Neuro

Neuroscience Discoveries Show Inflammation Can Cause Depression – Especially If You Experienced Severe Stress in Early Childhood

Lillian was in second grade when her mom went to work full-time. For the first time in her life, she would get off the school bus and walk down the street to her house, pull out her key and unlock the door.

Lillian was intelligent and responsible. But when she opened the front door and walked into the dark house, she was scared. She’d creep to the couch, shaking as she turned on a lamp, and sit there until 5:30 when her parents got home.

She often cried during those hours.

Some people could adapt to that just fine. But for some, experiences like this can be traumatic.

Second grade, third grade, fourth grade…. Those long hours in that dark and empty house were a crucible of terror for this sensitive little girl. It didn’t help that her parents weren’t the “sensitive” types. They chuckled about her fear. They just didn’t get it.

A Child Silently Suffers

As little Lillian advanced to middle school and beyond, she suffered for years with undiagnosed depression. Not that her parents were aware. Quite to the contrary, they were proud of their talented and intelligent daughter. As long as she continued to perform, they were happy.

“I see you have an A- on your report card. What happened? Why wasn’t it an A?” Their idea about parenting was to expect the best of their children, and never praise anything short of that. They fully expected their high-achieving daughter to go to medical school, and they had no intention of threatening their bragging rights by supporting what they considered mediocre.

In fact, they expected her to become a pediatrician. That was the plan.

But Lillian, in spite of her high grades, wanted to ride horses, study animal husbandry, and write songs.

Unwitting Parents Tear Down Resilience

This isn’t the first time parents’ dreams for their child remained unrealized. Neither was it the first time a budding teenaged girl felt misunderstood.

When Lillian and her friend dressed to go to an 8th grade dance, before they walked out the door, her mom said, “Lillian, you need to cut your hair. It looks shaggy. And you need to lose weight in your hips. They’re too big!”

The lithe but discouraged girl looked at her shoes… wishing she could be swallowed up by a hole. How could she face the 8th grade boys when she felt so ugly?

Experiences like these accumulated through her teens. Once she was married and gave birth to her first child, the depression grew more severe. It became worse and worse until she stayed in bed most of the days…unable to function to care for her children.

Finally, she was admitted to a community psychiatric hospital. The depression that had plagued her during her formative years escalated to full blown disability. And she improved only marginally from that hospitalization. There would be many to follow.

But why?

Can Inflammation Cause Depression if You Suffered Early Childhood Stress?

An article by Carmine Pariante, MD, PhD published in Psychiatric Times in May, points out some of the ways research is revealing patients with depression have increases in their inflammatory system. Elevated levels of “cytokines” which are substances, like interferon, interleukin, and some of the growth factors, secreted by the immune system indicate inflammatory activity.

Even so, what’s interesting is that not all people who suffer from depression also suffer from inflammation.

They found through a series of studies between 2009 and 2017 that excessive stress early in life, as well as the stress of lower socioeconomic status and cardiovascular risk factors, can lead to inflammation. But of these factors, early life stress was by far the largest correlate to inflammation.

Can Inflammation Cause Depression?

In recent years, we’ve been able to even connect the dots of inflammation in adults who were exposed in the womb to their mothers’ perinatal depression. The link was so significant that researchers were able to make the connection that stress in the womb is linked to inflammation in adults, with or without depression symptoms.

Stress in the womb is a risk factor for inflammation in adults!

Then they took it a step further…

Several studies revealed that certain genetic variations lead to depression symptoms…but only in those who suffered early life stress.

Then things got even more interesting.

Can inflammation cause depression?

Since omega 3 fatty acids fight inflammation, the researchers found that patients with low levels of DHA and EPA had more inflammation. So they speculated that when the levels of DHA and EPA are low, that condition would cause inflammation-induced depression.

DHA is the nutrient added to many infant formulas that’s also found in breast milk. DHA and EPA are long chain omega 3 fatty acids that account for 97% of the omega 3 fatty acids in the brain. They’re vital for optimum brain function and development.

And the researchers were right. They performed a clinical trial with patients who had these low levels…dosed them with EPA and DHA… and found it prevented or delayed onset of this type of depression.

This discovery showed them that patients with low levels of EPA and DHA omega 3’s can be treated with nutrients to restore these reserves and potentially prevent the inevitable depression that can follow.

Personalized Medical Care Means Faster and More Effective Treatment

This innovative discovery empowers us with one way to provide personalized interventions for depressed patients based on their individual cause of depression.

They also found that of those with low omega 3 levels, only those who experienced early life stress became depressed. Others with low omega 3 levels showed inflammation without depression.

What’s more, those who experienced stress in the womb due to their mother’s depression during pregnancy, showed inflammation and depression in adulthood.

Certainly, not everyone who is depressed shows those inflammation markers in their lab work.

But for those who do, we can provide more effective and novel treatments to help them recover.

If they don’t need an antidepressant, but do need dosing of EPA and DHA, and if that intervention will restore their emotional balance, how much better to treat the real fundamental problem.

More Neuroscience Research is Needed

Neuroscience researchers continue to uncover mysteries as they work to find solutions for your suffering. I would like to see studies involving depressed patients who fit these categories treated with IV ketamine infusions.

Is it possible that the patients who don’t seem to readily respond to ketamine treatment are actually those low in EPA and DHA?

On the other hand, would these patients respond to ketamine treatment without doses of EPA and DHA?

So many more studies are needed. In fact, the more we learn, the more we realize what the questions are!

At Innovative Psychiatry, we continually seek novel and effective treatments for you if you suffer from treatment-resistant psychiatric disorders.

Personalized treatment drives us with each patient.

We work hard to find out how to help you get better, based on what factors led to or contributed to your symptoms.

From ketamine treatment to strengthening your microbiome to adding nutrients to your diet and more… we want you well.

Let’s work together to help you get better, so you can enjoy and build a fulfilling and rewarding life. Call us.

To the blooming of your best self,

Lori Calabrese, MD