Yet another study that gets at the “inflammation plays a big role in depression” hypothesis, and this time, it has to do with the release of histamine.

You already know this, but when we’re having an allergic response to anything, our immune system fights it by releasing histamine.

It’s a protective measure, and utterly vital for a properly functioning body, but sometimes it can start a chain reaction of crazy things (read here for that mechanism) that leads to allergies and other stuff under the hood that’s bad for us, as well.

It also can provoke high levels of inflammation throughout the body.

Chronic inflammation is a well-known risk factor for developing depression, and just about every other mental health disorder.

In fact, Dr. Charles Raison at Wisconsin wrote in 2018 (emphasis added): “Far from being specific to any one mental illness, or a sub-population within a mental illness, inflammation turned out to be a common denominator and likely risk factor for every manner of psychiatric disturbance, from schizophrenia to obsessive compulsive disorder, from mania to depression.”

That, for example, is just one of the reasons why researchers speculate that exercise, meditation, certain foods, and yes, antidepressants, can all help alleviate depressive symptoms — their effect on inflammation (among many other things).

(It’s important to note that, as Dr. Raison wrote in 2018, studies show that depression and other mental health challenges can’t entirely be explained by inflammation, and that we still can’t entirely explain them fully, scientifically, because they’re so enormously complex).

But…a recent study from researchers at Imperial College London and the University of South Carolina finds yet another way inflammation seems to affect depression — histamine release.

Here’s the very short version, and I would read Science Daily’s write-up for the longer, more comprehensive explanation.

Researchers used mice (of course) to test the idea that SSRI’s effect on serotonin (the neurotransmitter that helps regulate, among other things, our emotions) might be blunted by an interaction between neurotransmitters which include serotonin and histamine.

So they injected some mice with a toxin, provoking inflammation, and the control group mice got off mercifully with a placebo.

The mice who got the inflammatory toxin saw their serotonin levels immediately drop, whereas the control group’s serotonin level remained constant.

Now here’s the fascinating thing (if you haven’t stopped reading because you’re not into this type of thing).

The inflammatory injection was unable to cross the blood-brain barrier, meaning it could only affect serotonin another way.

And they found it was through histamine.

The inflammatory response triggered histamine in the brain, and that’s what seemed to lead to the reduction in serotonin levels.

I won’t bore you further, but I will.

Science Daily notes that the researchers gave the depressed, histamine flooded mice SSRI’s, but unfortunately, their levels of serotonin still didn’t rise to the level of the control group’s.

However, when the researchers gave them anti-histamines, suddenly, the inflammatory mice saw their serotonin levels rise back to the level of the control group’s.

In other words, the anti-histamines seemed to restore the feel-good neurotransmitter back to normal levels.

Now….. it’s really important to note that you shouldn’t reach for benadryl for your depression, because the anti-histamines researchers administered affected the whole body, and antihistamines for seasonal allergies only affect histamine’s effects on neurons.

Nevertheless, the potential impact is profound — both for future research and understanding depression itself.

The study authors urge more research into histamine’s role in depression, and of course, the possibility that a new drug could work on histamine in the brain to help fight depression (or at least make SSRI’s more effective).

The study’s lead author, Dr. Parastoo Hashemi, tells Science Daily:

 “Inflammation could play a huge role in depression, and there is already strong evidence that patients with both depression and severe inflammation are the ones most likely not to respond to antidepressants.

“Our work shines a spotlight on histamine as a potential key player in depression. This, and its interactions with the ‘feel-good molecule’ serotonin, may thus be a crucial new avenue in improving serotonin-based treatments for depression.”

As a site dedicated to the message — Mental health is not reflection of spiritual health — this is yet another of scores of data points, reinforcing that.

(Of course, I can already hear deniers say, “The stress from an adulterous relationship could lead to chronic stress, inflammation, and therefore depression” and of course circumstances do play a role, but I suspect that’s not what’s going on with the vast majority of the millions of Christians and nonChristians who battle these diseases.)

There are a million more likely causes for the inflammation in our bodies. Completely amoral ones.

Like, did we eat deli meat for lunch today? I think there are more people, stopping for a quick inflammatory lunch, or working insanely hard to meet a stressful noon deadline, or operating on less than 8 hours of sleep than driving off for a lunchtime rendezvous at Red Roof Inn.

And that’s not even getting into genetics and the millions (hyperbolically) of other things involved, both known and unknown, in the development and persistence of mental health disorders.

P.S. The Atlantic had a fascinating piece on the mechanistic relationship between allergies and anxiety a few years ago, as well.

