Inflammation: Depression Fans the Flames and Feasts on the Heat
Open accessAbstract
Depression and inflammation fuel one another. Inflammation plays a key role in depression's pathogenesis for a subset of depressed individuals; depression also primes larger cytokine responses to stressors and pathogens that do not appear to habituate. Accordingly, treatment decisions may be informed by attention to questions of how (pathways) and for whom (predispositions) these links exist, which are the focus of this article. When combined with predisposing factors (moderators such as childhood adversity and obesity), stressors and pathogens can lead to exaggerated or prolonged inflammatory responses. The resulting sickness behaviors (e.g., pain, disturbed sleep), depressive symptoms, and negative health behaviors (e.g., poor diet, a sedentary lifestyle) may act as mediating pathways that lead to further, unrestrained inflammation and depression. Depression, childhood adversity, stressors, and diet can all influence the gut microbiome and promote intestinal permeability, another pathway to enhanced inflammatory responses. Larger, more frequent, or more prolonged inflammatory responses could have negative mental and physical health consequences. In clinical practice, inflammation provides a guide to potential targets for symptom management by signaling responsiveness to certain therapeutic strategies. For example, a theme across research with cytokine antagonists, omega-3 fatty acids, celecoxib, and exercise is that anti-inflammatory interventions have a substantially greater impact on mood in individuals with heightened inflammation. Thus, when inflammation and depression co-occur, treating them in tandem may enhance recovery and reduce the risk of recurrence. The bidirectional links between depression, inflammation, and disease suggest that effective depression treatments could have a far-reaching impact on mood, inflammation, and health.
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Obesity and exposure to childhood adversity are associated with systemic inflammation.
“acknowledging factors that are associated with systemic inflammation, such as obesity and exposure to childhood adversity, is critical for better informing treatment selection in individuals with fearand anxiety-based disorders (Kiecolt-Glaser et al, 2015).”
From Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond (2017) · cites this paper as Kiecolt-Glaser et al, 2015
If combined with other predisposing factors, cytokine responses lead to prolonged pro-inflammatory and anti-inflammatory processes, prolonged dysregulation of various axes, stress, pain, mood changes, anxiety, and ultimately depression.
“If combined with other predisposing factors, these responses lead to a prolonged fight of pro-inflammatory and anti-inflammatory processes, prolonged dysregulation of various axes, stress, pain, mood changes, anxiety, and ultimately, depression [21,22].”
From Selected biomarkers of depression: what are the effects of cytokines and inflammation (2022) · cites this paper as [21]
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Comparison of Inflammatory Markers as Moderators of Depression Outcomes: A CO-MED Study
Czysz, A. H., Mason, B. L., Li, Q., Chin-Fatt, C., Minhajuddin, A., Carmody, T., & Trivedi, M. H. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.08.116 · Cited by 4 · see citing works
- Authors
- Kiecolt-Glaser, J. K., Derry, H. M., & Fagundes, C. P.
- Affiliations
- From the Institute for Behavioral Medicine Research and the Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus; and the Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston.
- The University of Texas MD Anderson Cancer Center (US)
- Venue
- American Journal of Psychiatry
- Published
- 2015-11-01
- Volume
- 172
- Issue
- 11
- Pages
- 1075-1091
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC6511978
- OpenAlex
- W2159036260
- Cited by
- 844
- References
- 204
- Citations by year
- 2026: 61 · 2025: 117 · 2024: 109 · 2023: 93 · 2022: 91 · 2021: 83 · 2020: 58 · 2019: 77 · 2018: 78 · 2017: 47 · 2016: 26 · 2015: 4
- FWCI
- 2.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (R01CA186720, CA186251, CA172296, K05CA172296, R01CA186251, CA186720)
- Topics
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- depression, inflammation, cytokines, sickness behavior, childhood adversity, obesity, gut microbiota, intestinal permeability, stress response, diet, anti-inflammatory therapy, omega-3 fatty acids, celecoxib, physical activity, depression recurrence
- MeSH terms
- Gastrointestinal Microbiome, Adult Survivors of Child Adverse Events, Depression, Major Depressive Disorder, Humans, Inflammation, Intestinal Mucosa, Obesity, Permeability, Stress, Psychological, Health Behavior, Cytokines, Dysbiosis
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