Inflamed Bodies, Depressed Minds

The mysterious connection between the immune system and the brain

Ed Bullmore
Elemental

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Images: Jutta Kuss/Getty

We all know depression. It touches every family on the planet. Yet we understand surprisingly little about it.

This dawned on me in an acutely embarrassing way one day in my first few years of training as a psychiatrist, when I was interviewing a man in the outpatient clinic at the Maudsley Hospital in London. In response to my textbook-drilled questioning, he told me that his mood was low, he wasn’t finding any pleasure in life, he was waking up in the small hours and unable to get back to sleep, he wasn’t eating well and had lost a bit of weight, he was guilty about the past and pessimistic about the future. “I think you’re depressed,” I told him. “I already know that,” the patient told me, patiently. “That’s why I asked my GP to refer me to this clinic. What I want to know is why am I depressed and what can you do about it?”

I tried to explain about anti-depressant drugs, like selective serotonin reuptake inhibitors (SSRIs) and how they worked. I found myself burbling about serotonin and the idea that depression was caused by a lack of it. “Imbalance” was the word I had heard more-experienced psychiatrists deploy with aplomb on these occasions. “Your symptoms are probably caused by an imbalance of serotonin in your brain, and…

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