The Robin Williams tragedy has highlighted depression and the terrible consequences it can have. It has also highlighted that most with depression are improperly treated. Only 30% achieve remission with one treatment, and only 70% with 4 cumulative treatments. Clearly there is need for better treatments. But what if the treatments just aren’t that effective? Perhaps medicine is treating the wrong thing? Recent study has shown an enormous publication bias when it comes to the efficacy of antidepressants. Studies that show positive outcomes are much more likely to be published and even studies that aren’t positive are, in the author’s opinion, are published in a way that make them appear positive. Imagine the effect that might have on the prescription habits of doctors. Again, a new, more comprehensive approach is necessary.
More and more information is linking depression with inflammation. This inflammatory load causes changes in neurotransmission leading to depression in susceptible individuals. Inevitably, some are going to experience mood so low they see suicide as the only way out. A big piece of the depression-inflammatory link is gastrointestinal health. Yes, your gut and your brain are connected and it can affect you mood. Here is a summary of how it occurs.
Bacterial load in the gut is immense. There are more bacterial cells in your gut than there are cells in the rest of your body. This collective load of bacteria can be considered an inner organ. Just as disruptions in the function of other organs in your body can affect brain function, disruptions of this “organ” can affect your mood. The balance of the bacteria is key. A shift that allows overgrowth can cause many symptoms. Some of them may be gastrointestinal, some of them dermatological, some of them might cause fatigue, some might cause mood change. And here’s how.
There is a toxin on the surface of many of the bacteria in our gut. It’s called lipopolysaccharide (LPS). LPS should stay in the gut where it belongs. However, when it gets out of the gut it causes a potent immune response. This immune response is inflammatory. Over time, inflammatory load builds and builds to a point where it begins to cause systemic levels of inflammation to rise. Once this has happened, this inflammation begins to break down the blood brain barrier (BBB). The BBB is critical for keeping our brain in an isolated and controlled environment. With its breakdown, inflammatory chemicals circulating in the blood stream gain access to the brain and can begin to alter neurotransmitter levels, including serotonin. Eventually, these changes in neurotransmission result in altered synaptic plasticity and, literally, alters the way your brain is wired. This is reversible and can be improved, but only if the right treatments are applied. For many, the right treatment is not antidepressant medication. Unfortunately, they don’t know the above information either and they’re left to suffer. A new paradigm is starting to unfold in mental health – one that addresses overall health of the individual to get results rather than simply altering neurotransmitters with drugs that, arguably, don’t work.
Here are some good references for the information above if you’re a glutton for punishment :)