#585: Inflammation, Saunas, and the New Science of Depression
Feb 17, 2020
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Charles Raison, a psychiatrist and co-author of 'The New Mind-Body Science of Depression,' discusses the intriguing link between inflammation and depression. He questions the very existence of major depression and explores how inflammation can arise from both physical illness and psychological stress. Raison highlights the surprising benefits of short-term inflammation through exercise and sauna use, and the potential of intermittent fasting. He also emphasizes the importance of personalized treatment approaches for mental health.
The podcast challenges the notion of major depression as a uniform condition, emphasizing its diverse manifestations among individuals requiring personalized understanding and treatment.
Emerging research links inflammation to depression, suggesting that both psychological stress and physical illness can trigger inflammatory responses affecting mental health.
The discussion highlights how short-term exposure to physical stressors like exercise and sauna use may enhance mood by reducing long-term inflammation.
Deep dives
Depression and Its Definition
The discussion raises the provocative question of whether major depression truly exists as a uniform condition. The speaker emphasizes that depression can manifest in countless unique ways, suggesting that if you assess a group of depressed individuals, they'll display a diverse array of symptoms. This variability challenges traditional categorizations of depression and points toward a need for a more individualized understanding of the disorder. It also highlights that depression may not stem from a single causative factor, suggesting various biological, psychological, and environmental contributors.
The Role of Inflammation in Depression
The conversation delves into the emerging theory that inflammation might be linked to depression, as inflammation affects bodily functions on multiple levels. Psychiatric research indicates that individuals with depression often exhibit elevated inflammation levels, which can manifest in symptoms akin to sickness behavior. This understanding aligns with findings that acute inflammation can lead to depressive episodes, while chronic inflammation is tied to long-term emotional disturbances. Furthermore, it points to both psychological stress and physical illness as potential triggers for inflammatory responses, thereby complicating the understanding of what contributes to depression.
Exercise and Heat Exposure as Therapeutic Practices
Engaging in physical exercise and heat exposure, such as sauna use, has been studied for their potential beneficial effects on both inflammation and mood. While inflammation is typically associated with a negative state, short-term, controlled exposure to these stressors can actually promote resilience and enhance mood. The speaker underscores the paradox whereby acute inflammation induced through exercise may lead to a reduction in long-term inflammation and improved mental health outcomes. This insight suggests that ancient practices like sauna use could be leveraged as alternative treatment modalities in addressing depression.
Antidepressants and Their Limitations
The efficacy of traditional antidepressants is scrutinized, particularly regarding how they interact with an individual’s inflammatory state. Evidence suggests that while certain antidepressants might work well for some, their effectiveness can diminish or even worsen when inflammation levels are present or elevated. Additionally, the speaker elaborates on the limitation that many individuals who start on antidepressants may find it challenging to discontinue them without experiencing relapse into depression. This relationship highlights the need for clinicians to better assess inflammatory markers before prescribing certain antidepressants.
Holistic Approaches to Treating Depression
A more holistic approach to understanding and treating depression is proposed, integrating mind and body interventions. The speaker emphasizes that many factors contribute to depression, ranging from physiological influences like inflammation to environmental and relational adversity. Ongoing research into ancient practices and emerging treatments like psychedelics shows promise for expanding how depression is approached therapeutically. Ultimately, the speaker highlights a need for personalized treatment strategies, inviting a shift in thinking that considers both psychological and physical health as interconnected.
I've dealt with depression in my life. My body temperature also seems to run hot; in fact my wife Kate has nicknamed me "the baked potato."
My guest today says that there may be a connection between those two things. His name is Charles Raison, he's a psychiatrist, professor of psychiatry, and the co-author of The New Mind-Body Science of Depression. We begin our conversation with why Charles thinks it's important to ask the question, "Does Major Depression even exist?" and what we do and don't know about what causes depression. We then turn to the emerging theory that physical inflammation may play a role in depression; Charles describes what inflammation is, and why the body may become inflamed and physically hotter not only in response to physical illness, but psychological stress as well. We then discuss the paradoxical finding that short-term exposure to inflammation in the form of exercise or sitting in a sauna can reduce long-term inflammation, and how hot you probably have to get in a sauna for it to have antidepressant effects. We also talk about how intermittent fasting may have a beneficial effect on inflammation, before turning to whether taking anti-inflammatory drugs could also help, and why you might want to get a blood test to see if your body's inflamed. We end our conversation with Charles' thoughts on how to figure out the right treatment for depression for each individual.
