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.

Reply
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

Reply
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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Yes anxiety can be so crushing, and yes it can intrude into every part of their everyday. But the more we talk about anxiety as a disorder, the more we drive ‘anxiety about the anxiety’. Even for big anxiety, there is nothing to be served in talking about it as a disorder. 

There is another option. We change the face of it - from an intruder or deficiency, to an ally. We change the story - from ‘There’s something wrong with me’ to, ‘I’m doing something hard.’ I’ve seen the difference this makes, over and over.

This doesn’t mean we ignore anxiety. Actually we do the opposite. We acknowledge it. We explain it for what it is: the healthy, powerful response of a magnificent brain that is doing exactly what brains are meant to do - protect us. This is why I wrote Hey Warrior.

What we focus on is what becomes powerful. If we focus on the anxiety, it will big itself up to unbearable.

What we need to do is focus on both sides - the anxiety and the brave. Anxiety, courage, strength - they all exist together. 

Anxiety isn’t the absence of brave, it’s the calling of brave. It’s there because you’re about to do something hard, brave, meaningful - not because there’s something wrong with you.

First, acknowledge the anxiety. Without this validation, anxiety will continue to do its job and prepare the body for fight or flight, and drive big feelings to recruit the safety of another human.

Then, we speak to the brave. We know it’s there, so we usher it into the light:

‘Yes I know this is big. It’s hard [being away from the people you love] isn’t it. And I know you can do this. We can do hard things can’t we.

You are one of the bravest, strongest people I know. Being brave feels scary and hard sometimes doesn’t it. It feels like brave isn’t there, but it’s always there. Always. And you know what else I know? It gets easier every time. I’ve know this because I’ve seen you do hard things, and because I’ve felt like this too, so many times. I know that you and me, even when we feel anxious, we can do brave. It’s always in you. I know that for certain.’♥️
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Every time we hold a boundary, we are giving our kids the precious opportunity to learn how to hold their own.

If we don’t have boundaries, the risk is that our children won’t either. We can talk all we want about the importance of boundaries, but if we don’t show them, how can they learn? Inadvertently, by avoiding boundary collisions with them, we are teaching them to avoid conflict at all costs. 

In practice, this might look like learning to put themselves, their needs, and their feelings away for the sake of peace. Alternatively, they might feel the need to control other people and situations even more. If they haven’t had the experience of surviving a collision of needs or wants, and feeling loved and accepted through that, conflicting needs will feel scary and intolerable.

Similarly, if we hold our boundaries too harshly and meet their boundary collisions with shame, yelling, punishment or harsh consequences, this is how we’re teaching them to respond to disagreement, or diverse needs and wants. We’re teaching them to yell, fight dirty, punish, or overbear those who disagree. 

They might also go the other way. If boundaries are associated with feeling shamed, lonely, ‘bad’, they might instead surrender boundaries and again put themselves away to preserve the relationship and the comfort of others. This is because any boundary they hold might feel too much, too cruel, or too rejecting, so ‘no boundary’ will be the safest option. 

If we want our children to hold their boundaries respectfully and kindly, and with strength, we will have to go first.

It’s easy to think there are only two options. Either:
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‘It’s okay to be angry, and it’s okay not to like my decision. It’s not okay to speak to me like that. I know you know that. My answer is still no.’

Then, when they’re back to calm, have the conversation: 

‘I wonder if sometimes when you say you don’t like me, what you really mean is that you don’t like what I’ve done. It’s okay to be angry at me. It’s okay to tell me you’re angry at me. It’s not okay to be disrespectful.

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Boundaries without the ‘loving’ will feel shaming, lonely, harsh. Understandably children will want to shield from this. This ‘shielding’ looks like keeping their messes from us. We drive them into the secretive and the forbidden because we squander precious opportunities to guide them.

Harsh consequences don’t teach them to avoid bad decisions. They teach them to avoid us.

They need both: boundaries, held lovingly.

First, decide on the boundary. Boundaries aren’t about what we want them to do. We can’t control that. Boundaries are about what we’ll do when the rules are broken.

If the rule is, ‘Be respectful’ - they’re in charge of what they do, you’re in charge of the boundary.

Attend to boundaries AND relationship. ‘It’s okay to be angry at me. (Rel’ship) No, I won’t let you speak to me like that. (Boundary). I want to hear what you have to say. (R). I won’t listen while you’re speaking like that. (B). I’m  going to wait until you can speak in a way I can hear. I’m right here. (R).

If the ‘leadership’ part is hard, think about what boundaries meant for you when you were young. If they felt cruel or shaming, it’s understandable that that’s how boundaries feel for you now. You don’t have to do boundaries the way your parents did. Don’t get rid of the boundary. Add in a loving way to hold them.

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