Patrick J. Skerrett

Infection, autoimmune disease linked to depression

Depression, bipolar disorder, and other mental health problems arise when something goes wrong with brain function. What causes that malfunction is an open question. In some people, a serious infection or autoimmune disease could be the trigger.

A report published online in JAMA Psychiatry explores this hypothesis. Researchers turned to comprehensive Danish databases that include all Danes born in the country, each identified by a unique registration number. One of the databases stores health-related information, including records of hospitalizations. Among Danes born between 1945 and 1995, almost 92,000 had a mood disorder. Of these, 36,000 had suffered a severe infection or developed an autoimmune disease (such as type 1 diabetes, celiac disease, lupus, and the like) at some point before being diagnosed with the mood disorder.

People who had been treated for a severe infection were 62% more likely to have developed a mood disorder than those who never had one. An autoimmune disease increased the risk by 45%. Multiple infections or the combination of severe infection and an autoimmune disease boosted the odds of developing depression, bipolar disorder, or another mood disorder even further.

The researchers estimated that in the Danish population, severe infection and autoimmune disease account for 12% of mood disorders.

“A link between infection and depression and mood disorders is intriguing,” says Dr. Michael C. Miller, assistant professor of psychiatry at Harvard Medical School and a member of JAMA Psychiatry’s editorial board. “But it’s important to keep in mind that both infections and mood disorders are very common, making it difficult to tease out what causes what.”

He ticks off three possible explanations for the results:

  • Severe infection and autoimmune disease may cause mood disorders.
  • Mood disorders may create a susceptibility to infection or autoimmune disease.
  • Mood disorders, severe infection, and autoimmune disorders may share common triggers.

What’s the connection?

The Danish study isn’t the first to explore links between infection or autoimmune diseases and depression. Much of the evidence supports a connection.

Depression isn’t the only mental health issue that may be related to infections and autoimmune condition. Writing last year in the Harvard Health blog, Dr. Jeff Szymanski described how some children with strep throat suddenly develop obsessive-compulsive disorder. It’s one manifestation of pediatric acute-onset neuropsychiatric syndrome. Quick treatment with antibiotics can reverse the problem.

How might an infection or autoimmune disorder lead to a mood or other mental health disorder? Infection causes localized and body-wide inflammation. Inflammation generates substances called cytokines that have been shown to change how brain cells communicate. In autoimmune diseases, the body’s defense system attacks healthy tissues rather than threatening invaders. It’s possible that in some cases the wayward immune reaction could target brain cells and other nerve cells throughout the body.

The connection between infection, autoimmune disease, inflammation, and mood disorders has prompted some researchers to wonder “Can we vaccinate against depression?” The short answer, at least for now, is “no.”

But there are things you can do. “Healthy living has all sorts of benefits,” says Dr. Miller. It can help you fight infection, reduce inflammation, ease stress, and make you feel better day to day, all of which work against the development of a mood disorder.”

Related Information: Understanding Depression

Comments:

  1. Imran Khan

    OCD, anxiety, depression, schizophrenia , bipolar disorder are all triggered by infections , these are all autoimmune diseases and thus can be treated effectively with antibiotics.
    This research has been reported by CIDPUSA in their book flame within and patients reversed with the use of Vibramycine.

  2. Jane

    Thank you for this article – it’s an area that requires greater awareness. I had a streptococcus overgrowth and developed panic disorder and OCD. Treatment with erythromycin has helped and I was totally symptom free for 6 months. It has now returned (confirmed with strep blood and stool testing) and so now I return to erythromycin again to get the strep under control. Importantly, adults can experience this, it is not just children with PANDAS.

    This book makes for gripping reading by the way: Brain-Fire-My-Month-Madness

  3. Donner

    Antibiotics can alter gene expression too, by reducing the gut bacteria that produce HDAC-i compounds known to affect gene transcription. These don’t change the genetics, but they can awaken a silenced gene.

  4. it cannot be denied that if we don’t care how we living, we would get many health problems. It’s better to have more healthy diet and more exercise in order the body keep to health :)

  5. Gerlind

    my observation is, that whenever I have some even minor general viral infection (usually with some bone aches, a cold, not necessarily a fever, but nevertheless a sense of being affected in the whole body with some kind of virus, my mood gets often into a depression, as if the virus also attacks the brain in a way.
    Viruses generally do lead to an increase of the cytocine y-Interferon.
    y-Interferon is also used for the treatment of Hepatitis C, which has the common very well known side effect of depression. Many Hep C treated patients also pass some time on a psychatric ward due to depression as a side effect of y-Interferon. I assume there is a similar connection between common viral diseases, increase of y-interferon and depression.

  6. Paulette Provost

    Interesting hypothesis however, my family has a history of generational depression. Suicide, bipolar, depression that has resulted in self medicating i.e. alcoholism and drug abuse. I think that there are several causes of depression and mental disorders. Having said that, thank you for your continuing endeavors in medical research.

    • Maria

      Paulette, Many infections can be passed in utero to the baby. Also, many infections can be transmitted to family members due to their close living situation. This could explain why many families have a history of depression.

      There are many infections that can alter neuronal gene expression – which would explain the genetic component.