Many new studies focus on inflammation as a source of depression and other mental health issues: Inflammatory markers, like CRP, IL-6, and (TNF)-α have been studied and found to be strongly associated with depression and anxiety [1-7]. The authors of one study stated that lifestyle may be the culprit [2]. One large study found that a CRP between 3 and 10 increased the odds of being hospitalized for depression by 84% [8].

Inflammation Causes Neurotransmitter Interference

The drugs given to people with depression or anxiety are generally designed to boost neurotransmitter activity. For example, SSRIs and SNRIs are ‘reuptake inhibitors,’ which means they keep serotonin or norepinephrine in the synapse longer, increasing the activity of those neurotransmitters. If someone is taking an SSRI or SNRI and they are in an inflamed state, it is a lot like bailing out a boat with a huge hole by using a teacup.

Neurotransmitter What happens chemically Shortage may cause these symptoms:
Serotonin Inflammation keeps tryptophan from becoming serotonin. Instead, it becomes quinolinic acid, which is a neurotoxin Can lead to persistent low mood, irritability, mood swings, sleep disturbances, fatigue, and even anxiety.
Dopamine BH4 is a critical cofactor for tyrosine to become dopamine. Inflammation depletes BH4, thereby reducing dopamine production. Low dopamine may lead to low motivation, reduced enjoyment or pleasure, fatigue, difficulty concentrating, and slowed movement or thinking.
Norepinephrine Dopamine converts to norepinephrine; so the same chemistry applies here. Reduced norepinephrine activity may contribute to reduced alertness, low energy, difficulty sustaining attention, and poor concentration.
GABA GABA is the brain’s main inhibitory neurotransmitter. It is a brake that keeps nerve-cell activity from becoming excessive.  Inflammation can shift the balance toward excess glutamate and reduced GABA activity. When GABA signaling is impaired, those circuits can become more excitable, potentially contributing to anxiety, difficulty settling down, and disturbed sleep. Altered GABA signaling has also been implicated in panic disorder.

Diet is the key: Fruits, vegetables, nuts and seeds reduce inflammation. Sugar, refined food, processed food, and chemicals increase inflammation. You want them to increase the former and decrease the latter.

Nutrition Is not “All or None”

Improving diet and reducing inflammation is perhaps the best thing you can do to improve brain health with a goal of improving mental health. Addressing diet is the best way to accomplish that. Unfortunately, people love their habits and if they are struggling with depression, anxiety, sleep issues, or other mental health issue, change comes hard. Here are some suggestions that may help:

  • Concentrate on “dos” and not “don’ts”: Junk food is addictive. People love “comfort foods.” Make changes and reduction in inflammatory foods. Increase foods that control inflammation—fruits, vegetables, nuts and seeds. Work on replacing inflammatory foods with anti-inflammatory foods. Instead of thinking, “I can’t have junk.” Crowd out the junk with foods that fight inflammation
  • Consider juicing: This will massively increase polyphenols and lower inflammation. Juicing gets a bad rap because you don’t get fiber. Simply taking citrus pectin will mitigate that AND the combination of juice and fiber will improve the microbiome. You can also make juice in a Vitamix or Ninja; these products keep the fiber in the juice. Juice vegetables, not fruit. You can add some carrots or an apple to sweeten a bitter juice, but there is too much sugar in fruit juice.
  • Be strict for 30 days: Most people can do anything for 30 days. Use the Roadmap to Health because it will also improve microbiome health. Here is a link: https://wholehealthweb.com/roadmap-to-health/ . Thirty days is long enough for the you to notice how much better they feel. It helps motivate them to improve the diet going forward.

The 80% Rule: A very old concept, the alkaline ash diet, has been recommended by natural health practitioners for decades. They would say that to heal, you need to eat 80% alkaline foods and to maintain health the diet should contain 60% alkaline foods. The idea of diet changing the body’s pH is not true, but the diet was very effective. “Alkaline” foods are fruits, vegetables, nuts, and seeds—the foods that reduce inflammation. “Acid” foods include (most lists also included grains and animal protein) sugar, alcohol, refined foods, chemical additives and processed food. Consuming a lot of polyphenols and a lot of fiber produces amazing results. Clinically, it works.

Selected References:

  1. Psychoneuroendocrinology 2013 Sep; 38(9): 1573-85 Differential association of somatic and cognitive symptoms of depression and anxiety with inflammation: findings from the Netherlands Study of Depression and Anxiety (NESDA
  2. Brain Behav Immun. 2012 Jan;26(1):90-5 Treatment response and cognitive impairment in major depression: association with C-reactive protein
  3. Psychoneuroendocrinology 2013 Sep; 38(9): 1573-85 Differential association of somatic and cognitive symptoms of depression and anxiety with inflammation: findings from the Netherlands Study of Depression and Anxiety (NESDA)
  4. Brain Behav Immun. 2015 Jul;47:193-200 Inhibition of tumor necrosis factor improves sleep continuity in patients with treatment resistant depression and high inflammation
  5. Anxiety in relation to inflammation and coagulation markers, among healthy adults: the ATTICA study Atherosclerosis. 2006 Apr;185(2):320-6.
  6. Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond Neuropsychopharmacology. 2017 Jan;42(1):254-270.
  7. Inflammatory markers in post-traumatic stress disorder: a systematic review, meta-analysis, and meta-regression Lancet Psychiatry. 2015 Nov;2(11):1002-12
  8. JAMA Psychiatry. 2013 Feb;70(2):176-84 Elevated C-reactive protein levels, psychological distress, and depression in 73, 131 individuals