The role of inflammation in anxiety and depression

For some time psychology has recognized a relationship between stress, anxiety, and depression.  Anxiety and depression are associated with increased risk for certain health problems like diabetes, high blood pressure, and heart disease.  


In recent years, chemical reasons for the link have been studied.  This research suggests that our immune systems may play a critical role in the process.  George Slavich and Michael Irwin of UCLA recently wrote a review of research on the subject in the journal Psychological Bulletin.

Most of us know our immune system for its role in healing cuts and fighting off illnesses.  The system detects an open wound and sends clotting agents and white blood cells to the site of the bleeding in order to create a scab and prevent infection.  The immune system also reacts to the presence of viruses or bacteria in the bloodstream by using different cells to fight the invading organisms. 

The immune system doesn't just wait passively for an injury or invasion to occur.  In times of danger the immune system will proactively activate, or go on a sort of heightened alert.  For example, if a lion or grizzly bear is running towards us, the immune system will kick into gear so that no time is lost if an actual injury occurs. 

In addition to predators, some social events also cause the immune system to prepare for a threat.  Specifically, certain major life events like loss of a loved one due to separation or death, loss of a job, and especially social rejection seem to cause the immune system to kick in.  Note that these sorts of major events are also predictive of the onset of a depressive disorder.

The link between the immune system and depression appears to be inflammation. Short term inflammation is beneficial to the immune system and recovery.  It speeds up recovery from injury or illness by helping the rest of the immune system recognize and quickly respond to threats that could lead to injury.

Alongside internal changes, certain behavioral changes are also associated with inflammation including social withdrawal, tiredness, lethargy, etc.--in other words behaviors that look a lot like depression. 

The research is pointing us in the direction of understanding that chronic stressors such as social rejection, financial insecurity, and social threats can cause our bodies to maintain a state of more or less constant inflammation.  There appears to be a link between the constant inflammation and major depressive disorder.  It is also thought that people who experience significant traumas early in life has immune systems that are quicker to activate inflammation and slower to turn it off and are therefore more prone to anxiety and depression in later life.  

The evidence for a link between inflammation and depression is growing and is leading to improved treatments for both anxiety and depression based on anti-inflammatory agents, including anti-inflammatory medicines. Effective non-chemical treatments include Cognitive Behavioral Therapy (CBT) and Mindfulness Based Stress Reduction (MBSR). 

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