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Name: The Inflamed Mind
Rating: 4.5 (258 reviews)
Author: Edward Bullmore

Edward Bullmore

A Radical New Approach to Depression

4.5 (258 ratings)

27 mins

Brief summary

The Inflamed Mind by Edward Bullmore is a fascinating journey through the link between inflammation and mental disorders. It explores what we know, what we don't know, and what we can do to uncover cures and improve overall mental health.

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The Inflamed Mind
Summary of 9 key ideas

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What’s in it for me? Learn about a promising theory of depression.

If cancer is the emperor of all maladies, then depression surely is the king of mental illness. But what exactly is depression? And what causes it? While the overwhelming majority of research so far has looked for the origins of depression in the brain and the mind, groundbreaking new studies are revealing how depression is not just a mental illness, but a bodily one too. And the crucial link is the immune system.

These blinks take a look at some of the latest science to explain how the immune system uses inflammation to fight disease, why this can negatively affect our mood and behavior, and how the inflammation hypothesis could advance revolutionarily new, holistic treatments of depression.

In these blinks, you’ll discover

which unlikely side effect exposed the depressive effects of inflammation;
how depression could have saved our ancient ancestors’ lives; and
why antidepressants might be shooting at the wrong target.

Physical illness can make you feel depressed, and the reason for this could be inflammation.

Have you ever caught a bad cold that made you inexplicably sad, lethargic and antisocial?

When you’re sick, it’s normal to feel a bit gloomy. In fact, it makes sense for you to feel this way, so that you’ll stay in bed and save your energy for fighting off the infection. Your immune system does this by causing inflammation throughout your body that’s meant to destroy the cold virus. Once the virus is gone and the inflammation subsides, your mood lifts again.

But there might be more to the process of cold-induced gloominess than we thought. A growing number of scientists are arguing that it could provide an essential clue to understanding depression.

They believe that gloominess is not caused by the sickness itself or your negative thoughts about being sick, but by your immune system’s reaction to the sickness: widespread bodily inflammation. These scientists are also starting to suspect that lingering inflammation could be the cause of the long-term mood disorder we commonly call “depression.”

An anecdote about a drug for rheumatoid arthritis illustrates the powerful effect that inflammation can have on our mood.

Rheumatoid arthritis is an autoimmune disease of the joints that makes them increasingly stiff and swollen. In autoimmune diseases, the immune system causes an unnecessary, chronic inflammation in response to some of the body’s parts or components – in this case, the joints.

In the 1990s, scientists finally found an antibody against one of the key inflammatory proteins of the disease. With this antibody, they developed a drug that would help reduce the inflammation, and so ease the painful side effects of stiffness and swelling.

In 1999, the first such drug came to market under the brand name Remicade. To many rheumatic patients, Remicade felt like a miracle cure. Administered as an infusion, not only did it immediately relieve pain, but it also made users feel instantly happy and cheerful. At the University College Hospital in London, the patients’ euphoric “Remicade high” caused nurses to fight over who got to administer the infusion.

Though not well studied, this Remicade high suggests that reducing inflammation can boost people’s moods. Conversely, it seems that too much inflammation can make people depressed. To understand why this might be, let's have a closer look at how inflammation works.

Inflammation is a natural reaction of our immune system to protect us from infection.

Since the beginning of time, humans have been at war. With one another often enough, but also against the thousands of tiny non-human invaders that swarm our bodies on a daily basis. The immune system doesn't only activate when we get a cold. Day and night, our immune systems defend us against hostile bacteria, germs, bugs, pathogens, viruses and worms – collectively called antigens – which could otherwise lead to serious illness or death.

The human immune system consists of various parts and structures. Its most important soldiers are white blood cells, which can be divided into different types of specialized immune cells such as macrophages, and lymphocytes.

The doctrine of Cartesian dualism has kept modern medicine from exploring the links between mind and body.

In his early training as a physician, the author treated an older lady for her rheumatoid arthritis. Because the woman seemed very depressed, he questioned her about her mood and social life during the examination. Back then, he didn’t suspect that the inflammation underlying her arthritis could also be causing her depression – but he felt it was important to address all of her issues holistically.

