The Biology of Depression, Anxiety, Depersonalization- Brain Cell Inflammation

brain workoutIf you suffer from a condition that involves the brain, be it depression, anxiety, depersonalization, autism, ADHD, etc. you may be tempted to think that somehow this is genetic, emotional, or psychiatric, or even that this is somehow not a typical medical condition like diabetes or heart disease. The article “Inflammation and its Discontents: The role of cytokines in the pathophysiology of major depression” (which you can read here… ) brilliantly diagrams and discusses the very physical and chemical nature of the brain related disorders.  What is exciting about this study is that once you become aware of the things that might be triggering your stress and inflammation, you may actually be able to take control of these chemical responses and the brain inflammation that is underlying your suffering.

As shown below in Figure 1 from the article, inflammation molecules carried in the blood can cross into the brain triggering a host of chemicals that result in the release of glutamate, an excitatory chemical at the synapses (nerve cell connections) within the brain. It seems the excessive glutamate, it’s inadequate re uptake along with activation of NMDA receptors disrupts neural plasticity (the ability of the brain to heal itself).

BrainCellInflammation Fig 1

Figure 1



As shown below in Figure 2 from the article, stress (adversity, interpersonal conflict, isolation, etc.) along with other external inflammatory molecules as outlined above, activates the central nervous system. The corticotropic releasing hormone (CRH), from the hypothalamus, activates the hypothalamic-pituitary-adrenal axis and cortisol, which short term is anti-inflammatory, becomes pro-inflammatory in the chronic stress situation.

The complexity of the H-P axis and it’s link to stress and stress hormones, along with the steroid sex hormones like testosterone, may also explain the connections we are now starting to see between anxiety disorders and low testosterone in young men.

BrainCellInflammation Fig 2

Figure 2


TAKE HOME MESSAGE: if you suffer from any brain disorder like anxiety, depression, etc. the key message is to reduce your triggers of inflammation (for many, this is processed foods, sometimes specifically gluten and saturated fat in the diet) and reduce your stress.  Reducing stress means a real focus on self care.  Avoid toxic people, don’t isolate, exercise, take care of any addictions you may have as these add enormous stress and stimulate the H-P axis, and consider counseling and mindfulness training.  Lack of regular and adequate sleep is a huge stressor.


For the brain that has been out of balance for a long time (months or years), the journey back to a healthy balance may take months or years.  Slowly and consistently, work on these areas of inflammation and stress reduction until the brain heals.  It can and it will if you give it a chance.



Dr. Paul



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