The secrets of depression are not only in the brain

The website covid-19 pandemic put mental health disorders, including depression, at the center of the debate. She pushed people to find out more on this painful problem. Also for to rethink more thoroughly new treatment models. For example, one of those on the table is the treatment of depression and post-traumatic stress disorder with psychedelics.

” We have been 30 years talk about how depression is caused by a serotonin deficiency [la sustancia química producida por el cerebro y la médula espinal que regula las emociones]. There are depressions that do, but others that don’t, which are related to immune system where the microbiota”, grades Amanda Rodriguez, psychiatrist at Vall d’Hebron Hospital (Barcelona). “Psychiatrists need to get out of the brain to treat depression,” he insists.

Studies suggest that the the microbiota, the intestinal flora, has a “direct relationship” with depression. The Vall d’Hebron participates in a European research called “Discovery” which studies this association. “The microbiota is like a virtual brain which gives information to the body, which activates or deactivates the the immune system. An altered microbiota is associated with depressive changes,” says Rodriguez.

So far, we have seen an “association”, but not a “causality”. “We cannot say that the microbiota causes depressive states. But we can say that there is changes in the microbiota that have been observed in people suffering from depression, says this psychiatrist.

“Multi-causal disease”

Depression, Rodriguez explains, like all mental disorders, is a “multi-causal disease,” that is, there is no single factor that explains it. There is no single cause in the human body. HAS immune system or one hormonal system modified, or gastrointestinal tract -also called the “second brain”, may have been the… origin depression,” he continues.

Thereby, All depressions are not the same, the origin of depression is “very diverse” and therefore psychiatrists must take into account different systemic factors in the treatment of these disorders. ” Eat well or have healthy social relationships is important in preventing future depressive states,” he says. For example, now with the pandemic, we have seen that the social environment is linked to depression.

All this changes the paradigm of the treatment of the disease because, if it is an immune-mediated depression, it must be treated by anti-inflammatory drugs, for example. Or if it is mediated by the microbiota, with probiotics. These include, in particular, what is called “resistant depressions”: those who do not respond to conventional antidepressant treatments. ” The ideology depression is very diversified and over the past 30 years we focused on just one, on serotonin processing,” says the psychiatrist.

All these aspects are now under investigation. So psychiatrists have recently started giving sketamine [un psicodélico disociativo] people with resistant depression. “It’s a very recent drug that has given very good responses. Medications that have increased serotonin in the body were a failure in these patients,” he says.

According to him, “eventually”, when the society is very damaged and the depression rate are so high, it’s because it’s a disease. “very linked to the environment”. “It is likely that the hypotheses that we psychiatrists have developed so far were not entirely complete and that we are now paving the way for new therapies. Doctors must come out of the brain to treat depression,” concludes Rodriguez. In other words, to get out of the prescription of anxiolytics and antidepressants. and push the boundaries.