Depression is a disease that has plagued humankind for centuries and which unfortunately remains prevalent today, affecting 1 out of 5 individuals at some point in their lives. Up to 50% of the population may be seasonally affected, experiencing a mild form of depression due to fewer daylight hours during the winter. Moderate to severe depression is more likely to occur in the year following hospitalization for a physical illness or the death of a loved one.

Antidepressants are a common treatment and can be effective for many. However, one third of people with depression fail to respond to this type of medication. To find other avenues to treat depression, research during the last decade has looked at depression as an inflammatory disease, noting that physical symptoms in depression mimic those of a cold or flu: fatigue, loss of appetite, listlessness, change in sleep patterns, and lethargy. This sickness behavior is induced by inflammatory chemicals released in response to illness, and some patients with depression show an increase in these inflammatory markers.

During an inflammatory episode the body releases cytokines, small protein molecules that incite the immune system into action. One such molecule which is well-known and often tested through routine blood work is C-reactive protein. Anything over 3 mg/L is considered a marker of high inflammation, but values greater than 1 are an indicator that a patient is less likely to respond to selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft.

Adding aspirin or the non-steroidal anti-inflammatory drug celecoxib to a medication regimen can improve symptoms during a major depressive episode. For people who want to avoid drugs and their side effects, there are many ways to lower inflammation naturally.

First, follow an anti-inflammatory diet. This requires eliminating processed foods, eating as many plant-based foods as possible, and consuming a high amount of omega-3 oils from avocados, salmon, olives, hemp seeds, flax seeds and nuts. Refined starches in bread and baked goods, cane sugar and alcohol all increase inflammation in the body. Diets characterized by high consumption of red meat, sweets, high-fat dairy products and low intake of fruits and vegetables are associated with an increased risk of depression.

Second, exercise moderately. When you are depressed, it can be difficult to motivate yourself to get moving. But if you do, you will get the benefits of increased endorphin production, weight control and reduced cardiovascular risk, along with a 5% reduction in inflammatory cytokines from just 20 minutes of walking on the treadmill. Low-intensity exercise causes nerve cells to grow and make new connections. This improvement in brain function helps relieve depression.

Third, manage your stress. Inflammation is your body’s response to stress, and stress can induce or worsen chronic conditions, depression included. Cortisol is a hormone produced under conditions of stress, which leads to increased inflammation. Meditators and yoga practitioners lower their cortisol and inflammatory levels, but you can choose any stress reduction method you enjoy such as journaling, spending time in nature, deep breathing or petting an animal. Chronic stress makes people more likely to neglect healthy behaviors and thus increases the risk of major depression, so lowering your stress now can prevent recurrence later.

Dr. Jessica Needle is a naturopathic doctor practicing at Optimal Health Center in Palm Desert and can be reached at (760) 568.2598.