Inflammation, Depression, and How Doing Good for Others Can Improve Both

Recent research has suggested there’s a link between conditions such as heart disease, diabetes, Alzheimer's disease, stroke, and cancer and chronic inflammation.

Inflammation is the body’s (yes, it’s possessive) natural response to injury and outside irritants. But with constant stimulation from a diet of high-fat foods, excessive body fat, and smoking, for example, the immune system can turn on itself and increase the risk for disease. Researchers say when inflammation becomes chronic it can damage heart valves and brain cells, trigger strokes, and promote resistance to insulin, which leads to diabetes. It also is associated with the development of cancer.

Much of the focus has been on fighting inflammation with new medications, but researchers have come to better understand the links connecting diet, inflammation, and illness and are discovering ways that foods can help keep inflammation in check. More recently, researchers have found that inflammation as a common mechanism of disease can be extended to include psychiatric disorders such as major depression. Patients with major depression have been found to exhibit increased inflammatory biomarkers (cytokines) in their blood.

Further linking inflammation and depression are data that show that psychosocial stress, a well-known precipitant of mood disorders, is capable of stimulating inflammatory signaling molecules, in part through activation of sympathetic nervous system pathways.

Interestingly, depressed patients with increased inflammatory biomarkers have been found more likely to be resistant to antidepressant medications.  In several studies, antidepressant therapy has been associated with decreased inflammatory responses. These findings are of great interest to us in psychiatry, especially those who prescribe medications that can be valuable adjuncts to cognitive-behavioral therapy. 

But here’s the most recent eye-opening conclusion about a powerful cause of chronic inflammation: researchers at the University of North Carolina found that people who experienced the well-being that comes from self-gratification (hedonic well-being) had high inflammation and low antiviral and antibody gene expression, a finding similar to that observed in people who are depressed or under great stress.

On the other hand, the people who found happiness by pursuing a greater good and community connectedness (eudaimonic well-being) had a lower level of this inflammatory gene expression and strong antiviral and antibody gene expression.

One of the study’s authors, Barbara L. Fredrickson, found the results initially surprising, because all study participants reported overall feelings of well-being. One possibility, she suggested, is that people who experience more hedonic than eudaimonic well-being consume the emotional equivalent of empty calories.  “Their daily activities provide short-term happiness yet result in negative physical consequences long-term,” she said.

“We can make ourselves happy through simple pleasures, but those ‘empty calories’ don't help us broaden our awareness or build our capacity in ways that benefit us physically,” she said. “At the cellular level, our bodies appear to respond better to a different kind of well-being, one based on a sense of connectedness and purpose.”(1)

She notes that in interpreting the results of the research, it is important to note that hedonic and eudaimonic well-being are not mutually exclusive approaches to happiness, nor do they represent a simple tradeoff.

Both types of well-being share some common sources (e.g., perceived social connections) and can reciprocally influence one another (i.e., positive affect predisposes people to find positive meaning, and finding positive meaning increases positive affect). For people in whom one form of well-being outweighs the other, striving predominately toward meaning may have more favorable effects on health than striving predominately toward positive affect per se.(1)

For years, I have been encouraging, sometimes cajoling, urging, or downright writing prescriptions for my patients, particularly the depressed ones, to get involved in something outside themselves that once was meaningful to them. For one woman who was rather shy and inhibited, that activity turned out to be volunteering at our local Society for the Prevention of Cruelty to Animals,  socializing the kitties before they were put up for adoption.

Where once I might have sounded like just a do-gooder, now I have the research to back up my insistence on finding some form of good works and community connectedness as another means to overcoming depression.

Reference

1. Fredrickson BL, Grewen KM, Coffey KA, et al. A functional genomic perspective on human well-being. 2013. Proceedings of the National Academy of Sciences, PNAS Early Edition. doi:10.1073/pnas.1305419110.

Leslie Durr, PhD, RN, PMHCNS-BC is an advanced practice psychiatric-mental health nurse with a private psychotherapy practice in Charlottesville, Virginia.

The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors.