Chronic inflammatory disorders like rheumatoid arthritis and psoriasis are painful and often stigmatizing, greatly reducing the quality of life of people afflicted with them, and often leading to mental disorders like depression and anxiety. However, could depression be a reaction to a chronic inflammatory disorder or a consequence of it? Emerging literature has shown that the persistent inflammation, which is a highlight of chronic inflammation, may modify brain’s function and structure leading to the development of mental disorders.
Previous research has also shown that certain inflammatory disorders like psoriasis are linked with an increased risk of developing depressive symptoms. However, till date, there is a dearth of research that explores anxiety and depression across a spectrum of inflammatory disorders. In addition, previous research have mainly focused on the geriatric population.
Higher risk of anxiety and depression in those with inflammatory disorders
The present study was published in the journal Annals of the Rheumatic Diseases. The authors investigated 500,000 patients from GP practices to explore the incidence of anxiety and depression across multiple inflammatory disorders in the U.K. The study focused on exploring a link between the ages at which inflammatory disorders usually onset with the prospective risk of developing anxiety or depression symptoms.
The study highlighted that there was a 16 percent higher risk of developing anxiety and depression in people with inflammatory disorders than in those who did not have these disorders. Further, the age at which these disorders manifested also impacted the risk. A 70 percent higher risk of anxiety and depression, across all inflammatory disorders, was found for those diagnosed before the age of 40.
What comes first? Inflammation, disorder or depression?
The young adult’s social, educational and occupational opportunities are greatly influenced by the pain and stigma associated with the inflammatory disorders. Moreover, the early onset of inflammatory disorders is linked with extensive inflammation, frequent flare-ups, and highly aggressive disease and therapy compared to a late onset. This intense inflammation could be responsible for an increase in mental health symptoms.
However, it is challenging to determine what comes first? Is the inflammation causing disorders like rheumatoid arthritis and then depression as a reaction or is the inflammation causing both the depression and the disorder? The present study was dependent on medical records which indicated when a patient visited a doctor with a particular problem. The authors had no idea about how long the patient had endured the problem before seeing the doctor. It is also possible that when the patient saw their doctor for their inflammatory disease, they could be depressed but had refrained from reporting it.
Additional research is warranted to explore if the heightened risk of developing anxiety or depression with early onset disorders is due to the fact that one has to live with the disturbing disorder or due to the presence of a persistent and an overactive inflammatory system. The study findings also suggest that the treatment for inflammation might alleviate depressive symptoms in those with treatment resistant depression.
Seeking help for depression
Targeted treatments could be discovered if there is an improved understanding of the link between excess anxiety and depression risk with different pathways linked to the inflammatory disorders. The present study suggests that mental health of young people with inflammatory disorders should be routinely checked so that timely diagnosis and intervention can be provided when needed.
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