A Compelling New Theory of Depression

A Compelling New Theory of Depression

A fascinating theory has been put forward by Turhan Canli PhD, Associate Professor of Psychology and Radiology at Stony Brook University, which could change the future direction for research and treatments of depression. 

According to Dr Canli, depression should be re-conceptualised as an infectious disease. His argument is a compelling one.

In a paper published in Biology of Mood & Anxiety Disorders, Dr Canli suggests that depression could be the result of a parasitic, bacterial or viral infection.

Depression is a pervasive illness, with around 16% of people experiencing an episode at some point in their lives.

There has been little change in treatments over the last few decades and although antidepressants are effective in reducing symptoms in patients with severe symptoms, in patients with mild to moderate symptoms they are no more clinically effective than placebos.

Recurrence of depression is common. Those who have experienced one episode have a 50% chance of recurrence. Those who have experienced depression twice have an 80% chance of experiencing it a third time.

Dr Canli explains, ‘Given this track record, I argue that it is time for an entirely different approach. Instead of conceptualising depression as an emotional disorder, I suggest to reconceptualise it as some form of an infectious disease.’

Dr Canli is also a member of the Program in Neuroscience, and a Senior Fellow in the Center for Medical Humanities, Compassionate Care, and Bioethics. ‘I propose that future research should conduct a concerted search for parasites, bacteria, or viruses that may play a causal role in the etiology of depression.

 Dr Canli presents three arguments for reconceptualising depression as an infectious disease:

  1. ‘Patients with depression experience sickness behaviour’.

    The main criteria for a diagnosis of depression are affective symptoms, specifically a loss of energy and diminished interest in the world and previously enjoyable activities. However  inflammatory biomarkers of depression strongly suggest the origin of depression to be illness related. Dr Canli suggests that the inflammatory markers may indicate the stimulation of the immune system in response to a pathogen such as a parasite, bacterium or virus. He acknowledges that there is currently no direct evidence that depression is caused by a micro-organism, however the process is a plausible one and warrants further research.

  2. There is clear evidence that parasites, bacteria and viruses can affect emotional behavior.

    Parasites: There is evidence that infection by the parasite, T. gondii is associated with elevated inflammatory biomarkers similar to that observed in depressed patients;

    Bacteria: Research has begun to investigating the causal links between emotional behaviour and bacteria in the gut.

    Viruses: A meta-analysis of 28 studies looked at the link between depression and infectious agents. Borna disease virus (BDV) has been found to be 3.25 times more likely to be found in depressed patients than in normal controls. Further research is necessary to understand the link.

  3. The genetics of the illness.

    Genetic studies to date have looked at human genes within the human genome (complete set of DNA). However, the human body is host to other micro-organisms, with their own genetic makeup, that can be passed across generations. As a result, ‘the opportunity for genetic discoveries is vastly amplified’.

Based on these three arguments, Dr Canli suggests the future research in the area involve large-scale studies with depressed patients, controls, and infectious-disease related protocols. He explains, ‘Such efforts, if successful, would represent the ‘end of the beginning’, as any such discovery would represent the first step toward developing a vaccination for major depression.’

[irp posts=”897″ name=”Depression: Why Talking Isn’t Enough”]

13 Comments

Jack

i have had terrible depressive symptoms for the past 9 months. my life had fallen apart around me. Anyway, two weeks ago i got a nasty ear and throat infection. i was prescribed antibiotics which didnt work. i was then prescribed a different type which worked a lot better.
This week, for the first time since January i have no depressive symptoms at all. i feel better than i have for a long time.
i was trying to understand what had happened. the only change was the antibiotics, which is what led me to this page. Could this be the answer?

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Meg

This is particularly fascinating to me as my 15-year-old son was brought almost literally to his knees by a sudden, severe depression the week after doing his first 5K obstacle mud run which took him through countless flooded swamps and even a flooded cow pasture. The depression has barely loosened its grip and continues to flare. Because he has never once had depression or even much sadness I am thoroughly convinced there is something biological at work. Blood tests today!

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heysigmund

That is really interesting. There seems to be a lot of research happening around depression at the moment. It’s opening up different pathways but it’s also making me realise that there’s so much more to know about it. I’m pleased your getting blood tests – it sounds as though your son is in good hands. It will be really interesting to see what they reveal. It must have been awful to see such a sudden change in your son. I hope they find something that can give you both comfort. Would love to hear how you go.

