Depression isn’t fun. It is typically described as a state of low mood but is really much, much more than that.
We all go through ups and downs in our mood. And Sadness is a normal reaction to struggles, setbacks, disappointments and losses that are a part of human life. So while many people use the word “depression” to explain these kinds of feelings, it’s important to note that depression is much more than just sadness.
Depressed people may feel sad, anxious, empty, hopeless, worried, helpless, worthless, guilty, irritable, or restless.
Some people describe depression as “living in a black hole” or having a feeling of impending doom. However, some depressed people don’t feel sad at all—they may feel lifeless, empty, and apathetic, men in particular may even feel angry, aggressive, and restless.
It turns out that depression is much more complicated than simply feeling ‘sad’.
We know that some people seem to be genetically predisposed to depression and that certain stressors can bring on or exasperate a depressive episode. These events can include personal conflicts or disputes with family members or friends, bereavement, moving, losing a job, divorce, stress, retirement, menopause, social isolation, and social rejection.
Not only can genetics and life events cause a person to be more susceptible to depression, but certain medications are known to cause depressed mood in a significant number of patients.
Depression has become much more common affecting almost 17% of the population. It is more prevalent in women, closing in on the 1 in 5 mark. In fact, Unipolar major depression is the leading cause of disease burden among women ages 5 and older world wide…how messed up is that?
I’ve found stats saying it’s the 4th leading cause of disability worldwide and that mood disturbances including depression will lead to an epidemic of disease in the 21st century in the western world. It’s clear that depression needs to be addressed more often than it currently is in the mainstream and health and fitness media.
I find depression particularly interesting because of the connection with inflammation.
Elevated inflammatory cytokines are a major risk factor for depression. Thus ‘The Cytokine Theory of Depression’.
Depression seems to involve changes in various aspects of immunity, particularly those having to do with the inflammatory cytokines. People with rheumatoid arthritis, systemic lupus (SLE) and other forms of autoimmunity are often depressed.
While it is unlikely that depression is a primarily ‘inflammatory’ disorder, there is evidence to suggest that inflammation may play a role in its pathophysiology.
Most of the evidence that links inflammation to depressions comes from some consistent observations:
A) One-third of those with major depression show elevated markers of inflammation, even in the absence of a medical illness;
B) Inflammatory illnesses are associated with greater rates of depression
C) Patients treated with cytokines are at greater risk of developing major depressive illness.
D) A meta-analysis of 22 antidepressant treatment studies found inflammatory cytokines decreased in response to therapy, along with a reduction in depressive symptoms.
Another interesting connection is that adding Low dose testosterone to treatment of depression helps improve scores of mood (testosterone is known to have anti-inflammatory properties).
In women Testosterone declines about 50% between the ages of 20 and 40, and doesn’t change much after that. A 20 year old woman is considered at hormonal balance since both estrogens and androgens are high. As a woman ages these ratios change, and during menopausal transition 50–70% of women experience all kinds of somatic and emotional symptoms (Sowers MF, 2001).
In fact a population based study out of Germany showed that symptoms of a depressive mood, sad, and being tearful in women increased from 20% in 18–29 years old, to 48% for 50–59 year old and remains at this level after the age of 60 years
The connection between testosterone and depression isn’t just in women either, in men decreased testosterone production is also linked to depression (Giltay EJ, 2008)
Finally, Sleep disturbances and fatigue are physical and physiological stressors that increase the risk of depression
So where does this leave us, and why is this the connection between inflammation and depression so interesting?
Because inflammation is something we can control (or at least influence) through our diets.
Plus this connection gives us with even more evidence that an active lifestyle that includes eating a little less, weight training, a lean body and a good nights sleep is not only a great way to get and keep a lean body, but also a way to increase your odds of fending off depression.
We know adipose tissue has been shown to produce 10-35% of IL-6 in a resting individual, and this production increases with increasing adiposity (Mohamed-Ali V, 1997).
We know that Chronic Exhaustive Exercise increases inflammation (Gleeson M, 2006), so exercise is good, but too much inflammation can be bad.
We know that lack of sleep increases inflammation (Mullington JM, 2010)
We know there is some (but not conclusive evidence) that weight training helps maintain testosterone levels in the aging male (Kostika T, 2003)
So it looks as though there are lifestyle factors that can contribute to depression. From Eat Stop Eat that intermittent fasting, exercise and eating less can reduce inflammation. And, while I understand the old saying that just because A=B and B=C it doesn’t mean A=C, but together all of the research suggests that this is more evidence that there may be a benefit to fasting beyond just the way you look, as it also might affect the way you feel.
Eat Less, move more, stress less, sleep more, and don’t be afraid to break a sweat every once in a while.
or perhaps the saying Sharp Body, Sharp Mind would be more fitting.