5/16/2016 1 DEPRESSION, INFLAMMATION AND BOTANICAL INTERVENTION (ALMOST DR.) LYDIA ANNE M BARTHOLOW, PMHNP, CARN-AP Down in the Dumps: depression, inflammation and botanical intervention Who the hell am I? Agenda Ancient news Monoamine hypothesis Psychopharm minute: allopathic antidepressants Inflammation and Depression 101 Vehicles Allostatic load: Stress & Trauma BDNF and Neurotrophins Epigenetics Food Lifestyle Thoughts Interventions
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Down in the Dumps: depression, inflammation and botanical ... · DEPRESSION, INFLAMMATION AND BOTANICAL INTERVENTION (ALMOST DR.) LYDIA ANNE M BARTHOLOW, PMHNP, CARN-AP Down in the
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5/16/2016
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DEPRESSION, INFLAMMATION AND BOTANICAL INTERVENTION
Ancient news Monoamine hypotheiss Psychopharm minute: allopathic antidepressants
Inflammation and Depression 101 Vehicles
Allostatic load: Stress & TraumaBDNF and NeurotrophinsEpigeneticsFoodLifestyleThoughts
Interventions
Inflammation and depression: 101
Monoamine transporters (receptors) influenced by neuroinflammation
Impaired neuroplasticity
HPA axis dysregulation via inflammation
Agenda
Ancient news Monoamine hypotheiss Psychopharm minute: allopathic antidepressants
Inflammation and Depression 101 Vehicles
Allostatic load: Stress & TraumaBDNF and NeurotrophinsEpigeneticsFoodLifestyleThoughts
Interventions
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Vehicle: Allostatic load
Stressor or Threat:(cop in rearview mirror)
Amygdala
attaches fear to stimuli
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Stressor or Threat:(cop in rearview mirror)
AmygdalaHypothalamus
Stressor or Threat:(cop in rearview mirror)
AmygdalaHypothalamus
Direct stimulation of fight or flight neurons
Adrenal Glands
Stressor or Threat:(cop in rearview mirror)
AmygdalaHypothalamus
Direct stimulation of fight or flight neurons
Adrenal Glands
cortisoladrenaline/
catecholamines
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Adrenal Glands
cortisol
adrenaline/
catecholamines
-- immune system suppression-- suppression of inflammation-- water retention-- hyperglycemia/insulin resistance-- muscle breakdown-- fat redistribution-- decreased gastric integrity-- removal of calcium from bones-- thyroid dysregulation
-- pupil dilation-- sweat-- muscle contractility-- increased HR-- increased BP-- blood flow away from stomach -- bloood flow away from brain (30 IQ points) -- blood flow to vital organs-- increased blood sugar
effects of long term cortisol…
-- immune system suppression/suppression of inflammation:
-- water retention:
-- hyperglycemia/insulin resistance:
-- muscle breakdown:
-- fat redistribution:
-- increased gastric juices:
-- decreased gastric integrity:
-- removal of calcium from bones:
-- thyroid dysregulation:
effects of long term cortisol…
-- immune system suppression/suppression of inflammation:
-- water retention:
-- hyperglycemia/insulin resistance:
-- muscle breakdown:
-- fat redistribution:
-- increased gastric juices:
-- decreased gastric integrity:
-- removal of calcium from bones:
-- thyroid dysregulation:
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Th1
Th2
Systemic inflammation via imbalance
Neuronal Inflammation
Who is stressed out?
Not you, right?
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White folks
Cisgendered folks
Christian folks
Higher SES
Straight Folks
Folks of Color
Transgender folks
Non-Christian folks
Lower SES
LGBTQI Folks
Privilege Oppression
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Agenda
Ancient news Monoamine hypotheiss Psychopharm minute: allopathic antidepressants
Inflammation and Depression 101 Vehicles
Allostatic load: Stress & TraumaBDNF and NeurotrophinsEpigeneticsFoodLifestyleThoughts
Interventions
effects of long term cortisol…
-- immune system suppression/suppression of inflammation:
-- water retention:
-- hyperglycemia/insulin resistance:
-- muscle breakdown:
-- fat redistribution:
-- increased gastric juices:
-- decreased gastric integrity:
-- removal of calcium from bones:
-- thyroid dysregulation:
a quick note on
BDNF
BDNF is a cute little brain helper in the neutrophin family.
Cortisol = BDNF
BDNF = Hippocampalatrophy
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Stressor or Threat:(cop in rearview mirror)
Adrenal Glands
cortisoladrenaline/
catecholamines
Hippocampusnegative feedback
Hypothalamus
Agenda
Ancient news Monoamine hypotheiss Psychopharm minute: allopathic antidepressants
Inflammation and Depression 101 Vehicles
Allostatic load: Stress & TraumaBDNF and NeurotrophinsEpigeneticsFoodLifestyleThoughts
Interventions
Epigenetics
The study of heritable changes in gene expression that are caused by factors such as DNA methylation(primarily) rather than by a change in the sequence of base pairs in DNA itself.
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5-HTTLPR
Serotonin-transporter-linked polymorphic region
Two alleles: short (s) and long (l)
S + hypercortisolemia = downregulation of 5HT receptors = depression, “neurosis”, PTSD
D. A. Collier, G. Stober, T. Li, A. Heils, M. Catalano, D. Di Bella, M. J. Arranz, R. M. Murray, D. Bengel, C. R. Muller, G. W. Roberts, E. Smeraldi, G. Kirov, [P. Sham & K. P. Lesch (December 1996). "A novel functional polymorphism within the promoter of the serotonin transporter gene: possible role in susceptibility to affective disorders". Molecular Psychiatry 1 (6): 453–450.
Agenda
Ancient news Monoamine hypotheiss Psychopharm minute: allopathic antidepressants
Inflammation and Depression 101 Vehicles
Allostatic load: Stress & TraumaBDNF and NeurotrophinsEpigeneticsFoodLifestyleThoughts
Interventions
effects of long term cortisol…
-- immune system suppression/suppression of inflammation: