Is Depression a Disease—or a Symptom of Inflammation?
For educational purposes only.
Most psychiatrists believe that depression is caused by low levels of the chemical serotonin. This is why the treatment for depression is often selective serotonin reuptake inhibitors (SSRIs), which boost serotonin levels in the brain.
But a new study suggests that there are at least five biotypes of clinical depression. William J. Walsh, Ph.D., president of the Walsh Research Institute, and his team looked at about 300,000 blood and urine chemistry test results and 200,000 medical history factors from approximately 2,800 patients diagnosed with depression. They found that five major depression biotypes represented about 95 percent of the patients.
Upon close examination, Walsh and his team discovered that three of these forms of depression are not caused by fluctuating serotonin levels.
A New Way to Diagnose Depression?
A urine test can detect pyrrole depression, while blood testing can identify the other biotypes.
Walsh said a physician-training program is in place to expand the testing throughout the world. Last month, 66 doctors from Australia were trained in the approach, and training for U.S. physicians will take place in October. Walsh's goal is to educate 1,000 doctors on this issue in five years.
“Psychiatrists appear to be the most enthusiastic participants,” he said.
David Brendel, M.D., Ph.D., a Boston-area psychiatrist, said it would be a “significant advance” to diagnose treatable forms of depression with objective medical tests.
“But I don't see adequate evidence that these (or other) researchers are anywhere near accomplishing this,” he said. Brendel added that depression likely has many causes and complex neurophysiological underpinnings. He said the medical community is still “entirely unable” to diagnose it using medical tests, though he said researchers may be closer to having tests, such as gene assays, that can identify the most effective medical treatment for a specific patient.
Mona Shattell, Ph.D., a nurse and professor at DePaul University specializing in mental health, said that being able to diagnose depression with a blood test could potentially increase the number of people diagnosed—and lead to more people being treated for the condition.
“It would also be helpful because depression, and other mental illnesses, are still stigmatizing,” she said. “If depression could be detected via a blood test, it would clearly be in the realm of ‘medical illness’ and therefore a ‘real’ problem that is not due to individual weakness or other equally stigmatizing reasons.”
The idea that depression and other mental health conditions are caused by an imbalance of chemicals (particularly serotonin and norepinephrine) in the brain is so deeply ingrained in our collective psyche that it seems almost sacrilegious to question it.
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