MAJOR DEPRESSIVE DISORDER (MDD)
is one of the most common mental illnesses in the United States. Each year, about 6.9% of adults in the U.S. experience at least one major depressive episode.1 Although the problem is so widespread, people may only seek treatment because of the physical symptoms of depression, such as muscle pain and stomach problems.2Furthermore, of those who do seek treatment, only around one-third achieve complete remission.3 Some of the most promising research for treatment-resistant depression lies in anti-inflammatory medication.
“Some of the most promising research for treatment-resistant depression lies in anti-inflammatory medication”
Many chronic illnesses, such as heart disease, Type II diabetes, and rheumatoid arthritis, are associated with inflammation.4 Inflammation is usually a well-controlled response to local injury or infection and is essential to survival. However, when inflammation becomes chronic or widespread, chemical signals can cause damage in healthy tissue.5 Some of these signals, called proinflammatory cytokines, are elevated in people with depression; high levels of certain cytokines can even predict the future development of MDD.3Psychosocial stress can trigger inflammation in the same way that injury to the body does. When someone is physically hurt or undergoes stress, the same areas of the brain are activated.3 Activity in these areas can lead to increased levels of proinflammatory cytokines, which in turn influence brain activity, leading to a positive feedback loop.
“Anti-inflammatory medicine and lifestyle changes may greatly improve the lives of the millions of people affected by depression.”
A meta-analysis conducted in 2014 suggests that supplementing traditional therapies like antidepressants and counseling with anti-inflammatory medication, especially the prescription medication Celebrex, can be more effective than traditional therapies alone.6 Studies so far have been limited to small groups, so further research into how anti-inflammatory medicine works in the body – and how much it could benefit people with depression – is needed.
Despite being such a prevalent health problem, MDD is still poorly understood. It seems to be influenced by many factors, including genetics, childhood trauma, and physical health. Further research into proinflammatory mechanisms in the body can help doctors understand why some people respond to certain treatments and some do not. Although they seem to be unusual treatments for mental illness, anti-inflammatory medicine and lifestyle changes may greatly improve the lives of the millions of people affected by depression.
Amber Nadeau is a senior from Brown College at Rice University.
REFERENCES
National Institute of Mental Health Online. n.d.http://www.nimh.nih.gov/health/topics/depression/index.shtml (accessed Jan. 25, 2015).
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Glaser, Ronald, and Janice K. Kiecolt-Glaser. Nat Rev Immunol. Online 2005, 5.3, 243-251.http://www.nature.com/nri/journal/v5/n3/full/nri1571.html (accessed Jan. 25, 2015).
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Slavich, George M., and Michael R. Irwin. Psychol. Bull. Online 2014, 140.3, 774-815.http://psycnet.apa.org/psycinfo/2014-01013-001 (accessed Jan. 25, 2015).
Köhler O, Benros ME, Nordentoft M, et al. JAMA Psychiatry. Online 2014, 71:12, 1381-1391.http://archpsyc.jamanetwork.com/article.aspx?articleid=1916904 (accessed Feb. 9, 2015).