Inflammation and Mental Health

Mental health is a forgotten by-product of the global pandemic we find ourselves living through.  Depression rates have greatly increased around the world during this pandemic.  In the US alone it is believed to have tripled.

Mental health issues have a huge impact on society. Some suggest that their impact is larger  than any other chronic disease, including heart disease and diabetes.

There are many factors involved in complex conditions like mental health. Science has identified inflammation as being a key piece of the puzzle.

First, we’ll go over the many links between inflammation and mental health (there are a few). Then, we’ll talk about some exciting research into natural approaches and how important these are to better mental health. Natural approaches like:

• foods, 
• nutrients, 
• and lifestyle upgrades 

NOTE: None of these are a substitute for professional medical advice. If you have any of these conditions, make sure you’re being monitored regularly by a licensed healthcare professional.

First let’s talk about what inflammation really is in the first place. The word inflammation comes from the Latin word “inflammo,” meaning “I set alight, I ignite.”

Because inflammation can get out of balance and become harmful, it has gotten a lot of bad press lately. Inflammation isn’t always a bad thing though. Like in most areas of health, it’s the balance that’s important!

What is inflammation?

1. Inflammation is a natural process that our body uses to protect against infections, irritants, and damage. 

2. Inflammation helps our bodies eliminate damaged cells and tissues, and helps them to repair. 

3. It also helps to reduce the cause of the damage, for example, by fighting the infection. 

Inflammation that happens in a big way, but for a short time can help the body to heal these injuries and infections.

When inflammation becomes chronic

On the other hand, lower levels of inflammation sometimes stick around longer than necessary. 

This long-term “chronic” inflammation can cause damage over time. Often, there aren’t any symptoms or very few. 

It’s this chronic inflammation that is linked to many conditions including mental health.

Inflammation mostly comes from our immune system’s response to infections and injuries. It also involves our blood vessels (arteries and veins) and other molecules.

A few of these inflammatory molecules, or “markers,” include free radicals (oxidants), cytokines, and C-reactive protein (CRP).

The links between inflammation and mental health

There are many factors linked to suboptimal mental health. One of these is inflammation. 

In terms of depression, the link with inflammation was first discovered back in 1991. With respect to bipolar disorder, the link between it and immune dysfunction was put forward as far back as 1981.

Research shows that inflammation may be a factor for about one-third of people with depression. 

We will focus specifically on links between inflammation, the causes of inflammation and mental health in this article. 

Link 1 – Stress, inflammation and mental health

First of all, some mental health issues are associated with increased inflammatory markers like cytokines and CRP. 

For example, people with depression tend to have higher levels of cytokines. 

High levels of inflammation may also inhibit recovery in people with mental health symptoms.

Some researchers actually believe that levels of inflammation may be able to predict poor mental health outcomes.

While inflammation may be part of the cause, it can go in both directions. Mental health issues may also increase some of these inflammatory markers.

Some animal studies show that stress can cause a significant increase in these markers. 

Even people who are stressed tend to have increased levels of inflammatory markers and lower levels of anti-inflammatory markers.

Link 2 – Inflammatory illnesses and mental health

Inflammatory illnesses like allergic and autoimmune diseases, as well as metabolic conditions (e.g. heart disease, diabetes, and obesity) are associated with higher rates of mental health symptoms. 

And this link also goes both ways – people with mental health symptoms are more likely to get metabolic-related conditions. 

This link between mental health symptoms and metabolic conditions has led some researchers to coin the term “mood-metabolic syndrome.” This is meant to show that both mood and metabolic syndrome are connected, and also that the connection can go both ways.

Link 3 – Inflammatory medications and mental health

People who take certain inflammatory medications are at an increased risk of developing mental health symptoms. Some medications for depression (e.g. SSRI’s) on the other hand reduce the levels of inflammatory markers.

Inflammatory diets and mental health

The studies between how we eat and how we feel is fairly new. The first studies to be published on this were as recent as 2009. This new area is called “nutritional psychiatry.”

The relationships between foods and mental health are complex, and we’re just starting to understand them. 

What foods are associated with worse moods? 

• Saturated fat and processed meats;
• Refined sugars and starches; and 
• Fried and processed foods. 

People who eat this way tend to report more mental health symptoms than those who eat a more healthy diet. 

There are several recent studies that consider poor eating habits to be a risk factor for mental health issues.

