Depression Ties to Immunity - Western Findings, Chinese Medicine Theory

A research team from the Korea Advanced Institute of Science and Technology (KAIST) was interested in finding valid biological markers that can be used to help diagnose Major Depressive Disorder (MDD) and hopefully lead to novel treatment mechanisms (article at medical xpress). They found that depression is not just a brain problem but “is deeply connected to abnormalities in the body’s overall immune response”.

In their study, they are proposing research avenues for both diagnosing and, hopefully, leading to targeted treatment options for these imbalances. While that is certainly positive and we can always be optimistic that western medicine can arrive at a precise treatment. However, as these avenues can take quite some time to materialize and approximately half of the people experiencing MDD are western treatment resistant, it is important to note that Chinese Medicine has long accounted for these types of relationships. Many of the commonly used Herbal Formulas and certainly techniques like acupuncture have broad effects that touch on immune markers, blood circulation, gut microbes as well as most, if not all, of the mechanisms they discussed in this article.

In particular, the researchers found that MDD patients had elevated levels of DCLK3, CALY and Complement Protein C5. These proteins are essentially contributors to the communication between the brain and the immune system. I won’t get into all of the biochemistry here, but suffice it to say that all of these proteins are linked to a range of inflammatory, immune, and psychological issues, and there are numerous studies looking at the effects of modulating these proteins.

On the side of acupuncture it has been shown in numerous studies to calm inflammation and have positive effects on the immune system more broadly. One of the benefits of Chinese Medicine in terms of outcomes is the broad regulatory effects it will have on a person when properly applied. This, however, is also a downside in terms of biomedical research, as it can be hard to pinpoint exactly what it is doing. What these researchers are highlighting, however, is potentially one of the ways to look at how acupuncture helps depression. A potential avenue of clinical research verification so to speak.

In the literature review "revealing the magic of acupuncture based on biological mechanisms", in regards to the treatment of depression with acupuncture, they state:

"acupuncture involves multiple mechanisms, including inhibition of hypothalamo-pituitary-adrenal (HPA) axis hyperactivity, regulation of neuropeptides and neurotransmitters, promotion of signaling pathways, modulation of the expression of particular genes, a reduction in levels of proinflammatory cytokines, and restoration of hippocampal synaptic plasticity"

In another review entitled "the immunomodulatory mechanisms of acupuncture practice", researchers found that:

"in addition to dramatically regulating immune cells and molecules, including innate and adaptive immune responses, acupuncture can stimulate and support immunological responses that are anti-inflammatory and anti-infectious.”

It is clear from these two broad meta-analyses that acupuncture does contribute to positive changes in the immune/inflammatory systems as well as much broader responses leading to the improvement and/or resolution of depression.

The herbal side is somewhat more difficult to easily encapsulate due to the extremely broad range of formulas and potential modifications within Chinese Medicine. Again, the benefit of Chinese Medicine is in the ability to tailor everything directly to the needs of the patients at that time, but that also makes studying precise effects in pure western terms slightly more difficult. That said, there are studies such as "Chai hu shu gan wan improves depression and ameliorates osteoporosis", that found that treatment with Chai Hu Shu Gan Wan not only improved symptoms of depression but it had broad effects on lowering inflammatory markers/contributors in the body. This, according to the line of thought of the researchers from KAIST may be “how” it helps with depression - that is, by reducing inflammation systemically along with improvements in various aspects of digestion (also intertwined with inflammation).

There are many, many studies related to Chinese herbal medicine discussing aiding depression and inflammation - far too many to discuss here. Suffice it to say that this relationship of inflammation and mental health and digestive health is a well accounted for set of relationships in Chinese medicine diagnostic and treatment terms.

While Chinese Medicine likely takes some tweaking (and time) for each individual to get the results they are looking for. The broadness of effect from what both acupuncture and Chinese herbal medicine can provide is not only part of the effectiveness but part of the longer-term, more stable results (in cases full resolution) that patients may experience.

While again, western medicine has value particularly in the precision and at times arguably better reproducibility of its effects, it currently offers mixed results with mental health issues such as depression. While it will improve, it’s very possible that the broader relationships and dynamic effects of Chinese Medicine and acupuncture may be a far more valid way to influence these interwoven systems and lead to better results with less side effects. For now, I’m happy to see these unique avenues of research into more precise ways of both diagnosing and potentially helping these conditions in western medical terms.