The Inflamed Mind by Edward Bullmore

Author:Edward Bullmore
Language: eng
Format: epub
Publisher: Picador

Figure 9: What I was taught at medical school, in the 1980s (left) was that depression was caused by reduced levels of serotonin in synapses between nerve cells. It was also common knowledge that the brain was completely separated from the body’s immune system by the blood–brain barrier (BBB), a wall of densely packed endothelial cells, which did not allow circulating macrophages or cytokines to enter the brain.

What we know now (right) is that there are many channels of communication across the BBB. Inflammation of the body can cause activation of the inflammatory microglial cells in the brain, which in turn causes collateral damage to nerve cells in the amygdala, the cingulate and other hubs in the brain’s emotional network. We can also see more clearly that there are many potentially relevant drivers of inflammation. Auto-immune disease, like Mrs P’s arthritis, obesity and physical trauma can all cause bodily inflammation. But so too can social stress, even a brief and relatively mild stress like public speaking. It used to be impossible to imagine that inflammation and depression were mechanistically connected; now we are getting closer to answers to the questions of how and why inflammation could cause depression.

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