After the examination, the author was sternly told by his supervisor that it was his job to treat the lady’s arthritis, not her depression. After all, anyone with such an awful disease would probably be a little depressed.

Since the invention of Prozac in the '90s, there have been no major breakthroughs in depression treatment.

If you’re an ironclad Cartesian dualist, the notion that you can cure the mind by tweaking chemicals in the brain is inconceivable.

But today, antidepressant drugs that claim to balance the chemical composition of the brain have become one of the few treatment options for depression.

New fields of medical research are uncovering promising links between inflammation and depression.

Around the time Prozac launched in the '90s, the first papers linking depression to the immune system were published in obscure medical journals. They included titles such as "The Macrophage Theory of Depression" (1991) and "Evidence for an Immune Response in Major Depression" (1995). In hindsight, these theories seem like a massive breakthrough. But at the time, they were largely ignored – they didn’t fit the new serotonin story.

Nevertheless, these papers marked the beginning of two new medical fields of research: neuroimmunology, which studies the link between the immune system and the brain; and immunopsychiatry, which focuses on the connection between the immune system and mental health.

Inflammation in the body can cause an inflammatory reaction in the brain that affects our mood and behavior.

Just a few decades ago, scientists were convinced that it was nearly impossible for the immune system to affect our brain. They thought the brain had its own, completely separate immune system, shielded from the rest of the body by the so-called Blood-Brain Barrier, or BBB. The BBB is a dense wall of cells that surrounds the brain and prevents molecules circulating in the blood from directly passing through to the brain.

But in recent years, scientists have discovered that the BBB isn’t as impermeable as previously thought. Not only are there gaps between the BBB cells that allow certain molecules and proteins to enter the brain; the cells themselves can respond to inflammatory signals of the body, and pass that information on to the brain.

Chronic inflammation can be caused by autoimmune disorders, age, obesity and stress.

So far, we’ve learned that inflammation is a natural response of the immune system, but it causes serious collateral damage to our bodies and brains when it becomes chronic. This, in turn, affects our moods, thoughts and behavior.

But what causes chronic inflammation?

A sensitivity to inflammation and depression could have helped our ancestors survive.

Now that you’ve learned about how inflammation can cause depression, you probably want to know why this is the case.

When we ask why our bodies and brains do this or that, the answer will usually be natural selection. If we adhere to Darwin’s evolutionary theory, then somehow, at some point in human evolution, inflammation and depression must have helped the human species survive.

Medication and therapy that reduce inflammation promise new hope for treating depression.

If you suspect that your depression is caused by inflammation after reading these blinks, you probably want to know what you can do about it.

Unfortunately, professional treatment options for inflammatory depression are still limited.

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What is The Inflamed Mind about?

The Inflamed Mind (2018) explains the latest science behind a new theory linking depression to inflammation of the body and brain. Bringing together insights from medicine, psychology and evolutionary theory, psychiatrist Edward Bullmore reveals the complex connections between our immune system and our mental health – and shows how a new holistic understanding of body, mind and brain could revolutionize the way we see and treat depression.

The Inflamed Mind Review

The Inflamed Mind (2018) explores the fascinating connection between inflammation in the body and mental health. Here's why this book is worth your time:

It presents compelling evidence linking inflammation to conditions like depression and Alzheimer's, shedding new light on the field of psychiatry.
With its accessible explanations and relatable anecdotes, the book is a valuable resource for both medical professionals and general readers.
Through its thorough research and thought-provoking insights, it challenges conventional wisdom and opens up new possibilities for understanding and treating mental illness.

Who should read The Inflamed Mind?

Med students, physicians and scientists interested in the mind and brain
Psychologists and therapists interested in how physical illness affects mental health
Anyone who has dealt with depression

About the Author

Edward Bullmore is a psychiatrist, neuroscientist and mental health expert from the UK. He studied medicine at the University of Oxford and is now a Professor of Psychiatry at the University of Cambridge. Since 2005, he has been working for pharma company GlaxoSmithKline on developing new anti-inflammatory drugs for depression.

Categories with The Inflamed Mind

Health & Nutrition Science Psychology

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