Depression is one of the most common psychiatric disorders and has a prevalence of 5%. There are various causes of depression ranging from devastating or stressful life events to having a genetic predisposition.
Researchers from Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta – Dr. J.C. Felger et al. tried to correlate the elevated biomarkers of inflammation with the disease process of depression and came to a conclusion that could alter the entire modality of treatment for depression.An earlier study was done in persons suffering from persistent anhedonia (even after treatment) and also with high levels of inflammatory markers. There was evidence of an improved response to treatment with anti-inflammatory antibody infliximab.
Studies have shown that hypofunction of monoamine neurotransmitter systems (5-HT & norepinephrine), and abnormal hypothalamo-pituitary-adrenal axis regulation might be a few organic causes for this disease.
Depression may be:
- Reactive/Neurotic/Psychological – It involves an exaggerated response in grief or particular adverse situations.
- Melancholic/Endogenous – It usually occurs in middle or later years of life and people have a greater tendency to commit suicide in this group.
“Anhedonia is a core symptom of depression that is particularly difficult to treat. Some patients taking antidepressants continue to suffer from anhedonia,” says Dr.Felger.
“High levels of the inflammatory marker CRP (C-reactive protein) in patients with depression were linked to a failure in communication between regions of the brain important for motivation and reward, as seen through brain imaging.”
The major limitation of the study was the presence of a healthy control group. Yet, Dr. Felger hopes that their data will help reverse anhedonia in depressed patients who do not respond to antidepressants. She is now planning on testing the efficacy of L-DOPA in the treatment of resistant major depression.
“We hope our investigations may lead to new therapies to treat anhedonia in patients with depression and high inflammation,” she says.
In conclusion, the study has provided a new perspective on depression and its treatment. An effort to remove the stigma revolving around mental health issues, and such research to improve existing methods of their management will help the wide majority of depressed people emerge out of their cocoons and seek timely medical assistance.
References:
1. http://news.emory.edu/stories/2015/11/brain_imaging_depression_felger/2. Davidson’s Principles & Practice of Medicine – 21st Edition
3. Pharmacology and Pharmacotherapeutics by R.S. Satoskar – 21st Edition
Source-Medindia