[Painting: Monet, Fields in Spring. Of course, histamine can be released by many things, but that field…..]

Research shows insomnia is a major risk factor for depression, and that depression itself can also leads to insomnia.

Not only are they correlated, but it appears either can cause the other.

And we’ve also heard all about good sleep hygeine — you know, turn off the electronics, set up a regular bedtime etc.,

But a brand new study shows that the most effective sleep training isn’t simply about education, but primarily, working with a counselor on building strong sleep habits through cognitive behavioral therapy for insomnia (CBT-I).

Scientists are particularly excited about this study, because as study author Dr. Michael Irwin (UCLA) tells CNN, “We have shown that we can actually target insomnia with cognitive behavioral therapy and prevent depression from occurring.”

In other words, it’s possible to ward off encroaching depression in elderly adults by helping them get better sleeps. (That’s particularly good news for the elderly because sleep medications can lead to struggles with balance, which can lead to falls and fractures).

But to achieve the greatest success, the study showed it was best to work with a therapist using behavioral sleep training, CBT-I.

So what is CBT-I?

Well, according to the study it involves stimulus control, sleep hygiene, relaxation, CBT, and sleep restriction.

What are each of those?

The Sleep Foundation offers these explanations.

Basically, stimulus control is about using your bedroom for just two things — sleep and sex. That way, your mind begins to think, “sleep or sex” when it enters your bedroom and both of those are good for you and for your sleep.

Sleep restriction is somewhat related. Let’s say you spend eight hours in bed, but only actually sleep 3 hours. That’s five hours of existential tossing and turning (which is really bad for depressed people, or people prone to it).

In sleep restriction, you just get up and do something else and literally only sleep once you can’t hold your eyelids up anymore. That forces the issue on using your bed, purely for sleep.

As your mind recalibrates, it will hopefully increasingly associate sleep with bed and you’ll get back (theoretically) to the intended 8 hours.

However, the Sleep Foundation notes that people with bipolar disorder and seizures should be careful about this practice.

Relaxation training involves breathing exercises (here are the 9 best ones for sleep), progressive muscle relaxation (read here about pmr for sleep), autogenic training, biofeedback, hypnosis, meditation, or some combination of those.

Then there’s the psychoeducation component, which is a person-to-person connection where you discuss all of this, and other factors like diet and nutrition.

Now, does this all work?

The Sleep Foundation notes studies showing that 70-80% of patients experience improvements in their insomnia, including pregnant women, those with PTSD, and other high risk groups.

And now, according to the new study in JAMA Psychiatry, elderly adults. And not only does it help their sleep, it can ward off depression!

Woo-hoo!

Of course, you might be wondering — why can’t I research this online and just do it myself, without all the hassle of involving a therapist?

Well, you could.

But it probably wouldn’t be as effective, because you probably wouldn’t keep at it.

Researchers noted that the study group that received sleep training, without counselor interaction, showed improvements, but they weren’t durable, because people often just gave up when they didn’t work.

The group that had counselors was much less likely to give up.

SO… how do you find one of these sleep counselors?

Here’s a map, courtesy of the Society of Behavioral Sleep Medicine, where you can click on your state and find just such a therapist.

I’m a huge fan of therapists because they’ve helped me so much.

But I’m also a huge fan of online support because it’s helped me, as well.

But online support, reading sites — they can only go so far.

And relatedly, there was a study, published this week, showing that those digital apps for depression and anxiety are helpful, but the problem is that people are much less likely to stick to them than they are going to a therapist.

Face-to-face therapy is just clutch.

But I understand not everyone can do it, for various reasons, including financial ones. So I’m also a big believer in discussion boards.

I’ve often found browsing these forums helpful.

No More Panic:

Beyond Blue:

Reddit’s Anxiety Board:

Reddit’s Depression Board:

Patient Info: (numerous boards for many health conditions)

Mental Health Forum: (Anxiety, Depression, OCD, Bipolar, Covid and Mental Health)

Anxiety Community.

Spend some time there, and you’ll come away thinking “I’m not alone in this,” and that shared sense of suffering can build deep bonds.

[Painting. Portrait of a Sleeping Marguerite, Matisse (1920)].

By the way, HuffPost has an interesting piece on why artists have historically been so keen on capturing sleep in their work.

Yale Professor Meir Kryger explains that, among other things, “When one goes to sleep, one falls alone, and when one enters dreamland, one walks by one’s self. Here lies the appeal for artists.” That’s as good as anyone can say it.