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Meg

Strange to say how upset I am that his blood tests showed nothing. They did a whole CBC workup and blood counts, adrenal function and thyroid are all perfectly normal. No sign of infection. I am waiting to hear the results of Lyme’s disease and thinking of using a consult with a pediatric neurologist to look at other testing. Has anyone heard of PANDAS? It’s a strep infection that affects the ganglia/brain stem and causes mood disorders, tics, etc. It’s a stretch but worth exploring. Maybe I’m in denial? But the suddeness and severity of this has me thinking physiological illness.

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heysigmund

I completely understand why you would be upset about the bloods not showing anything. It’s just not making any sense for you is it, that’s the awful thing about this. There was a comment in the article on the Anxiety in Kids post about PANDAS. The post is on the home page – the first one in the slider up the top. It was posted on 15 March by a mother who’s been there. There’s a link there that might be helpful for you. I really don’t know enough about it to comment but I think it’s good to be open to everything. Your doctors would be the ones to talk to. It sounds as though you have a good team there who are trying everything they can to get to the bottom of it. Having said that, there’s a lot to be said for a mother’s intuition.

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Debra Farrell

I have suffered since I was 15 years old, I have years where I am fine but it comes back. My mother and my daughter also suffer, my Daughter most off the time. It is very encouraging that research could be going in a new direction.

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heysigmund

Be assured that there is so much research happening around depression. It just affects so many people and it’s important that the research keeps moving forward so we can come up with better treatment options. Just know that it’s happening. Thank you for taking the time to make contact.

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Mandy Titterton

I think he could be right, i’ve suffered with depression all my life and have thought for some time i could have a bacterial infection or parasites

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Karen Young

His arguments make really good sense don’t they. We’re learning more about depression every day but there’s still so much to learn. It’s so good to see new research tracks opening up. Hope you’re doing okay.

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Susan

I became mentally ill at 37, at the same time I had bad acne rosacea, with lots of pustules, I have noticed that with a flare of this disease I also had major depression . So now when the flare starts i have two weeks on antibiotics and then have a treatment with Limelight strength laser to my face. This keeps it away for two years. I have also had weight gain and gut problems from the drugs I was prescribed, i know my gut flora was affected so i am also thinking there is a link to a germ. I still struggle but can manage with these measures and a sensible diet, however weight loss doesnt seem to happen easily once your body has aclimatISed to a larger weight.

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When things feel hard or the world feels big, children will be looking to their important adults for signs of safety. They will be asking, ‘Do you think I'm safe?' 'Do you think I can do this?' With everything in us, we have to send the message, ‘Yes! Yes love, this is hard and you are safe. You can do hard things.'

Even if we believe they are up to the challenge, it can be difficult to communicate this with absolute confidence. We love them, and when they're distressed, we're going to feel it. Inadvertently, we can align with their fear and send signals of danger, especially through nonverbals. 

What they need is for us to align with their 'brave' - that part of them that wants to do hard things and has the courage to do them. It might be small but it will be there. Like a muscle, courage strengthens with use - little by little, but the potential is always there.

First, let them feel you inside their world, not outside of it. This lets their anxious brain know that support is here - that you see what they see and you get it. This happens through validation. It doesn't mean you agree. It means that you see what they see, and feel what they feel. Meet the intensity of their emotion, so they can feel you with them. It can come off as insincere if your nonverbals are overly calm in the face of their distress. (Think a zen-like low, monotone voice and neutral face - both can be read as threat by an anxious brain). Try:

'This is big for you isn't it!' 
'It's awful having to do things you haven't done before. What you are feeling makes so much sense. I'd feel the same!

Once they really feel you there with them, then they can trust what comes next, which is your felt belief that they will be safe, and that they can do hard things. 

Even if things don't go to plan, you know they will cope. This can be hard, especially because it is so easy to 'catch' their anxiety. When it feels like anxiety is drawing you both in, take a moment, breathe, and ask, 'Do I believe in them, or their anxiety?' Let your answer guide you, because you know your young one was built for big, beautiful things. It's in them. Anxiety is part of their move towards brave, not the end of it.
Sometimes we all just need space to talk to someone who will listen without giving advice, or problem solving, or lecturing. Someone who will let us talk, and who can handle our experiences and words and feelings without having to smooth out the wrinkles or tidy the frayed edges. 

Our kids need this too, but as their important adults, it can be hard to hush without needing to fix things, or gather up their experience and bundle it into a learning that will grow them. We do this because we love them, but it can also mean that they choose not to let us in for the wrong reasons. 

