Depression and Chronic and Autoimmune Diseases Essay Paper

Depression and Chronic and Autoimmune Diseases Essay Paper

Depression, bipolar disorder, and other mental health problems arise when something goes wrong with brain function. What causes that malfunction is an open question. In some people, a serious infection or autoimmune disease could be the trigger.Depression and Chronic and Autoimmune Diseases Essay Paper

A report published online in JAMA Psychiatry explores this hypothesis. Researchers turned to comprehensive Danish databases that include all Danes born in the country, each identified by a unique registration number. One of the databases stores health-related information, including records of hospitalizations. Among Danes born between 1945 and 1995, almost 92,000 had a mood disorder. Of these, 36,000 had suffered a severe infection or developed an autoimmune disease (such as type 1 diabetes, celiac disease, lupus, and the like) at some point before being diagnosed with the mood disorder.Depression and Chronic and Autoimmune Diseases Essay Paper

People who had been treated for a severe infection were 62% more likely to have developed a mood disorder than those who never had one. An autoimmune disease increased the risk by 45%. Multiple infections or the combination of severe infection and an autoimmune disease boosted the odds of developing depression, bipolar disorder, or another mood disorder even further.

The researchers estimated that in the Danish population, severe infection and autoimmune disease account for 12% of mood disorders.

“A link between infection and depression and mood disorders is intriguing,” says Dr. Michael C. Miller, assistant professor of psychiatry at Harvard Medical School and a member of JAMA Psychiatry’s editorial board.Depression and Chronic and Autoimmune Diseases Essay Paper “But it’s important to keep in mind that both infections and mood disorders are very common, making it difficult to tease out what causes what.”

He ticks off three possible explanations for the results:

  • Severe infection and autoimmune disease may cause mood disorders.
  • Mood disorders may create a susceptibility to infection or autoimmune disease.
  • Mood disorders, severe infection, and autoimmune disorders may share common triggers.

What’s the connection?

The Danish study isn’t the first to explore links between infection or autoimmune diseases and depression. Much of the evidence supports a connection.

Depression isn’t the only mental health issue that may be related to infections and autoimmune condition. Writing last year in the Harvard Health blog, Dr. Jeff Szymanski described how some children with strep throat suddenly develop obsessive-compulsive disorder. It’s one manifestation of pediatric acute-onset neuropsychiatric syndrome.Depression and Chronic and Autoimmune Diseases Essay Paper Quick treatment with antibiotics can reverse the problem.

How might an infection or autoimmune disorder lead to a mood or other mental health disorder? Infection causes localized and body-wide inflammation. Inflammation generates substances called cytokines that have been shown to change how brain cells communicate. In autoimmune diseases, the body’s defense system attacks healthy tissues rather than threatening invaders. It’s possible that in some cases the wayward immune reaction could target brain cells and other nerve cells throughout the body.

The connection between infection, autoimmune disease, inflammation, and mood disorders has prompted some researchers to wonder “Can we vaccinate against depression?” The short answer, at least for now, is “no.”

But there are things you can do. “Healthy living has all sorts of benefits,” says Dr. Miller. It can help you fight infection, reduce inflammation, ease stress, and make you feel better day to day, all of which work against the development of a mood disorder.”

The Rise of Autoimmune Brain Problems

Autoimmune conditions themselves have also grown to epidemic proportions in our lifetime, affecting an estimated 50 million Americans. Today there are close to 100 recognized autoimmune diseases, with 40 more disease processes likely having an autoimmune component, and I predict that we will uncover more still.

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Autoimmune disease attacks the body’s own tissues in an overzealous attempt to slay invaders like viruses or bacteria, and frequently attack specific areas of the body – the brain included.

Millions of people’s immune systems are attacking their brain and nervous tissue, and this particular problem is drastically under-diagnosed. Autoimmune brain diseases like multiple sclerosis, Parkinson’s, Alzheimer’s, and autism are affecting people now more than ever before in human history. Even Celiac disease, so often considered a GI disease, can be strictly neurological in its symptoms, leading to severe anxiety disorders and other brain problems.Depression and Chronic and Autoimmune Diseases Essay Paper

So what gives? As I mentioned in my previous article, fascinating new research is looking at how inflammation can damage the brain’s protective blood-brain barrier (BBB) and possibly lead to brain problems such as what is now often referred to as neurological autoimmunity.

This inflammation activates the brain’s immune microglia cells, which can trigger an inflammatory-autoimmune response. In other words, people’s immune systems might be attacking their brain and nervous tissue in response to inflammation that could have started somewhere else entirely, such as in the gut.

The Anxiety/Depression and Autoimmune Connection

In order to be diagnosed with most autoimmune diseases, there must first be evidence that the immune system has destroyed a significant amount of tissue – in this case, the brain or nervous system tissue. Yet, autoimmune disease starts long before conditions are sufficient for an official diagnoses.Depression and Chronic and Autoimmune Diseases Essay Paper Typically it progresses along an autoimmune spectrum in this order:

  1. Silent Autoimmunity: Labs show up with positive antibodies, but there are no noticeable symptoms.
  2. Autoimmune Reactivity: There are positive antibody labs and some symptoms, but no radical tissue destruction.
  3. Autoimmune Disease: There is enough body destruction to warrant an official diagnosis.

The patient I mentioned earlier is like the countless other people on the autoimmune spectrum: Not sick enough to be labeled with an autoimmune disease, but demonstrating symptoms that interfere with her life and function.

Why aren’t we catching these diseases sooner? Brain destruction should never be taken lightly. Research has shown that depression and anxiety are more common in patients with autoimmune diseases than chronic degenerative conditions, likely due to the direct effect of inflammatory cytokines on the central nervous system. Further, someone with one autoimmune disease has a higher chance of suffering an immune system attack on another system, such as the brain.Depression and Chronic and Autoimmune Diseases Essay Paper This is called polyautoimmunity. For example, one study looking at lupus found higher rates of anxiety due to inflammation in the brain.

Up to 50% of patients with autoimmune diseases show an impairment of health-related quality of life and exhibit depression-like symptoms.Depression and Chronic and Autoimmune Diseases Essay Paper The immune system not only leads to inflammation in affected organs, but also mediates behavior abnormalities including fatigue and depression-like symptoms. This review focuses on the different pathways involved in the communication of the immune system with the neuronal network and the body’s timing system. The latter is built up by a hierarchically organized expression of clock genes. As discussed here, the activation of the immune system interferes with high amplitude expression of clock genes, an effect which may play a pivotal role in depression-like behavior in autoimmune diseases.Depression and Chronic and Autoimmune Diseases Essay Paper

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