It’s not surprising then that these unhealthy foods are also linked with higher inflammatory markers like CRP. It has been shown that improving the diet can reduce levels of those inflammatory markers.

In fact, some studies show that the higher the “inflammatory factor” of the diet, the higher the risk for mental health issues.

One dietary pattern that’s been studied a lot is the Mediterranean diet. This diet includes a lot of vegetables, fruit, whole grains, legumes, fish, and olive oil. It also contains a lot of nutrients and fibre. Eating a Mediterranean-style diet is associated with lower levels of inflammatory markers and a reduced risk of mental health issues.

This complex association between food and mental health can go both ways. 

Mental health symptoms can also influence appetite and food choices. 

We don’t know exactly how these eating patterns affect mental health but we know that inflammation is definitely one possibility. 

Nutrition can impact how our immune system functions, and this can affect levels of inflammation, and mental health issues. 

It could also be through the effects of the nutrients themselves, and even directly through the digestive system (microbiota-gut-brain axis).

Natural approaches to better mental health

Better foods for better moods

A recent clinical study found that when people start eating a healthier diet, they can actually reduce some of their mental health symptoms!

This study called the SMILES trial is particularly interesting. 

What makes the results from the SMILES trial strong is that it was an actual experiment. It didn’t just ask people what they ate, measured their inflammatory markers, and what their symptoms were. It was “interventional” – people agreed to actually change the way they ate.

According to the researchers:

“…this is the first RCT [randomized control trial] to explicitly seek to answer the question: If I improve my diet, will my mental health improve?”(Jacka et. al, 2017)

Here’s how it worked:

The SMILES trial recruited 67 people with with depression and poor dietary quality to a trial for 12-weeks. These were people who reported a high intake of sweets, processed meats, and salty snacks; and a low intake of vegetables, fruits, lean protein, and dietary fibre.

Half of them were asked to:

1. Eat more vegetables, whole grains, fruit, legumes, low-fat unsweetened dairy, raw and unsalted nuts, fish, lean red meat, chicken, eggs and olive oil; and 
2. Eat less sweets, refined grains, fried food, fast food, processed meats and sugary drinks; and, 
3. Drink no more than 2 glasses of wine per day (with meals, preferably red wine).

This half of the participants who upgraded their diet were also given seven professional nutrition counselling sessions. 

The other half of the people in the SMILES trial were given social support. They were “befriended” and discussed sports or news, or played cards or board games. There was no nutrition support, nor any dietary recommendations given to people in this group.

The researchers found that in 12-weeks the people who improved their diet actually also improved some mental health symptoms! They said:

“We report significant reductions in depression symptoms as a result of this intervention… The results of this trial suggest that improving one’s diet according to current recommendations targeting depression may be a useful and accessible strategy for addressing depression in both the general population and in clinical settings.”(Jacka et. al, 2017)

It would be great for other, larger trials to confirm these results. In the meantime, eating a more health-promoting diet is helpful for so many conditions, not just mental health!

Better nutrients for better moods

Is there something special in these foods that may help with moods?

We know the brain needs enough of all essential nutrients in order to function properly. And insufficient levels are linked with the stress response and the immune response.

Eating nutrient-dense foods is the best way to get nutrition. Foods are complex combinations of nutrients. Supplementing with individual nutrients is not the same as eating a healthy diet. 

Let’s go over a few key nutrients for better moods.

B-vitamins such as B6, B9 (folic acid), and B12

People who tend to be low in B-vitamins are more likely to have mental health issues. Higher intakes of vitamin B6 (pyridoxine) and B12 (cobalamin) may reduce risk.

With folic acid in particular, the connection may be due to its different forms. “Folic acid” is the inactive form of vitamin B9. 

Our bodies naturally converted it into the active form (called L-methylfolate) by the enzyme methylenetetrahydrofolate reductase (MTHFR).

Once folic acid has been activated, it goes to the brain and is used to make neurotransmitters like serotonin, melatonin, dopamine, epinephrine, and norepinephrine.

What’s interesting is that many people with mental health issues are not able to convert folic acid into its active form. 

One study tested supplements with the active form of folic acid (L-methylfolate) on people with mental health issues. While some people had a moderate improvement, the people who also had inflammation had an even greater improvement.

