Depression and Anxiety
More than 1.6 million Swedes are prescribed psychiatric medication, of which just over one million receive antidepressant drugs. Although pharmaceutical interventions may be appropriate, it only provides symptom relief. In addition, several studies show that they have poor efficacy and come with potentially severe side effects.
At Nordic Clinic, we set our ambitions high – we want to succeed far better than standard healthcare in improving the quality of life for this patient group. We do this by keeping up with the latest research on mental ailments and by looking wide and deep for potential root causes in each patient case.
Without a doubt, psychosocial factors have a profound impact on our mental well-being. Psychosocial factors include the loss of a loved one, occupational stress, performance stress, ostracism and bullying, involuntary loneliness and lack of social support or a sense of meaning. Screen time and excessive use of social media also come into play. But in recent years, the view of depression has become increasingly departed from as a problem caused exclusively by psychosocial factors. Scientists have come to fascinating and important conclusions.
As for clinical depression, researchers agree that it occurs when inflammatory proteins spill over into the brain. Inflammation can arise from countless sources. This is the likely reason depression occurs so commonly with other inflammatory diseases. Unfortunately, knowledge thereof is rarely used when working with patients in standard medicine.
There’s plentiful direct and indirect evidence that inflammation causes depression. When researchers inject potent pro-inflammatory lipopolysaccharides from bacteria into the blood of study participants, they suddenly develop symptoms of clinical depression. Furthermore, when patients with hepatitis C are treated with highly pro-inflammatory drugs containing interferon, depression is a common side effect ‒ a direct consequence of increased inflammation. People with severe treatment-resistant depression have higher levels of pro-inflammatory cytokines in the blood than people with milder depression. In addition, anti-inflammatory drugs such as ibuprofen reduce symptoms of depression.
Many factors may be behind the inflammation that leads to psychiatric conditions. The hottest research areas involve intestinal function, and our gut microbiome is right at the centre. Anxiety, depression and bipolar disorder have all been linked to our gut flora. When the intestinal barrier becomes hyperpermeable (a phenomenon also called “leaky gut”), bacteria and bacterial toxins leak across the mucus barrier where they meet the enteric nervous system and our blood circulation. These bacteria and toxins spread further, causing an inflammatory cascade when immune cells are activated to destroy them throughout the body. This inflammatory process can also affect the brain. Chronic infections are potent inducers of depression, and for some patients, infection testing may be recommended.
Physical activity is protective depression. Exercise reduces inflammation long-term, by reducing the levels of the neurotoxic molecule kynurenine, especially after aerobic exercise. Stress also contributes to depression, by increasing proinflammatory cytokines in circulation at exposure to stressful situations. In the case of obesity, proinflammatory cytokines are formed in our adipose tissue which can contribute to depression.
Awareness that physical symptoms are sometimes mistaken for psychological, since symptomatology overlaps markedly. For example, hypothyroidism can cause depressive symptoms while hyperthyroidism can, conversely, cause anxiety. More than 400 000 Swedes take thyroid medication, but it’s believed that many cases remain undetected. Frequently, the standard pharmaceutical drugs offered for hypothyroidism are inadequate. Sadly, the very same treatment can cause symptoms of hyperthyroidism (such as anxiety), while still failing to correct other hypothyroid symptoms.
To address the problem, listening to the patient is crucial and to one’s best ability try to get to the clarify whether one is dealing with clinical depression, grief or sadness. What makes it better and what makes it worse? Furthermore, we might investigate the patient’s lifestyle, stress, sleep, diet and gut microbiome. We can also look at deficiencies of specific nutrients that are needed to produce or break down neurotransmitters in the brain. According to studies, vitamin D deficiency is also a common contributing factor in depression.
At Nordic Clinic, we consider different aspects of our patients’ life and develop individual action plans. We recommend lab tests that can help us find important clues. When appropriate, we refer the patient to a psychologist. Our coaches support the patient and create motivation to cope with lifestyle changes.