The Inflamed Mind: A Radical New Approach to Depression

Ok - in summary he posts the very likely thesis that depression is the result of inflammatory conditions that impact brain tissue and chemistry. He fails completely to suggest the most likely causes of the problem and solutions. So an interesting historical diatribe with no useful insights or take homes.

I've followed Ed Bullmore's work on network neuroscience for several years. This little book is a splendid description of Cartesian duality of medicine and psychiatry/psychology and the growing awareness of the (complex) unity of the human condition. An excellent, mid-depth look at the integrated systems that underlie our biology and psychology, with a targeted examination (and enlightenment) of neuro-immunology. Clearly a five-star read. If I were still teaching at university I'd make it required reading in my cognition, psychopathology, and neuroscience courses.

Depression is a systemic illness. That much has been clear for several decades, although it was sometimes forgotten during the years when the monoamine hypotheses of depression ruled supreme. The basic premise of this book — that some people with depression are suffering from an immune-mediated inflammatory condition — is not new. There have been sporadic reports of laboratory abnormalities for almost a century and the extraordinarily high rates of physical illness in people with depression have also been known for decades. After all, many of us have experienced transient depressive and cognitive symptoms when we are sick, and it has been known for years that some illnesses, such as hepatitis B, are more likely to engender depression than others.Many internists who would simply say, “Well of course he’s depressed, he’s sick,” while many therapists would say, “Well of course she’s sick, she’s depressed.” Both positions may contain a germ of truth, but there is more than that going on here.Depending upon the data that you look at, we now think that specific kinds of inflammation are present in anywhere from 30-60% of people diagnosed with major depressive disorder. The reason for this book is to publicize the fact and to begin to sketch out some potential practical strategies. For example which patients may benefit from anti-inflammatory approaches. There are already two dozen studies on using anti-inflammatory medications to help in the treatment of depression, as well as several attempted non-pharmacological approaches to reduce inflammation in people with major depressive disorder. The results are promising but far from conclusive. So we need to know more about how to modulate the inflammation in those people who have it. Is it likely that the reason why some people are helped by diet, exercise, meditation and sleep, is because these are all strategies that may reduce inflammation? Do some psychotherapies work by training people to control the body’s inflammatory responses?It is important to recognize that neurotransmitters have not gone away. I heard someone misquote the author of this book, saying, “Depression is caused by a depressed immune system, not chemical imbalances in the brain”. That’s not what he is saying. He is saying that inflammation is likely a key player in causing chemical and neural imbalances and also the physical complications in a large proportion of people with major depressive disorder.Where does the inflammation come from? That is a huge question, much of which the author discusses, and some of which has continued to be unraveled since this book went to press. But in general it is stress: physical, emotional, traumatic, social, environmental, even changes within the microbiome. And there is a two-way street between the body and the mind. What we now refer to as the “Bi-directional brain.”The author has been known for many years for his work in brain imaging and delineating neural network. He is something of a late convert to the immune/depression concept. But now he is becoming an ardent spokesman for it.Why put these ideas into a book? People rarely read online articles that are more than 1,000 words and some experts say that 500 is the recommended length. The obvious consequence is that most of the time we have to make do with single bullet points without any of the supporting arguments. Yet it’s those supporting arguments that allow clinicians and researchers to move the ball up the field.Bullmore writes very well. As an example, he says, “Someone with a deprived or abused childhood, whose macrophage army is already on yellow alert after exposure to such early and severe social stress might have a more inflamed and depressed reaction to hostile gut bacteria in the microbiome many years later”.What this book does is to present the information in a refreshing and coherent way, in the hope that the medical profession and the pharmaceutical industry will do more to explore this newly rediscovered frontier.Highly recommended.

Fascinating connections between the immune system and the mind can perhaps lead to new treatments for both . The divide between Psychiatry and Internal Medicine might be keeping treatment for chronic depression in the dark ages.

Provides information in a very readable manner and includes illustrations to help explain. Lots of citations, organized in an easy-to-navigate manner. The topic itself is incredibly interesting and enlightening. If you are a student of psychology or a medically related field, or even if you're just curious but have no prior reading experience in the subject, this book is a must-read.

A very thought provoking book. I really liked the history about how the drugs for mental illness came about and how the research has stalled. I will follow this space closely to see his the author's thinking about this area finds more footing to help people with mental illness.

Pretty technical. Believable but a hard read.

This has become one of the most influential books on how I view the world. Touching on psychology, evolution, Descartes, and the nature of belief, it offers truly thought provoking material. It was recommend by Gojiman on YouTube, and I am so glad he shared it!