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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Anxiety is a sign that the brain has registered threat and is mobilising the body to get to safety. One of the ways it does this is by organising the body for movement - to fight the danger or flee the danger. 

If there is no need or no opportunity for movement, that fight or flight fuel will still be looking for expression. This can come out as wriggly, fidgety, hyperactive behaviour. This is why any of us might pace or struggle to sit still when we’re anxious. 

If kids or teens are bouncing around, wriggling in their chairs, or having trouble sitting still, it could be anxiety. Remember with anxiety, it’s not about what is actually safe but about what the brain perceives. New or challenging work, doing something unfamiliar, too much going on, a tired or hungry body, anything that comes with any chance of judgement, failure, humiliation can all throw the brain into fight or flight.

When this happens, the body might feel busy, activated, restless. This in itself can drive even more anxiety in kids or teens. Any of us can struggle when we don’t feel comfortable in our own bodies. 

Anxiety is energy with nowhere to go. To move through anxiety, give the energy somewhere to go - a fast walk, a run, a whole-body shake, hula hooping, kicking a ball - any movement that spends the energy will help bring the brain and body back to calm.♥️
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#parenting #anxietyinkids #childanxiety #parenting #parent
This is not bad behaviour. It’s big behaviour a from a brain that has registered threat and is working hard to feel safe again. 

‘Threat’ isn’t about what is actually safe or not, but about what the brain perceives. The brain can perceive threat when there is any chance missing out on or messing up something important, anything that feels unfamiliar, hard, or challenging, feeling misunderstood, thinking you might be angry or disappointed with them, being separated from you, being hungry or tired, anything that pushes against their sensory needs - so many things. 

During anxiety, the amygdala in the brain is switched to high volume, so other big feelings will be too. This might look like tears, sadness, or anger. 

Big feelings have a good reason for being there. The amygdala has the very important job of keeping us safe, and it does this beautifully, but not always with grace. One of the ways the amygdala keeps us safe is by calling on big feelings to recruit social support. When big feelings happen, people notice. They might not always notice the way we want to be noticed, but we are noticed. This increases our chances of safety. 

Of course, kids and teens still need our guidance and leadership and the conversations that grow them, but not during the emotional storm. They just won’t hear you anyway because their brain is too busy trying to get back to safety. In that moment, they don’t want to be fixed or ‘grown’. They want to feel seen, safe and heard. 

During the storm, preserve your connection with them as much as you can. You might not always be able to do this, and that’s okay. None of this is about perfection. If you have a rupture, repair it as soon as you can. Then, when their brains and bodies come back to calm, this is the time for the conversations that will grow them. 

Rather than, ‘What consequences do they need to do better?’, shift to, ‘What support do they need to do better?’ The greatest support will come from you in a way they can receive: ‘What happened?’ ‘What can you do differently next time?’ ‘You’re the most wonderful kid and I know you didn’t want this to happen. How can you put things right? Do you need my help with that?’♥️
Big behaviour is a sign of a nervous system in distress. Before anything, that vulnerable nervous system needs to be brought back home to felt safety. 

This will happen most powerfully with relationship and connection. Breathe and be with. Let them know you get it. This can happen with words or nonverbals. It’s about feeling what they feel, but staying regulated.

If they want space, give them space but stay in emotional proximity, ‘Ok I’m just going to stay over here. I’m right here if you need.’

If they’re using spicy words to make sure there is no confusion about how they feel about you right now, flag the behaviour, then make your intent clear, ‘I know how upset you are and I want to understand more about what’s happening for you. I’m not going to do this while you’re speaking to me like this. You can still be mad, but you need to be respectful. I’m here for you.’

Think of how you would respond if a friend was telling you about something that upset her. You wouldn’t tell her to calm down, or try to fix her (she’s not broken), or talk to her about her behaviour. You would just be there. You would ‘drop an anchor’ and steady those rough seas around her until she feels okay enough again. Along the way you would be doing things that let her know your intent to support her. You’d do this with you facial expressions, your voice, your body, your posture. You’d feel her feels, and she’d feel you ‘getting her’. It’s about letting her know that you understand what she’s feeling, even if you don’t understand why (or agree with why). 

It’s the same for our children. As their important big people, they also need leadership. The time for this is after the storm has passed, when their brains and bodies feel safe and calm. Because of your relationship, connection and their felt sense of safety, you will have access to their ‘thinking brain’. This is the time for those meaningful conversations: 
- ‘What happened?’
- ‘What did I do that helped/ didn’t help?’
- ‘What can you do differently next time?’
- ‘You’re a great kid and I know you didn’t want this to happen, but here we are. What can you do to put things right? Do you need my help with that?’♥️
As children grow, and especially by adolescence, we have the illusion of control but whether or not we have any real influence will be up to them. The temptation to control our children will always come from a place of love. Fear will likely have a heavy hand in there too. When they fall, we’ll feel it. Sometimes it will feel like an ache in our core. Sometimes it will feel like failure or guilt, or anger. We might wish we could have stopped them, pushed a little harder, warned a little bigger, stood a little closer. We’re parents and we’re human and it’s what this parenting thing does. It makes fear and anxiety billow around us like lost smoke, too easily.

Remember, they want you to be proud of them, and they want to do the right thing. When they feel your curiosity over judgement, and the safety of you over shame, it will be easier for them to open up to you. Nobody will guide them better than you because nobody will care more about where they land. They know this, but the magic happens when they also know that you are safe and that you will hold them, their needs, their opinions and feelings with strong, gentle, loving hands, no matter what.♥️
Anger is the ‘fight’ part of the fight or flight response. It has important work to do. Anger never exists on its own. It exists to hold other more vulnerable emotions in a way that feels safer. It’s sometimes feels easier, safer, more acceptable, stronger to feel the ‘big’ that comes with anger, than the vulnerability that comes with anxiety, sadness, loneliness. This isn’t deliberate. It’s just another way our bodies and brains try to keep us safe. 

The problem isn’t the anger. The problem is the behaviour that can come with the anger. Let there be no limits on thoughts and feelings, only behaviour. When children are angry, as long as they are safe and others are safe, we don’t need to fix their anger. They aren’t broken. Instead, drop the anchor: as much as you can - and this won’t always be easy - be a calm, steadying, loving presence to help bring their nervous systems back home to calm. 

Then, when they are truly calm, and with love and leadership, have the conversations that will grow them - 
- What happened? 
- What can you do differently next time?
- You’re a really great kid. I know you didn’t want this to happen but here we are. How can you make things right. Would you like some ideas? Do you need some help with that?
- What did I do that helped? What did I do that didn’t help? Is there something that might feel more helpful next time?

When their behaviour falls short of ‘adorable’, rather than asking ‘What consequences they need to do better?’ let the question be, ‘What support do they need to do better.’ Often, the biggest support will be a conversation with you, and that will be enough.♥️
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#parenting #positiveparenting #mindfulparenting #anxietyinkids

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