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Depression's Unholy Trinity: Dysregulated Stress, Immunity, and the Microbiome (annualreviews.org)
51 points by yamrzou on May 28, 2022 | hide | past | favorite | 11 comments



I just quit my stressful job a month ago, started working out twice a week, and have switched to a probiotic with a bunch of bifidobacterium strains and my depression has disappeared. I can say 100% my experience validated this. The other thing I did was cut out alcohol for a few months.


> started working out twice a week

I would think that's extremely difficult if not impossible for many depressed people. What was your experience in that respect?


I recently quit for similar reasons. Exercise while working felt like an insurmountable thing. Exercise while on sabbatical is very challenging right now, but achievable.

This depends on the person, but for many, the inability to muster the motivation to exercise is a capacity thing. The capability is there, but the capacity is used just surviving the day.

Removing the work factor has freed some capacity for me. It's still a struggle, but the lack of work stress is a huge help.


Start small. "working out" doesn't have to be a full workout.

It can just be getting out of the house to go for a walk. Find something small to build on, and do your best to build a routine.

Trying to build and maintain a regular schedule is more important than the workout. You'll find yourself improving your workout naturally.

Marking a physical calendar can be helpful.

No need to push yourself, take it easy and in small doses, and after about a month you'll find it's no longer a struggle and the routine will start to take over for you.

The most important thing is that somewhere in your head you need to know that you want this for yourself. If you start looking it as something imposed on you, it becomes something you want to stop. Make sure you remind yourself that you're doing it for you.


I forced myself by getting a personal trainer where I would be charged if I didn’t attend. After I exercised I felt so much better for two or three days that I added another two days of exercise with my wife and daughter who are dragging me to go and I don’t have a choice. I’ve progressively improved.

My job is still stressful but with regular exercise I feel generally more resilient. Im still suffering a low grade depression and probably a diet revamp as well as other aspects would help a lot. But the exercise alone has completely changed my entire life perspective and my moment to moment life.

But without the forcing functions I found I wouldn’t be doing it, 100%. It’s all about burning the boats behind you.


> Increased plasma concentrations of interleukin-6 (IL-6), interferon-gamma (IFN-γ), and acute-phase proteins were initially reported, and it is now well established that these and other cytokines, including tumor necrosis factor (TNF) in particular, are elevated in depressed patients (Dowlati et al. 2010). This inflammatory phenotype is also believed to be a significant contributor to treatment resistance in depression.

So are hematologists regularly noticing chronic inflammation in depressed patients? Why isn't this fact used clinically, at least for diagnosis, then?


>Why isn’t this fact used clinically, at least for diagnosis, then?

1. Primarily because IL6 and IFNg are inflammatory cytokines that when increased can indicate any number of things, most commonly caused by infection tissue damage, or other chronic inflammatory diseases like IBD. These cytokines are not unique to depression.

2. Clinical definitions of depression are not related to or dependent on inflammation. AFAIK diagnostic measures of depression are only related to mood.

3. Medicine is notoriously slow at leveraging scientific findings. We’ve known for decades about the power of early cancer detection by cfDNA sequencing yet we still rely on symptoms to catch cancer, when it’s often too late. My jaded opinion is that fee for service is not compatible with disease prevention.


> 1. Primarily because IL6 and IFNg are inflammatory cytokines that when increased can indicate any number of things, most commonly caused by infection tissue damage, or other chronic inflammatory diseases like IBD. These cytokines are not unique to depression.

Yeah but if you already had been diagnosed with depression, it seems like they'd want to check this.


"psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests"

-Allen Frances

https://en.wikipedia.org/wiki/Allen_Frances


Not really, we don't do tests if it won't impact treatment, and in this case there is no change in treatment (yet) based on inflammatory cytokines.


Cold showers, breath exercises (i.e. Wim Hof method), intermittent fasting and physical exercise do wonders for regulating stress, boosting immunity, dopamine, and serotonin.

Cutting out sugar and eating fermented probiotic foods like sauerkraut, kimchi and apple cider vinegar can also help your gut microbiome immensely.

The Huberman Lab Podcast presents some very interesting data on the science behind these practices:

How to Enhance Your Gut Microbiome for Brain & Overall Health | Huberman Lab Podcast #61

https://www.youtube.com/watch?v=15R2pMqU2ok

Dr. Justin Sonnenburg: How to Build, Maintain & Repair Gut Health | Huberman Lab Podcast #62

https://www.youtube.com/watch?v=ouCWNRvPk20

Using Deliberate Cold Exposure for Health and Performance | Huberman Lab Podcast #66

https://www.youtube.com/watch?v=pq6WHJzOkno

Dr. Craig Heller: Using Temperature for Performance, Brain & Body Health | Huberman Lab Podcast #40

https://www.youtube.com/watch?v=77CdVSpnUX4

Dr. Jack Feldman: Breathing for Mental & Physical Health & Performance | Huberman Lab Podcast #54

https://www.youtube.com/watch?v=GLgKkG44MGo




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