Part 2: Inflammation (and Stress)

The role of inflammation in illness has been well documented. In recent years, inflammation has been linked to conditions not previously thought to have an inflammatory origin – from cancer to dementia and everything in between.

In the realm of mental health, inflammation is now recognized to fuel depression in certain susceptible individuals.

Inflammation of this type is chronic and persistent, and though at a relatively low level, it is harmful to the body and mind. 

So what drives inflammation? Anything that can increase inflammatory cytokines, and therefore inflammation, will increase the likelihood of depression and other mental health conditions. These include: 

– low physical activity

– an unhealthy diet

– a higher state of anxiety 

– higher level of perceived stress 

– sleep disturbances

– age (sometimes)

– a higher BMI (overweight and obesity)

Reading this list, we realize that most of these risk factors are modifiable, validating piles of research that have accumulated over the years that have shown that improvements in diet and life routines will lead to improvements in depression and other mental health conditions. Let’s take a closer look at a few of these.

Stress

Stress is not in itself bad. The stress response is meant to protect us from harm when faced with short-term stressors. However, the prolonged and ongoing stress – familiar to many of us – triggers inflammation and impairs our mental health, among other things (depletes our energy, affects our digestive function, messes with our hormones, triggers weight gain, etc.).

Managing our day-to-day stresses well goes a long way toward improving mental health and halting the long-term consequences of prolonged stress.  Stress management, along with other approaches to improving mental health, can be found in the book Beyond the Label, written by a fellow Naturopathic Doctor, Dr. Chris Bjorndal. Her book is available at Vive Integrative Health Group.

A few more words about stress can be found in this blog What is Stress? Stress and Your Health.

Diet

A diet with any level of processed foods and even moderate levels of refined sugar is inflammatory. These are major concerns as many of us generally consume far too many of these types of foods! 

An anti-inflammatory diet reduces inflammation in the body. Common characteristics include the inclusion of: 

– dark green leafy greens

– yellow and orange produce like carrots, squash, and sweet potato

– colourful fruits (berries, pomegranates, plums, red grapes, tomatoes)

– nuts (especially including walnuts, cashews, and almonds)

– whole grains (excluding wheat)

– fish (salmon, Arctic char, herring, trout, and sardines are good choices, but any fish is good!)

– legumes (beans, lentils, tofu) 

For a few great recipes, see our blog post Eating Well for Mental Health.

Food Sensitivities

Unlike food allergies (IgE mediated) which can trigger immediate and severe reactions, food sensitivities (IgG mediated) trigger a milder but persistent type of inflammation. It is difficult to identify our food sensitivities because symptoms develop slowly, and without knowing the foods we react to, we continue eating these foods, perpetuating the inflammation. Even healthy and typically “anti-inflammatory” foods can trigger inflammation in some people for a variety of reasons. 

There is good evidence that patients removing IgG reactive foods from their diet experience improvements in symptoms. This includes improvements in mental health symptoms as well as neurological, dermatological, respiratory, gastrointestinal, musculoskeletal, and a variety of other symptoms.  Furthermore, research has connected food sensitivities with migraine headaches, Irritable Bowel Syndrome (IBS), and weight gain. 

For more information on food sensitivities and how to test for these, visit our blog post Food Allergies versus Food Sensitivities.

The Gut Microbiome

The brain communicates with the gut microbiome via a number of pathways, and the relationship between the two has become known as the gut-brain axis. 

Studies have begun to discover how the makeup of a person’s gut microbiome can impact mental health and modify mood and behaviour. 

For example, depression has been linked to a less diverse microbiome. Encouraging more diversity in our microbiome is as simple as increasing fibre in our diet. 

In anxiety, research into the modification of intestinal microbiome has demonstrated that improvements are generally noted, including with non-probiotic interventions – meaning dietary modifications.

Benefits in microbiome assessment has also been demonstrated in schizophrenia and bipolar disorders.

Regarding probiotics, several human clinical trials have shown the beneficial effects of probiotics on mood disorders, even though probiotics are really only one part of the treatment strategy to optimize a person’s microbiome. 

Mental health conditions are expressed uniquely in each individual and can be addressed in many different ways. Naturopathic Medicine can identify the underlying multi-factorial causes and provide safe and effective approaches to treatment.

Many more of the root causes of mental illness are becoming better understood, and with what we have learned, we can be confident that mental illness can often be fully supported with an integrative approach that does not have to include medication.

To read part one of our series, click here

References:

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• Beurel, E. et al. the Bidirectional Relationship of Depression and Inflammation: Double Trouble. Neuron. 2020 July 22; 107(2):234-256.
• Bullmore, Edward. The Inflamed Mind. Picador Publishing, 2018.
• Hardman G, Hart G. Dietary advice based on food-specific IgG results. Nutr Food Sci Vol. 37.No. 1 (2007): 16-23.
• Drisko J, Bischoff B, Hall M et al. Treating Irritable Bowel Syndrome with a Food Elimination Diet Followed by Food Challenge and Probiotics. JACN Vol. 25.No. 6 (2006): 514-22.
• Alpay K, Ertas M, Orhan EK et al. Diet restriction in migraine, based on IgG against foods: A clinical double-blind, a randomized cross-over trial. Cephalalgia Vol. 30.No. 7 (2010): 829-37.
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• Evrensel A, Ceylan ME. Gut-brain axis: the role of gut microbiota in the psychiatric disorders. Curr Approach Psychiatry. 2015;7(4):461-472.
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• Akkasheh G, Kashani-Poor Z, Tajabadi-Ebrahimi M, et al. Clinical and metabolic response to probiotic administration in patients with major depressive disorder: a randomized, double-blind, placebo-controlled trial. Nutrition. 2016;32(3):315-320.
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