Vitamin D

Vitamin D is well known to help absorb calcium for strong bones, but has many other functions too. In terms of immunity, vitamin D can reduce inflammatory molecules in people with certain infections and inflammatory diseases. 

Vitamin D has a number of roles within the brain. Vitamin D plays a role in circadian rhythms and sleep, and influences the growth of nerve cells in the developing brain.

There is growing evidence that people who tend to be low in vitamin D also tend to have more mental health issues. In fact, some studies show that vitamin D supplementation can improve mood scores and reduce mental health symptoms.

Vitamin D is the most commonly deficient nutrient in Western countries. It’s known as the “sunshine vitamin” because our skin makes it when exposed to sunlight.  It is also found in a few foods, and as a supplement.

Minerals (Calcium & Selenium)

Low intake of calcium is associated with mental health symptoms, while high intake is associated with lower rates of mental health symptoms.

Depression has been associated with low blood levels of the essential mineral selenium. Low intake of selenium is also associated with an increased risk for depression.

Omega – 3s

Omega-3 oils are healthy fats found in many foods such as seafood, nuts, legumes, and leafy greens. They have been shown to reduce inflammation.

Some studies suggest that the omega-3 fats, specifically those found in fish and fish oil, have mental health benefits.

Better lifestyle for better moods

Foods aren’t the only thing that can be upgraded to improve your mental health and inflammation. Your lifestyle can have a big role too!

Both exercise and sleep are important factors that can improve moods and inflammation.

Lifestyle factor #1 – Exercise

People with mental health issues are more likely to lead sedentary lives. This is another factor that can increase levels of chronic inflammation.

Regular exercise reduces inflammation. We know this because CRP levels are lower in people who regularly exercise, than those who do not. 

Plus, people who exercise at a higher intensity have even lower levels of CRP.

“ treatment of clinical depression can be improved by the addition of cognitive-behavioral therapies & by exercise.”

( Craft &Perna, The Benefits of Exercise for the Clinically Depressed)

  According to the research, depressed patients are less fit and have diminished physical work capacity.  

What’s also cool is according to the research, the benefits of working out lasted a long time after the patients stopped exercising.  Research suggests that even after a 12 month follow-up period patients were still showing an upgrade in their depression and anxiety symptoms.   

It doesn’t take much, ( 30 minutes x 5 days per week of moderate exercise ) or (25 x 3 times per week of vigorous exercise) according to the physical activity guidelines for Americans.   

Click here for a 30 minute moderate intensity workout. 

I encourage you to reduce the amount of time you are sedentary, and take active breaks.

Lifestyle factor #2 – Sleep

Sleep plays a vital role in our physical and mental health. 

People who experience insomnia are at higher risk for later developing mental health issues.

Lower amounts of sleep can affect the immune system and increase chronic inflammation. Sleep deprivation shows measured levels of increased CRP and inflammatory cytokines.

If you’re not getting at least 7 hours of sleep each night, start to make it a priority.  This is easier said than done.  Here are a few tips on facebook link on getting to sleep or staying asleep during stressful times. 

If all else fails  consider taking an herbal sleep formula or magnesium, if needed, to help you relax so that you can have a better sleep. It’s also a good idea to talk to your healthcare practitioner if it becomes chronic.  There may be other underlying issues that are preventing you from getting a good night sleep.

Conclusion

Inflammation is one of several factors that is linked with mental health and mood issues. It may be a factor for up to one-third of the people with these issues.

The link between inflammation and mental health is thought to go both ways – inflammation can contribute to mental health and mood issues, and vice versa.

Eating a nutrient dense, anti-inflammatory diet, and getting regular exercise and quality sleep can help to reduce inflammation, and improve mental and overall health.

It’s an exciting area of research that will continue to answer more questions about this link. 

In the meantime, try eating a more health-promoting (anti-inflammatory) diet, and getting enough nutrients, exercise, and sleep.

NOTE: 

1. None of these are a substitute for professional medical advice. If you have any of these conditions, make sure you’re being monitored regularly by a licensed healthcare professional.

2. We spoke a lot on the many links between inflammation and mental health issues, but it’s important to keep in mind that it’s not the only connection. Others include neurotransmitter issues (e.g. serotonin, dopamine, etc.); reduction in growth factors (e.g. brain-derived neurotrophic factor, BDNF); and neuroendocrine issues (i.e. chronically increased stress hormone levels). 

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