In this article we will take a look at the phenomenon of inflammation, and its implication into mental health and clarity.
A common overall goal of any prescribed treatment, be it herbal, lifestyle, diet etc., is to curb levels of inflammation within the body. The focus has shifted to this bandwidth of the treatment paradigm as light is shone upon inflammation’s role in a myriad of health conditions – from heart disease, to skin disorders – and even it’s implication in the onset of mental conditions such as anxiety, depression and brain fog.
What is inflammation?
Typically we think of inflammation as part of the body’s immune response to an attack or injury. In these acute instances, we see inflammation as swelling, redness, heat and pain when we injure ourselves by say, falling off our bike and hitting our knee on the pavement. These effects are the results of the action of pro-inflammatory cells such as macrophages and chemical signaller, generally referred to as cytokines. The body causes blood to be delivered to the area, and calls upon these cells to fight off any pathogen that may cause infection, including bacteria and fungi.
However, inflammation is not exclusively limited to an acute response. Inflammation can be chronic when it has persisted for an extended period of time, and has become more generalised or even systemic. It is when inflammation develops into a chronic condition that it is often more difficult to treat. Many studies show that there is a correlation between chronic inflammation and a plethora of diseases and conditions, even mental disorders and mood/behavioural problems.
The inflammatory response may also occur in instances where the body incorrectly identifies it’s own cells as foreign, malevolent pathogens. In this case, the body’s immune system is essentially attacking the body’s own cells. Groups of diseases characterized by this unfortunate phenomenon are referred to as auto-immune disorders.
Microglial cells - an immune defence cell found in the central nervous system.
What increases inflammation?
Levels of inflammation can be influenced by genetic factors, but also extrinsic environmental factors including:
There are large amounts of evidence to suggest that stress actively influences levels of inflammation in the brain and body. Stress turns on the Hypothalamus-Pituitary-Adrenal (HPA) Axis – the system of interplay between the nervous system and endocrine organs that release stress related hormones. During stressful circumstances, the activation of the HPA can have a pro-inflammatory effect.
Furthermore, stress has been shown to activate pro-inflammatory mediators in the brain, which in both acute and chronic situations are implicated in many neurological conditions including brain fog, anxiety and depression. Simply put – the less stress, the less inflammation, rendering us more clear headed, with an improved sense of well-being.
There are many household and everyday items we use that contain chemicals and substances that heavily influence inflammation. These act on activating and promoting inflammatory markers within the body. From the sulphates in the shampoo we use, to the BPA in our water bottles, many household and everyday items have the potential to activate and raise levels of inflammation within our bodies.
Of particular note are any items that contain the following:
Sodium Lauryl Sulfate (SLS): mainly found in shampoos and haircare products
Phthalates: Found in containers of hard plastics
Bisphenol A (BPA): found mainly in plastic water bottles
Fragrances with high levels of volatile organic compounds (VOCs): Found in landry detergents and powders
Dusting polishes, air freshners and anything containing chlorine.
Sleep has long been associated with immune system regulation. Specifically, limited or poor sleep has been shown to increase activity and levels of pro-inflammatory cytokines. Although some cases of sleep deprivation may see only a small shift in these levels, changes to basal cytokine levels are associated with the development and onset of metabolic disease.
Interestingly, sleep loss has also been shown to activate phases of the acute immune response (as discussed earlier in this article).
Many foods and food groups actively induce immune responses. It is why suggestion to eliminate (or at least significantly reduce) things such as gluten, refined carbohydrates, alcohol and dairy from the diet is so prominent amongst health circles. https://gut.bmj.com/content/65/12/1930
https://www.ncbi.nlm.nih.gov/pubmed/22826636/ Inflammation is also commonly seen in instances of dysbiosis (a state where the ‘bad’ gut bacteria outweigh the ‘good’ gut bacteria). Dysbiosis results in ‘bad’ bacteria releasing products known as endotoxins, which signal an extremely important nerve (in relation to mood and well being): the vagus nerve to pass on inflammatory information to the brain. This results in mental states such as depression and anxiety.
The gut/brain connection via the vagus nerve.