We can’t help them if we don’t know what’s happening in their world, and entry will be on their terms - even more as they get older. As they grow, they won’t trust us with the big things if we don’t give them the opportunity to learn that we can handle the little things (which might feel seismic to them). They won’t let us in to their world unless we make it safe for them to.

When my own kids were small, we had a rule that when I picked them up from school they could tell me anything, and when we drove into the driveway, the conversation would be finished if they wanted it to be. They only put this rule into play a few times, but it was enough for them to learn that it was safe to talk about anything, and for me to hear what was happening in that part of their world that happened without me. My gosh though, there were times that the end of the conversation would be jarring and breathtaking and so unfinished for me, but every time they would come back when they were ready and we would finish the chat. As it turned out, I had to trust them as much as I wanted them to trust me. But that’s how parenting is really isn’t it.

Of course there will always be lessons in their experiences we will want to hear straight up, but we also need them to learn that we are safe to come to.  We need them to know that there isn’t anything about them or their life we can’t handle, and when the world feels hard or uncertain, it’s safe here. By building safety, we build our connection and influence. It’s just how it seems to work.♥️
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Words can be hard sometimes. The right words can be orbital and unconquerable and hard to grab hold of. Feelings though - they’ll always make themselves known, with or without the ‘why’. 

Kids and teens are no different to the rest of us. Their feelings can feel bigger than words - unfathomable and messy and too much to be lassoed into language. If we tap into our own experience, we can sometimes (not all the time) get an idea of what they might need. 

It’s completely understandable that new things or hard things (such as going back to school) might drive thoughts of falls and fails and missteps. When this happens, it’s not so much the hard thing or the new thing that drives avoidance, but thoughts of failing or not being good enough. The more meaningful the ‘thing’ is, the more this is likely to happen. If you can look behind the words, and through to the intention - to avoid failure more than the new or difficult experience, it can be easier to give them what they need. 

Often, ‘I can’t’ means, ‘What if I can’t?’ or, ‘Do you think I can?’, or, ‘Will you still think I’m brave, strong, and capable of I fail?’ They need to know that the outcome won’t make any difference at all to how much you adore them, and how capable and exceptional you think they are. By focusing on process, (the courage to give it a go), we clear the runway so they can feel safer to crawl, then walk, then run, then fly. 

It takes time to reach full flight in anything, but in the meantime the stumbling can make even the strongest of hearts feel vulnerable. The more we focus on process over outcome (their courage to try over the result), and who they are over what they do (their courage, tenacity, curiosity over the outcome), the safer they will feel to try new things or hard things. We know they can do hard things, and the beauty and expansion comes first in the willingness to try. 
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#parenting #mindfulparenting #positiveparenting #mindfulparent
Never in the history of forever has there been such a  lavish opportunity for a year to be better than the last. Not to be grabby, but you know what I’d love this year? Less opportunities that come in the name of ‘resilience’. I’m ready for joy, or adventure, or connection, or gratitude, or courage - anything else but resilience really. Opportunities for resilience have a place, but 2020 has been relentless with its servings, and it’s time for an out breath. Here’s hoping 2021 will be a year that wraps its loving arms around us. I’m ready for that. x
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Know that whatever happens, it’s all part of what the holidays are meant to look like. They aren’t meant to be pristine and orderly and exactly as planned. They were never meant to be that. Christmas is about people, your favourite ones, not tasks. If focusing on the people means some of the tasks fall down, let that be okay, because that’s what Christmas is. It’s about you and your people. It’s not about proving your parenting stamina, or that you’ve raised perfectly well-behaved humans, or that your family can polish up like the catalog ones any day of the week, or that you can create restaurant quality meals and decorate the table like you were born doing it. Christmas is messy and ridiculous and exhausting and there will be plenty of frayed edges. And plenty of magic. The magic will happen the way it always happens. Not with the decorations or the trimmings or the food or the polish, but by being with the ones you love, and the ones who love you right back.

When it all starts to feel too important, too necessary and too ‘un-let-go-able’, be guided by the bigger truth, which is that more than anything, you will all remember how you all felt – as in how happy they felt, how loved they felt were, how noticed they felt. They won’t care about the instagram-worthy meals on the table, the cleanliness of the floors, how many relatives they visited, or how impressed other grown-ups were with their clean faces and darling smiles. It’s easy to forget sometimes, that what matters most at Christmas isn’t the tasks, but the people – the ones who would give up pretty much anything just to have the day with you.

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