July 20, 2014

The Correlation between Physical and Mental Pain: A Chicken and Egg Scenario

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Chronic pain and mental health issues have perplexed doctors and aggravated patients for years. Researchers have been continually delving into the possible causes of depression including brain chemistry, genetics, environmental factors, and an imbalance of serotonin ( a neurotransmitter involved in the transmission of nerve impulses). Chronic pain, a persistent discomfort that no doctor has been able to diagnose a cause for, may actually be caused by a glitch in the brain. It appears that inflammation of the immune system chemical messengers called cytokines play an important role in brain function and may cause physiological symptoms. When the brain is aggravated by stresses, infections, trauma, stroke, poisons, or nutritional deficiencies inflammation spurs the release of pro inflammatory cytokines which may affect mood. Cytokines activate an enzyme indoleamine 2, 3 dioxygenase (IDO) which degrades serotonin resulting in low levels of the neurotransmitter. IDO also degrades the precursor to serotonin, tryptophan. Decreased levels of the neurotransmitter serotonin are likely the contributing factor to the development of depressive symptoms. The inflammatory processes contribution to the constant destruction of serotonin decreases the chances of recovery. Some forms of physical and emotional pain are caused by neuro inflammation (inflammation of the brain). When you cut yourself your body produces tons of white blood cells that flood the area, inflaming the site in order to knock out the infection. Once the infection is healed your body collects all the white blood cells and pulls them away from the infection site. However, sometimes the immune response keeps occurring long after the infection is gone. One form of inflammation, an over activity of immune cells in the area called microglia (brain and spinal fluid cells that act as a form of immune defense in the central nervous system) is at the root of unexplained chronic pain and depression. When physical injuries, psychological trauma, bacterial and viral infections as well as environmental toxins stress the central nervous system, microglia respond by omitting chemicals that destroy the invaders. If a person gets bombarded with too many physical injuries or emotional blows microglia can get stuck in the on position, continuing to spit out chemicals well after the trauma that originally caused them to become active has already healed. Research shows that inflammation in other parts of the body can spur microglia activity in the brain. Usually if a patient complains to their doctor of fatigue, depression, and pain the doctor takes x-rays, MRIs, and blood tests. If nothing shows up on the tests the doctors will assume its psychological and send the patient to a psychiatrist, For years doctors and scientists alike have tried to correlate depression with a deficiency of serotonin and related neurotransmitters in the brain. Understanding the connection between depression and inflammation gives researchers and pharmaceutical companies incentive to look for alternate meds and methods to treat depression. There are lifestyle changes you can make to alleviate inflammation and improve mood, such as exercise, stress reduction, taking nutritional supplements, and making healthy diet choices, just to name a few. Chronic stress is one of the major preventable contributors to inflammation and immune dysregulation. The inflammatory response is most likely brought on by a mix of causitory agents. Infection, stress, nutritional deficiencies, and sedentary lifestyles are the leading factors. A unique and personal understanding of inflammation and its contribution to the physiology of mood disorders is critical, but often ignored part of integrative therapies for depression. If you neglect the underlying causes of depression you can't expect to recover. A recent Denmark study found that elevated levels of c- reactive protein in the brain which is produced when the body experiences inflammation might just be associated with an increased risk for psychological distress and depression in the general population. Another study which can be found in the Journal of NeuroInflamation finds that high levels of Quinolinic acid in the spinal fluid are associated with chronic depression and suicide. The c-reactive protein, Quinolinic acid is another by product your body produces in response to inflammation. So what exactly does this mean? Your body becomes inflamed due to a response to something harmful. This inflammation protects you. For example, it protects a wound while it heals. Systemic, long term inflammation is related to a hallmark of chronic conditions like asthma, rheumatoid arthritis, diabetes, fibromyalgia, headaches, and PTSD to name a few. Don’t think that avoiding inflammation can help you dodge depression, but keeping inflammation at a minimal level is always good for your overall health. A Danish study which took place in Copenhagen as part of the Copenhagen general population study, which continually follows many different conditions in about 100,000 people in Denmark. Over there life span as adults the test subjects take surveys about there health, submit to physical exams, and blood work. The inflammation and depression study used 73,367 individuals ranging in age from 20 to 100 years old. The study found that elevated levels of fibrinogen were associated with psychological distress, use of antidepressant medication, and with hospitalization with depression in individuals from the general population, in cross-sectional studies and in prospective studies for hospitalization with depression. So how can an individual recover from this inflammation? There are ways you can fight inflammation in the body. Start by drinking plenty of water, limit trans-fatty acid, eat tons of dark, leafy greens and veggies, exercise regularly, de-stress whenever needed, get plenty of sleep, and eat a balanced diet. The last way to fight inflammation is probably the most important, after all we are what we eat. (healthlink.com) Eat to reduce inflammation by getting plenty of omega 3 fatty acids which can be found in things like olive oil in the form of oleic acid which fights inflammation. Eat plenty of fish, especially those high in omega 3 fatty acids such as snapper, tuna, cod, halibut, and bass. Eat plenty of nuts and fruits. Fill up on garlic which helps reduce swelling. Eat plenty of herbs like basil, chili peppers, oregano, thyme, and turmeric. Enjoy chocolate, but keep it at least 70% cocoa. Green tea works like liquid veggies, staging an anti-inflammatory fight within your body. A Copenhagen study thinks that you have to treat each ongoing assault that switched on the microgloia in the first place. Only then can the bigger issues like chronic pain and depression disappear. According to Wium-Anderson who also took part in the study, it appears that the inflammatory molecules affect some of the transmitter substances and receptors in the brain that determine our state of mind and regulate our mood. Anderson says they cannot prove it conclusively and it could just as well be the other way around, that the depression triggers inflammation. A third possibility could be that there are underlying diseases in the body that trigger inflammation and depression. The underlying cause needs to be determined with further studies. All that can be said with certainty at this point is that there is a correlation between the two conditions. An understanding of the biological cause is a key step towards effective prevention and treatment of the condition.

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