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Henry: Hello, I'm Henry Emmons and welcome to Joy Lab.
Aimee: And I am Aimee Prasek. So here at Joy Lab, we infuse science with soul to help you build your resilience and uncover your joy. We are talking about viruses and depression today, or viruses and mental health. Just like the most surface level discussion I think for today. Though, I think it will be very helpful. We will get into this topic in more depth, really around the relationship between inflammation and depression in future episodes. But for today we're very specifically talking about what happens to our mood when we get a virus. I think this is really helpful because it puts some cause behind some experiences of depression. And I think it can also kind of speak to how elegant and purposeful experiences of depression can be. Not all of them by any means, but some of them.
And if you're listening in real time, it's cold and flu season still. So this conversation may be very relevant. I personally am coming off of a journey with the stomach flu, which my coworkers have heard lots of details about. Too much. It was terrible. Uh, and no joke, as I lay on the bathroom floor, catastrophizing pretty certain that this was the end for me. I was, I was,
thinking, I know I, I took it too far, but, uh, I thought, "Hey, oh! There's that depression! And we should talk about this. We should talk this."
So that was the impetus for this conversation. So briefly, let me explain. When we catch a bug, when we have an infection, our body generally responds by depressing our entire system so that we can conserve energy; so that we are prompted to rest, sleep, and of course fight the infection. So the mood is depressed too. Motivation drops. We just wanna lay around and this is often called sickness behavior. I like how Dantzer and colleagues in one of sort of the key classic articles on this topic, how they describe this. They say "sickness is as normal to infection as the fear response is to a threatening predator. It's purpose is to promote survival of the organism."
henry_2_02-16-2024_143225: Well, I, as you were talking there, Aimee, I was reminded of something that I think a lot of parents of young children can relate to, which is when your kiddo is sick. A lot of times you can just hold them and they will sit still and they'll kind of cuddle up and they're just not moving.
Henry: And it's a sort of a bittersweet thing for a parent because you don't wanna see them sick. But at the same time, it's kind of nice to just be able to hold them like that sickness behavior
Aimee: Yeah.
They
demonstrate it. They don't hide it.
Henry: Right.
So, you know that, uh, quote that you gave, if I'm hearing it right, that sickness is as normal to infection as the fear response is to a threatening predator.
I think what they're saying is that, hey, this is normal. It's normal to look and feel depressed when you're sick. Just like it's normal to go on fight or flight when you're being chased by a tiger. I agree with that. That is how we're built, and your body should be primed for action when you're threatened and it should rest and recover when you're sick.
And that is all well and good. If the story ended there. Tiger's gone. We relax and return to normal. Illness ends, we bounce back to our old selves. And that's usually how it works. That's, that's how it worked for you, Aimee. We just were talking about this, you know, your, your illness is over and you're, you're actually, in a way, you're almost feeling better than normal.
Yeah, bring it on,
how I come out of an illness too.
But it doesn't always work that way.
And there's the, the rub.
Yeah.
So there appear to be at least two important ways in which viral illnesses mess up our moods. And both of them have to do with the immune system in one way or another. So first, in order to ramp up our immune system to fight off this infection, we increase a chemical called cytokines. Which are basically messengers that tell the body to make more immune cells. Get going, we gotta fight this thing off. So it kind of gets the whole system activated. But there are some people, like myself, whose immune systems tend to be overreactive. It just goes overboard. Over does it.
And so there's so much inflammation that that can then hurt the very tissue that you're supposed to protect. So people with autoimmune disorders, for example, which I'm sure we'll talk about when we really dig into inflammation and depression. So in the brain, inflammation can really mess with our chemicals of mood, including the serotonin and dopamine systems. And this can show up as depression. The second issue is that when there is inflammation in the brain, it can affect what are called glial cells. Glial cells are the, it's pretty much everything except the neurons in the brain. It's all the things that give structure and support to those really important neurons. And these are also very important for cognitive health as we age, but they're also very important for energy and mood. And inflammation. If it's bad or if it goes on a long time, it can even damage the mitochondria in these cells. You know, the mitochondria that produce energy.
And at first that might cause the brain to be overstimulated. But later on it can make it harder for these glial cells to produce their own energy.
And then unfortunately, when the stress hormones get in the act, it can create this negative loop that can be hard to break, where there's more inflammation, which creates more cell damage like we just talked about, which creates more stress hormones and it just keeps circulating.
You kind of get, get the idea.
Aimee: Yeah, I think I understand you're highlighting those normal, multiple processes that can initiate and sustain the sickness behavior and depression of the system. But some can surge too much. They can hang around too long, and then you get caught in that cycle. And I think it's interesting to note even if we're feeling good physically and mentally, of course we can still catch a bug. It can take a while to fight an infection, uh, and to recover. So our mood can be impacted for longer than a few days. It can be quite a bit longer. Even beyond, you know, when those sort of physical symptoms subside. Uh, and when this happens, it's sometimes called postviral fatigue or postviral syndrome, and that's real. there can be other symptoms along with it. And the fatigue and the mood can, the impacts on mood can be really substantial. And I think it's interesting to note as well that the research on this is pretty lacking, but it's growing a lot more thanks to covid long haul concerns. But as, as of now, there's not a clear predictor of who might experience these longer residual impacts of fatigue or mood after an infection. So if you've experienced this, it is not a statement on your current health status, you know, or your resilience, it just happens.