The gut and brain are two interconnected systems that both influence and inform each other. That is to say, two-way communication is established between these two systems, through the body’s largest cranial nerve – the vagus nerve. The importance of vagal health cannot be underestimated, as it is implicated in autonomic nervous functioning, and greatly influences our mood, clarity, well-being and even breathing. Amidst inflammatory states, the gut releases pro-inflammatory cytokines which inform the vagus nerve, in turn signalling the brain to release pro-inflammatory chemicals – the result of which manifests as mental states such as depression and anxiety (as previously mentioned). This in turn can influence the gut in unfavourable ways (poor digestion, bloating, gas etc), creating a dreadful positive feedback cycle. Conversely, when our gut and it’s bacteria are kept happy and healthy, vagal signaling informs the brain to release favourable chemicals which render us into a state of calm clarity. Simkin, D.R. Curr Psychiatry Rep (2019) 21: 93 https://doi.org/10.1007/s11920-019-1075-3
The vagus nerve.
The bad news is, that through the influence of these intrinsic and extrinsic factors, perpetual activation of the immune response may lead to a chronic condition, whereby it essentially rarely turns off. As you may imagine this wreaks havoc on the body – causing irregular or non-optimal functioning of many organs (including the brain), manifesting in ways including impaired mental cognition and mood regulation.
A balancing act.
When aiming to achieve mental clarity, we want our body to maintain a balance between two mediatory immune system responses known as TH1 and TH2 mediated immune responses. Think of TH1 and TH2 as two cytokine (chemical signallers) producers, both producing different types of cytokines (some anti-inflammatory and some pro-inflammatory). We want to achieve an optimal balance between these two systems, as imbalance leads to inflammatory conditions, caused by an abundance of pro-inflammatory cytokines and other pro-inflammatory cells.
Finding a balance between TH1 and TH2 mediated systems is a key in achieving optimal health.
Depression, anxiety and inflammation.
Individuals with depression have been found to contain elevated levels of Interleukin-6 (IL-6) and Tumor Necrosis Factor Alpha (TNFa), arguably indicating a dominant TH2 system.
This inflammatory state exerts a major influence on the HPA axis, and is hypothesized to induce depressive states by reducing the levels of available serotonin (our ‘happy’ neurotransmitter), and increasing levels of toxic breakdown products of tryptophan (a precursor to serotonin). Kynurenine (the toxic breakdown product of tryptophan) is both anxiety producing and depression inducing. Further to this, Kynurenine is metabolically broken down to quinolinic acid, which itself is neurotoxic and can lead to the destruction of neurons needed for optimal brain and nerve functioning.
In fact, some auxiliary actions of antidepressant medication are that of immune modulation – regulating and resorting balance to the immune response, thus bringing about a state of mental calm and clarity. Schwarz MJ, Chiang S, Muller N, Ackenheil M. T-helper-1 and T-helper-2 responses in psychiatric disorders. Brain Behav Immun. 2001;15:340-370. https://www.medscape.org/viewarticle/438509 https://www.ncbi.nlm.nih.gov/pubmed/20015486
Furthermore, the elevated presence of inflammatory cytokines has been shown to modulate and impair cognition and mood behavior by promoting excitotoxicity: a neural environment characterized by high levels of glutamate. High levels of glutamate is a common characteristic amongst anxiety and panic disorders (as well as symptoms such as brain fog, seizures and racing thoughts). Glutamate, in a simple sense, may be seen as the chemical opposite to GABA: the chemical of calm and clarity. That is to say it is the chemical (when in excess) of panic and anxiety. To compound things further – inflammation impairs neuroplasticity – the phenomenon the brain uses to heal itself and forge new neural pathways in order to develop and grow. https://www.ncbi.nlm.nih.gov/pubmed/29752710
How can we decrease levels of inflammation?
This is a big topic in and of itself – one far too big to fit into a summary such as this one. Inflammation can be targeted, local or even specific to a body system – each one appealing to its own specific remedy. For example – certain botanical treatments will target a TH1 dominant system, while others may target the TH2 dominant systems. Generally speaking, there are a few things we can do to lower levels of systemic and chronic inflammation within the body. These include: - Proper sleep hygiene and sleep time - Diet - Exercise - Stress regulation - Herbal intervention - Supplemental support