How The Inflamed Mind can cause depression

Book review: The Inflamed Mind, by Professor Edward Bullmore

Have you ever been in pain and then realised that you also feel tired, a little withdrawn and your mood has dipped? Has your energy and mood lifted as soon as that pain has gone away?

Edward Bullmore, the Head of the Department of Psychiatry of the University of Cambridge now thinks there is an important link between depression and inflammation and that an inflamed body can lead to an inflamed mind. Professor Bullmore’s research into the link between inflammation and depression has resulted in his new groundbreaking book The Inflamed Mind. He postulates that approximately a third of people who are depressed and are struggling with a black mood may be experiencing this due to underlying inflammation, rather than an issue with regulating serotonin. The fact that depression is not all in the mind could be a major breakthrough for those who have not responded to anti-depression medicine.

I remember experiencing this whole body inflammatory effect when I had a pesky sore shoulder a few years ago. It was Christmas time and I remember being overtired, constantly bursting into tears for no reason and rather disengaged from the buzz of Christmas. When my husband encouraged me to take a strong painkiller with anti-inflammatory properties, very quickly I was in less pain, but what was also interesting was that my mood was much brighter, I felt more energised and I swung back nice and quickly into the spirit of Christmas. This was one of the first times I made the connection between mood and inflammation.

Similarly, Bullmore made this connection when he had a tooth extracted. During the couple of days following his tooth extraction he also felt withdrawn and his mood and energy was lower than normal. It was a light bulb moment when he realised his mood was probably affected by his inflamed gums. His consequent research has discovered that inflammatory blood markers are found in many people who are depressed, and inflammation can affect the way we think and feel.

Historically, medical thinking has viewed the brain and body as being separate. They are divided by the blood brain barrier, which was mostly thought up until now to be an impenetrable Berlin Wall-like membrane. Therefore, physical illnesses have been treated by medical doctors and mental illness by psychiatrists with no overlap. Bullmore highlights this blind spot, and his research has shown that inflammation in some people can affect both the body and brain simultaneously.

If this is the case, imagine if your body has been in a state of inflammation for a long time, and how much this could have affected your long-term mood? Most of the time we associate inflammation with pain from injury, headaches or arthritis. However, it is also thought that diabetes, obesity, cardiovascular disease, autism spectrum conditions, dementia, asthma and eczema are linked to an underlying immune dysregulation which triggers chronic low-grade inflammation. Could this be why people with these conditions are more prone to depression and other mood disorders?

As my ardent readers know, one of my main interests lies in child mental health. And what I found fascinating was that Bullmore cites some large studies showing that children as young as nine years old show inflammatory blood markers including cytokine interleukin-6. What is apparent is that even if children do not show any signs of depression at that stage, these inflammatory markers at nine years old are predictors for mental health issues such as depression and bipolar disease later-on in their teens. So, this is why it is so crucial to help your children from being in an inflamed state.

The Inflamed Mind represents a whole new way of looking at how mind, brain and body work in harmony together to help us survive in a hostile world of stress and challenges. It is very exciting that top medical experts are now getting to grips with depression and other mental disorders and the future is looking much brighter for many.

In my clinics, I see many adults and children with inflammatory health issues stemming from an early age. Very often they say their mood and energy dipped for some time before the physical symptoms arose, and some report that these moods and energy issues are worsened when their physical issues are worse. Some present with arthritis, headaches, menstrual pain or chronic digestive pain, others with autoimmune conditions or chronic fatigue. Many of the children we see have behavioural problems, or neuro-developmental and learning issues, including problems with memory, focus and concentration. For a long time, I have had a very similar approach to these health challenges which is to help to reduce the underlying inflammation using a positive nutrition approach. So it is very exciting for me to see Professor Bullmore’s research.

While The Inflamed Mind does not itself delve into solutions to inflammation, what I find produces results in my clinic are nutrition measures including reducing pro-inflammatory foods such as ultra-processed foods and refined sugar from the diet and increasing fruits, vegetables, nuts, seeds and legumes. Not everyone seems to drink enough water, and little extra water every day can also help. I check vitamin D levels as well as the patient’s iron stores (called ferritin). I may also carry out stool, urine or blood testing to see if any infection could be causing the inflammation. I often add in gut health support such as probiotics and fermented foods, such as yoghurt and kefir. Omega 3, found in oily fish, is important for keeping inflammation under control and so I encourage eating oily fish 3-4 times a week; and may suggest supplementing with a fish oil until the inflammation is better controlled. Anti-inflammatory herbs such as turmeric and ginger are also useful, and these are easily added to food and drinks.

In short, anyone interested in understanding the science behind inflammation should buy The Inflamed Mind. It should certainly provoke more thought and research in the field of depression.