By Dr. Erin Wiley, ND

Stay tuned to the BLOG for parts two through four in this “Brain on Fire” series by Dr. Wiley!

North America is suffering from an epidemic of chronic inflammatory disease, caused by changes in our food supply, diet, and lifestyle. While you may be very familiar with joint or muscle inflammation, or with inflammatory diseases such as diabetes, heart disease and arthritis, you may not realize that we experience inflammation in our brain, or that when we look at the biochemistry behind depression, inflammation is considered a major contributing factor. Therefore, the North American inflammation epidemic could contribute to a dramatic increase in depression and mental illness.

Inflammatory markers are directly correlated with body fat percentage, waist circumference and insulin insensitivity [1]. The populations most at risk include those with metabolic syndrome and those with type II diabetes [1]. Approximately 59% of Canadian adults are overweight or obese and a growing number of our children are becoming obese. If current trends continue, by 2040 it is estimated that 70% of adults over the age of 40 will be overweight or obese [2]. A population trending towards an obesity epidemic is a population suffering from inflammation. That population is also physiologically at greater risk for developing depression.

An appropriate inflammatory response is when the body attacks foreign bacteria, a virus or damaged cells as a method of protection. An inappropriate response is when the inflammation becomes chronic and the immune system attacks and damages its own cells, including brain tissue! As a mechanism of action for depression, inflammation decreases 5-HTP, increases glutamate, causes microglia cells to release neurotoxic substances that damage brain tissue and lowers the number of astrocytes, thus decreasing the brain’s ability to protect and repair itself [3]. This creates an environment of increasing damage and decreased repair of brain tissue, which promotes depression.

The good news is that it is within our ability to promote an anti-inflammatory lifestyle, which can help prevent and treat depression. This four-part article will consider three main areas of influence. This Part I is an overview of the connection between inflammation and depression. In Part II, we will look at lifestyle components such as nutrition, exercise, and stress reduction. In Part III, we will explore key foundational nutrients such as fish oil and probiotics that decrease inflammation. Finally, in Part IV we will look at supplements such as anti-oxidants and Nrf2 activators that repair cellular damage and activate the genes in our body that regulate the production of antioxidants, regulate the production of detoxification enzymes and promote signaling in the body that down-regulates factors that promote inflammation.

Exploring the inflammatory mechanisms behind depression give us a powerful opportunity to promote healthy lifestyle change and decrease the rates of depression in our population. An integrative approach also gives individuals suffering with depression the opportunity to explore a synergy of treatment options or choose the ones that are best suited to their level of readiness for lifestyle change. Under the supervision of a licensed Naturopathic Doctor, many of these treatment options are well suited to be used in conjunction with standard medical treatments for depression, such as cognitive behavioral therapy and anti-depressant medications.

Dr. Erin Wiley is the Clinic Director of the Integrative Health Institute. IHI operates as a true integrative medical team where clinicians interact and communicate directly about their clients care. In her practice, Dr. Wiley has a special interest in digestive health, endocrinology and hormone balance with a clinical focus on fertility, menopause, anxiety, depression, healthy weight loss, detoxification and environmental medicine.

References
1. Festa, A, D’Agostino R, Howard G, Mykkanen L, Tracey R, Haffner S, Chronic Subclinical Inflammation as Part of the Insulin Resistance Syndrome. Circulation. 2000;102:42-47
2. Statistics Canada, Canadian Community Health Survey, 2009, 2010.
3. McNally L, Bhagwagar Z, Hannestand J. Inflammation, Glutamate, and Glia in Depression: A Literature Review. CNS Spectr. 2008;13(6):501-510