bhatt summarized, “The risks for depression are multi-factorial. Genetics, age, gender, lifestyle, physical conditions, socialization and others all are implicated as variables influencing the development of depression and other psychiatric illnesses. More and more recently, though, the presence of stress in one’s life as an overall risk favor has been correlated with changes in cortisol, which could alter the regulation of the body’s inflammatory response system. Studies have shown the possible association of this altered inflammatory response in a variety of health conditions from heart disease to depression.” Stress reduction should therefore be an important therapy included in the treatment of depression.
In the U.S., depression is one of the most common mental health problems affecting adolescents and adults today, and suicide is now a leading cause of death. If you or someone you love is experiencing depression and is at risk for suicide, understand that effective treatment is available. To find out more about depression treatment, please call our 24/7 helpline.
Sovereign Health of California is a leader in the treatment of individuals with mental illness, substance use disorders and co-occurring illnesses. We combine the most accurate and effective approaches to diagnostic assessment and treatment, providing optimal long-term outcomes. Comprehensive treatment includes novel, conventional and holistic therapies, and care plans are tailored for each individual patient. Our ongoing recovery management provides the support patients need to remain free from addiction and to recover from all of its consequences. To find out more about specialized programs at Sovereign Health, please call us at our 24/7 helpline.
About the author
Dana Connolly, Ph.D., is a senior staff writer for Sovereign Health, where she translates current research into practical information. She earned her Ph.D. in research and theory development from New York University and has decades of experience in clinical care, medical research and health education. Sovereign Health is a professional information resource, and Dr. Connolly helps to ensure excellence in our model. For more information and other inquiries about this article, contact the author at email@example.com.