A Common Link Discovered in Patients with Depression and Anxiety May Surprise You
New research regarding a common link shared between patients with depression and anxiety indicates a surprising culpritt: autoimmune disease. The rates of anxiety and depression almost doubled in patients with an autoimmune disease when functional medicine practitioners examined the findings of a platform called LivingMatrix.
LivingMatrix is a company that is fighting the underlying cause of depression. In a collaboration with Dr. Sam Yanuck (CEO of Cogence Immunology) and Dr. Nathan Morris (CEO of GoodMedicine), LivingMatrix identified a common statistic in functional medicine practices: 60% of autoimmune patients reported anxiety and almost half reported depression. Compared to patients without an autoimmune disease, these percentages were almost double the rates of anxiety and depression. According to LivingMatrix, depression and anxiety are:
“Often overlooked in the presence of an underlying chronic condition that may be causing or contributing to the anxiety or depression. We now know that chronic activation of the immune system which can happen in conditions like autoimmune disease (23.5 million Americans) that results in inflammation in the body, but also the brain. This brain inflammation then drives the sympathetic nervous system (flight or fight response) leading to anxiety and also diminishes the firing of neurons (nerve cells) in the prefrontal cortex, typical of depression.”
Interview with the CEO of LivingMatrix
LivingMatrix is a platform that functional medicine practitioners can utilize along with the Practitioner Research Network (LM-PRN) in their quest to find holistic answers and solutions as they seek to address the underlying root cause. The symptoms of depression and anxiety significantly improve in most patients after their practitioner treats the underlying autoimmune condition. I had the honor and the privilege of conducting an interview with LivingMatrix’s CEO, Priya Kamani M.D., regarding how autoimmune disease often contributes to depression and anxiety.
Kaitlin: What are the underlying causes of depression?
Priya Kamani: Family history or genetic predisposition, stressful life events, trauma, abuse, are what we typically associate with depression. Physical and mental health are often considered as separate and distinct issues; however, they are inextricably linked by our physiology.
Kaitlin: Are there symptoms of depression that are commonly attributed to other diseases or misdiagnosed?
a) LivingMatrix has identified that people with multiple chronic conditions (25 percent of the US population) are at significantly higher risk for anxiety/depression, and up to 50 percent of them suffer from it – particularly those with immune or inflammatory conditions. Inflammation in the body can give rise to brain inflammation which can then lead to symptoms of anxiety & depression.
b) Additionally, people with chronic disease are treated with drugs that may themselves have anxiety or depression as a side-effect. A recent study published in JAMA (JAMA. 2018;319(22):2289-2298. doi:10.1001/jama.2018.6741) found that 37.2 percent of the U.S. population are taking medications that have depression as a potential adverse effect.
Kaitlin: What steps can people with a diagnosis of depression or anxiety take to improve their quality of life?
Priya Kamani: Here are 3 things that can help:
i) If you have other symptoms in addition to depression or anxiety, please get yourself checked out to make sure you don’t have an accompanying chronic condition which needs to be addressed. In some cases, symptoms related to anxiety and depression may be very similar to the symptoms experienced by patients with certain chronic conditions. A good example of this is Hashimoto’s Thyroiditis. A recent study (10.1016/j.genhosppsych.2013.10.002) showed that patients with Hashimoto’s were much more likely to have major depression or anxiety compared to controls.
ii) Improve your nutrition: According to the experts at the Mayo Clinic, there have been several studies linking poor-quality diets that are high in processed meat, candy, sweet desserts, fried food, refined cereals etc. were much more likely to report symptoms of depression.
iii) Consider Mindfulness-Based Cognitive Therapy - a Lancet study showed that it was as effective as medication in preventing relapses in depressed patients.
Kaitlin: As a company, could you please explain how LivingMatrix is fighting the underlying cause(s) of depression?
Priya Kamani: LivingMatrix, the leading cloud-based, clinician-designed, Functional Medicine platform is designed to enhance patient engagement and clinician efficiency. The LivingMatrix practitioners are able to effectively engage with their patients to address underlying triggers and mediators and develop a personalized Functional Medicine Prescription that incorporates beneficial lifestyle changes. Improved nutrition, exercise, better sleep patterns, stress-reduction strategies have all been shown to be effective in improving symptoms.
Kaitlin: How does autoimmune disease contribute to depression and anxiety disorders?
Priya Kamani: Inflammation in the body can lead to inflammation of the brain, which can often manifest as anxiety and depression.
Kaitlin: Does LivingMatrix feel that epigenetics play an important role in both the development and progression of depression and anxiety?
Priya Kamani: Yes absolutely, there is significant on-going research in this area and DNA methylation is one of the most investigated epigenetic changes in depression research. In addition, several studies including one from Emory University have shown that an early childhood adverse environment leaves long-lasting epigenetic marks via changes in both DNA methylation. (Dialogues Clin Neurosci. 2014 Sep; 16(3): 395–404.)
Kaitlin: What alternative treatments, diets, and therapies do you recommend as functional medical practitioners for patients facing depression or anxiety that want to treat the root cause rather than merely taking a pill for the ill?
Priya Kamani: The reality is that there is not one common root cause, each one of us is different. It is important to work with a trained practitioner that can really help do the detective work to figure out what the underlying issues are. There are also no magic bullets (or pills) and it often requires working on multiple elements. Nutrition is the foundation of treatment and then your practitioner will work with you to improve your sleep, find the right exercise recommendation based on your condition and also work on stress reduction. Stress is a big contributor.
Kaitlin: Can you please describe for us in detail how both depression and anxiety affect brain function?
a) Much of the brain effect of anxiety and depression is thought to be mediated by Cortisol (fight or flight hormone) affecting three parts of the brain - Hippocampus, Pre-Frontal Cortex, and the Amygdala. Chronic cortisol activation that occurs due to high levels of stress and in depressive states prevents new neuron formation potentially shrinking the hippocampus and impacting memory. This same chronic cortisol elevation can also shrink the pre-frontal cortex and impact the ability to regulate emotions, make decisions, and form memories. The Amygdala, on the other hand, grows bigger and more active impacting emotions and the fear response.
b) Fortunately, especially early in the process, many of these changes can be stopped or reversed so I encourage patients to get help.
In conclusion, patients with a diagnosis of autoimmune disease share an increased risk for depression or anxiety. Functional medicine practitioners can help you take a holistic approach on your health journey whether you are battling depression, anxiety, autoimmunity, or another disease by finding and addressing the root cause of your illness. To find out more about LivingMatrix, please click here.