Depression
Feeling Sad? Blame Your Cold
It’s not in your head: Getting sick can make you feel depressed.
Posted April 26, 2023 Reviewed by Davia Sills
Key points
- People cannot distinguish whether they are getting sick or getting depressed early in either condition.
- The body’s immune response produces changes in the brain that can create depressive symptoms and make everyday tasks harder.
- People should be gentler with themselves when they get sick and embrace the sickness behaviors that help get them well.
Whenever I’m sick, I always get down. I feel like I can’t handle normal life, from walking the dog to cooking dinner. I think of myself as “weak.” I have thoughts of being a bad mom because I give my son more screen time.
I’m not alone. Studies show that people cannot accurately identify whether they are getting sick or developing depression early in the course of either condition. We can’t distinguish between the two.
Immune system science
In animals and humans alike, when the immune system gets activated, we feel lethargic, lose our appetite, and withdraw socially. Collectively called “sickness behavior,” these actions help conserve energy so the body can prioritize fighting the pathogen and prevent further spread to members of our kin.
This all makes sense. But why do we have depressive thoughts and feelings? Why do we get cranky or sad?
The culprits are cytokines, inflammatory proteins the immune system produces to signal an attack. Cytokines are like a firehouse alarm. They recruit immune cells (or firefighters) from around the body to help combat the infection or injury. When microglial cells, the immune cells of the brain, hear the cytokine alarm, they activate, causing damage to the surrounding nerve tissue. They reduce neuroplasticity, interfere with the supply of serotonin and other neurotransmitters in synapses, and even produce cell death.
These biological effects can create depressive symptoms. For example, when non-depressed individuals were treated for Hepatitis B with the cytokine Interferon, about a third of the group became clinically depressed. They felt guilty, pessimistic, self-critical, and anhedonic. Other studies show that the people who exhibited the strongest inflammatory cytokine response experienced the greatest deterioration in mood. The bigger the immune response, the worse the mood.
An immune response also makes it harder to do routine things. In a controlled experimental environment, participants who were given Interferon-alpha exhibited increased activation of the anterior cingulate cortex and more task-related errors than the control group. When we’re sick, our brains have to work harder to perform at a normal level.
The next time you get sick, when everything feels harder to do, and you feel down about yourself, remember that it is not in your control. Your immune system is driving the ship. Embrace sickness behaviors. Reduce as much of your daily load as you can, and rest. Let your kids have all the iPad time they want. Be gentle with yourself, knowing that you and your life aren’t the issue. You’re just sick.
References
Capuron, L., Pagnoni, G., Demetrashvili, M., Woolwine, B.J., Nemeroff, C.B., Berns, G.S., & Miller, A.H. (2005). Anterior cingulate activation and error processing during interferon-alpha treatment. Biological Psychiatry, 58, 190-196.
Harrison, N.A., Brydon, L., Walker, C., Gray, M.A., Steptoe, A., & Critchley, H.D. (2009). Inflammation causes mood changes through alterations in subgenual cingulate activity and mesolimbic connectivity. Biological Psychiatry, 66, 407-414.
Kinney, D.K., & Tanaka, M. (2009). An evolutionary hypothesis of depression and its symptoms, adaptive value, and risk factors. Journal of Nervous and Mental Disease, 197, 561-567.
Morris, G.P., Clark, I.A., Zinn, R., & Vissel, B. (2013). Microglia: a new frontier for synaptic plasticity, learning and memory, and neurodegenerative disease. Neurobiology of Learning and Memory, 105, 40-53.
Ratcliffe, M. (2013). A bad case of the flu? The comparative phenomenology of depression and somatic illness. Journal of Consciousness Studies, 21, 198-218.
Schaller, M., & Murray, D.R. (2008). Pathogens, personality, and culture: disease prevalence predicts worldwide variability in sociosexuality, extraversion, and openness to experience Journal of Personality and Social Psychology, 95, 212-221.