Henry: Yeah, that's right. it's another example of how differently. We are made from one another. And so this can look so different from one person to the next.
And I do think we're learning from long covid that for some folks, these symptoms can last for weeks or maybe even months. But you know, I don't think it's limited to long covid. I think that has been true for a long time with other viral illnesses too, but we just didn't recognize that, you know, until now.
I have always noticed that some of my patients seem to develop what ends up being this mystery illness that nobody can figure out, and it just goes on and on, and it's oftentimes they're more depressed, but it's very physical too. And I know from talking with them that at least some of the time they feel very misunderstood or, or judged even by their medical team. Um, sometimes their symptoms are just kind of dismissed as being in their heads or their chalked up to depression and, and just told to go back to their psychiatrist.
So anyway, I, I'm glad that this issue has gotten more attention. I think that we might finally be learning that depression is a lot more complex and nuanced than we thought. And you know, this whole topic of inflammation, as you mentioned, Aimee, is just really coming to the fore as a legitimate and maybe even a common cause of depression. And just knowing that if, if that's what's going on, being aware that that's what's going on can give us more tools to help get better.
Aimee: Yeah, that awareness is really, um, empowering. Depression does have so many forms and causes of which can be super helpful to be aware of. Like in this case we're talking about now. And in this case, the depression does have a lifespan or it should, the sickness behavior, the depression should lift. And it's pretty standard advice to see your doctor if this is sort of lingering out a few weeks from the infection. But along with that, let's talk about getting better. Let's touch on a few strategies and options that folks could consider, to support their mood after clearing a virus. So the first I'd say is to honor what our bodies are just still begging us to do. The purpose of that sickness behavior really. And that's to rest. The hardest, simple thing to do. And we have to remember that it takes so much energy. Like a huge energy expenditure to launch a fever, to fight an infection. We might be laying on the couch, seemingly doing nothing, but our system is just running little marathons inside of us. Working to heal itself. And we know how terrible running is if you've heard me talk about it before. So we know then that. This rest process, um, during the infection is essential. And that it also needs to happen in the recovery. Post marathon. After the fact. After the infection is cleared. So related to that would be sleep. If you're struggling with your sleep, head over to our Sleeping Well Workshop in our NMH community. I'll link, to that in the show notes. And then Henry, do you wanna talk about maybe some nourishment options and supplements perhaps to consider?
Henry: Sure. So which is it? Starve a cold feet of fever or the other way around. I can never or liquor before beer or be before? Yeah, I wanna share. I don't know, okay. 'cause I don't, I don't believe that anyway.
But, But, I do think the bottom line here is that when we're fighting something like this off, it's even more important that we are really well hydrated and as well nourished as we can possibly be. I think it's okay if it's, it's maybe good even to take cues from your body and not eat unless you're really hungry.
But, but when you do eat, or at least not eat much, but when you do eat, then really make it count. So in other words, this is a time to be extra careful about not just eating empty calories. Yeah, we need the fuel, that's for sure. But we just also want to pack as many micronutrients in there as possible. The body's needing those.
So even if you don't feel like eating solid food, this might be a good time for juicing if you've got a juicer or it can purchase it somewhere. Or just simply getting a good citrus juice to drink so you get, you get the quick calories, but also some extra vitamin C. I think it's good to get as many leafy greens and just plain colorful fruits and vegetables. 'Cause again, they're so brain and body protective. And then if you don't feel like you have much of an appetite, so you can't eat much, lean on more of the healthy fats than you usually do. So omega threes are good at reducing inflammation.
So you might wanna focus on things like nuts and seeds and olive oil and other brain healthy fats like avocado or coconut oil. I also think that this is a good time to look at supplements, even if you're not usually into them. So for example, I don't usually take vitamin C, I don't believe in using it every day. At least not for me. But when I'm sick, I'll add a thousand milligrams a day or more. Um, and I'll also add some zinc, probably 20 to 30 milligrams of zinc.
There are also some really good and gentle plant-based products that I think can help boost and support the immune system. A lot of folks have tried echinacea. I prefer a couple of other things like astragalus and elderberry, but again, anything that combines several of these ingredients into one I think is is worth looking at.
I think there's also a role here for medicinal mushrooms. It's not what you're thinking of. It's the, it's the the things that boost the immune system. Like, uh, reishi, shitake, maitake. And again, I really prefer to get products that combine a lot of things into one or two high impact formulas. So we'll list a couple of these again in the show notes.
Aimee: Great, Henry. Thank you for those. So I hope this has been helpful. Some encouragement to rest, to nourish yourselves. I hope that folks can take the time off from work when needed to support their bodies in these phases of healing that are essential. And to close, I wanna share a quote from writer and teacher, Hiro Boga I think this is, um, an invitation. She writes, "There's room for all of you. And for everything you experience. The grim and the glorious, the wounded, wounding, healing, and healed.
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