Inflammation

If we get a cut, the area around it becomes red, swollen, and hot. This is an example of acute inflammation, which works to heal the cut and prevent infection. This kind of inflammation is a good thing. Once the cut is healed the inflammation resolves.

Problems with inflammation start when the body remains in a state of low-level inflammation over a long period of time. This is called chronic inflammation. Current research is examining the role of inflammation in metabolic issues, cardiovascular disease, insulin resistance, obesity, diabetes, aging, and a number of brain conditions. This research suggests that inflammation may be the common pathway for many health issues.

Patients often report a variety of inflammatory and autoimmune symptoms in addition to mental health symptoms. Periods of increased emotional stress can at times induce flare-ups of pain, joint problems, skin issues, gastrointestinal dysfunction, and other symptoms suggestive of systemic inflammation. Chronic inflammation may be the underlying mechanism that could explain both the mental health and physical health issues.  Recent studies link inflammation to the following psychiatric conditions in adults and children:

  • Schizophrenia

  • Depression

  • Bipolar Disorder

  • Autism

  • Post-traumatic Stress Disorder

  • Cognitive Decline

In scientific research, proving causation is much more difficult than just pointing out that two things seem to be connected. So while we cannot say with certainty that inflammation causes mental illness, research has shown that inflammation is associated with some brain disorders. How big of a role inflammation plays in brain health remains controversial and the research remains mixed.

Causes of Inflammation

The early research on inflammation focused on inflammation caused by infections. However, we are learning that inflammation can be caused by a variety of factors.  As research on inflammation accumulates, the list of factors that cause inflammation continues to grow.  Here are a few key examples:

Stress

Studies show that both childhood and adult stress contribute to inflammation. Childhood trauma, such as bullying, is associated with increased levels of inflammation and may profoundly alter the activity of stress hormones. Stress increases the activation of the sympathetic nervous system; which is responsible for the “fight or flight” reaction, production of the stress hormone cortisol by the adrenal glands and other inflammatory mediators. These changes can last into adulthood.

What to do? Research studies confirm that mind-body practices, such as yoga and meditation, are effective at lowering stress, as well as lowering stress hormones, inflammatory markers, and the “fight or flight” response.

Diet and Metabolism

Foods that cause sensitivities and irritation of the digestive tract contribute to inflammation of the intestinal lining. Poor digestion and absorption of nutrients, as well as shortage of good bacteria or overgrowth of harmful bacteria in the gut, can worsen inflammation. Research is now exploring the link between gut problems and mental illnesses, such as schizophrenia.

What to do? Healing the gut can do much to reduce inflammation. The first step is improving the diet: remove harmful foods and add beneficial foods. One useful tool for discerning which foods are harmful for you is the elimination diet. You may also try adding probiotic foods, which support the growth of healthy bacteria, to help your body to rebalance its gut flora.

Sleep

Research shows that loss of sleep increases inflammation.

What to do? – Cherish your sleep and maintain good sleep hygiene. Aim for 8 hours per night and try to be as consistent as possible with going to bed and getting up at the same times everyday so that your body can settle into a routine.

Autoimmune conditions

Autoimmune conditions are characterized by an overactive immune system that attacks a person’s own healthy tissue, often causing severe pain. Common examples are Graves’ disease, systemic lupus erythematosus (SLE), multiple sclerosis, and rheumatoid arthritis. Inflammation plays a major role in the pathology of autoimmune disease and is thought to be a mediator between autoimmunity and the psychiatric conditions it effects, such as narcolepsy and schizophrenia.

What to do? – Reduce inflammation with the suggestions above, reduce stress as much as possible, and optimize your gut bacteria.

Environmental Exposures

Toxins like pesticides, herbicides, cosmetics, chemicals in cleaning products, flame retardants, dioxins, BPA and others may affect our immune system and contribute to inflammation in the body. The 100,000 new chemicals that were released into consumer products over the last few decades are considered safe until proven otherwise, and perhaps unsurprisingly, studies are now starting to document how some of these chemicals could be contributing to inflammation and disruption of the endocrine system.

What to do? – You can reduce your exposure to these chemicals by using non-toxic home products and cosmetics, and eating healthy and mostly organic food.

Prenatal Complications

There isn’t much we can do about the prenatal exposures that we ourselves had in- utero, yet people who are pregnant today can do much to protect their children from inflammation than in prior decades. 

What to do? – Reducing stress during pregnancy and getting the optimal prenatal care both lower the risk for prenatal complications.

Treatment for inflammation

Research is just beginning on the use of natural and pharmaceutical anti-inflammatory agents for the treatment of mental disorders.

Pharmaceutical Approaches

Depression — A recent review of 4 studies using an anti-inflammatory drug as a treatment for depression showed good results. The group receiving anti-inflammatory medication showed higher rates of improvement than the placebo group.

Schizophrenia — A review of 8 studies on non-steroidal anti-inflammatory drugs (NSAID), such as aspirin, in patients with schizophrenia found that the NSAIDs reduced symptoms, such as hallucinations and delusions, when added to other treatments. In addition, treatment with certain serotonin receptor antagonists (5-HT3) involved in the regulation of intestinal inflammation reduced the negative symptoms of schizophrenia; such as lack of interest in the world and emotional flatness.

Natural Approaches

While the studies above used anti-inflammatory medications, nature provides a wealth of natural anti-inflammatory agents. Some of the key natural approaches to reducing inflammation include:

  • Reducing stress

  • Eating an anti-inflammatory diet

  • Sleeping well

  • Normalizing weight and avoiding rapid weight changes

  • Avoiding infections and supporting the immune system by living a healthy lifestyle

  • Avoiding chemicals, pesticides and environmental toxins

We are just beginning to understand how preventing, reducing and treating inflammation may protect us from psychiatric and neurological conditions. There is a lot that we can do to reduce chronic inflammation and improve health through the healthy lifestyle changes discussed above. Mind Body 7 clinicians consider the role of inflammation in mental and physical health conditions.

Dr. Beata Lewis, MD specializes in understanding the role of inflammation in the body and addressing chronic inflammation through nutrition changes, stress reduction, psychotherapy and lifestyle modification.