Depression Distress Theory: What is it

In Spain, more than 2.4 million people suffer from depression in their day to day, this means that more than 5.2% of the Spanish population lives with a feeling of anguish and acute sadness that interferes or makes it impossible to live their life with normal.

Despite the high incidence of this disorder or emotional condition, there are still great disagreements within the scientific community regarding the true cause of it. One of these these theories is the malaise theory of depression, which we explain throughout this article.

• You may be interested: "Major depression: symptoms, causes and treatment"

What is the sickness theory of depression?

Also known as the inflammatory theory of depression, this explanatory model of endogenous depression disorders created by UK physician and researcher Bruce G. Charlton in the year 2000, he tries to explain the origin of depression from a physical or organic point of view and not as a psychological reaction.

This theory begins with the idea that when our body is a victim of some type of infection,

our own body emits an inflammation response through which a series of hemodynamic alterations, lymphatic levels and the release of a series of agents such as cytokines, histamine neuropeptides, etc., in order to restore the health of our Body.

Also, along with inflammation a psychological phenomenon known as disease behavior appears. This type of psychological response is characterized by the fact that the person experiences a series of feelings of fatigue, somnolence, anhedonia and cognitive alterations, all these symptoms coincide with part of the clinical picture of the major depression.

The origin of this disease behavior would be found in the effects that certain proteins, specifically cytokines, whose levels increase before the appearance of a virus or infection, cause in our brain.

This association between the physical or organic response to inflammation and the psychological response is suggested by the theory of discomfort. According to this, endogenous depression is a pathological variety of disease behavior. For which the symptoms remain over time. Therefore, according to this theory, depression is caused by the effects of chronic low-level organic inflation and by chronic activation of the immune system.

Finally, Charlton himself proposes that the true effect of antidepressant drugs when it comes to alleviating the symptoms of the disease is found in the analgesic effect that most of these have, so by reducing organic inflammation, the symptoms of depression also decrease.

On what evidence is this explanation based?

Although at first it is somewhat difficult to believe that depression is not caused by an external factor provoking this response, the theory of distress is based on a series of empirical evidence that the endorse.

1. Symptom coincidence

As mentioned above, the symptoms of major depression coincide in many respects with those of disease behavior, which tends to appear when we suffer some type of disease physical.

In these cases symptoms such as fatigue, decreased physical energy, or feelings of distress and sadness They appear with the aim that our body remains at rest and recovers as soon as possible.

2. The effect of cytokines

One of the physiological responses that our body causes to the threat of disease is increased cytokines. This protein causes inflammation with the intention of transmitting to our body that it is in a state of alert or threat.

If we take into account that, habitually, in disorders with depressive symptoms, the levels of cytokines are much higher than usual we can hypothesize a kind of relationship between these two factors.

Furthermore, in the specific case of Bipolar disorder, cytokine levels decrease during episodes of mania or remission of depressive symptoms, so this reinforces this association.

3. Action of antidepressants

Antidepressant drugs exert an effect on the levels of cytokines, specifically they decrease it. Therefore, this reinforces the idea that the main cause of endogenous depression is in the effects that these proteins cause in the body.

4. The inflammatory response system and depression

Some studies have shown that the laboratory inoculation of inflammatory substances or agents, causes a series of symptoms typical of clinical pictures of depression and anxiety.

Furthermore, a clear relationship has been established between the activation of our body's inflammatory response system and depression; since it is continuously activated during this disorder.

The inflammatory response system works through the activation of the hypothalamic-pituitary-adrenal axis, which affects the regulation of certain neurotransmitters such as serotonin and catecholamines, directly related to the states of depression.

5. Antidepressant action of anti-inflammatory drugs

Finally, some research has found that the administration of anti-inflammatory medication in some cases of Endogenous depression not only significantly improves its symptoms, but also does so in a greater proportion than some antidepressants.

What if there is depression but no inflammatory disease?

The main criticism of the explanatory model of the theory of distress in depression is that there are a large number of cases in which a physical cause could not be found or sign of organic inflammation in the patient.

However, according to this theory it is argued that psychological stress processes can cause this inflammation just as any type of infection does, thus causing the symptoms of depression.

Experimentation with high levels of stress over a long period of time has been linked to increased levels of pro-inflammatory cytokines. Which, as we have explained previously, exert a direct effect on the levels of serotonin and other neurotransmitters related to depression.