The Inflamed Mind

August 27, 2018
Psychiatry professor Bullmore’s debut implores depression sufferers to embrace the new field of neuroimmunology and the idea that mood and the immune response could be directly linked. He laments that doctors often treat the unhappy mental states of patients with inflammatory conditions as reasonable psychological responses to the stress of illness rather than as distinct and treatable health problems. He also blames this attitude for a lack of progress in treatment for depression in recent decades. Bullmore’s targeted, readable primer on the immune system focuses on the cytokines systemically produced as part of the inflammatory response. These are proteins that, Bullmore believes, based on current research showing the blood-brain barrier as more permeable than previously thought, could be interacting with cells in the brain and interfering with serotonin signaling. He may raise some eyebrows when he positions himself as an underappreciated maverick struggling against an oblivious medical establishment. However, he stops short of recommending anything other than further research, admitting that his ideas are still unproven, while leaving general readers with a well-informed and cogently argued brief for funding and more investigation in the field.

October 1, 2018

Since the introduction of Prozac 30 years ago, there has been little new in the way of psychiatric drugs. Bullmore (psychiatry, Cambridge Univ.) argues that Prozac and similar medications have proven to be dead ends because they don't address the root cause of depression. That cause, argues the author, is inflammation of brain tissue, the same condition responsible for arthritis, gum disease, and various digestive complaints. Bullmore reveals a scientific discipline on the verge of a paradigm shift, describing how immunologists and neurologists have overturned the notion of an impermeable blood/brain barrier to illustrate how byproducts of the body's fight against infection may contribute to changes in mood. VERDICT Readers looking for current treatments for depression or self-help advice will not find it here, but those concerned with the science behind depression or autoimmune disorders will discover the current state of research very compelling, as will general readers who enjoyed Siddharta Mukherjee's The Emperor of All Maladies.--Mary Ann Hughes, Shelton, WA

Copyright 2018 Library Journal, LLC Used with permission.

October 15, 2018
A rousing, straight-from-the shoulder call for a new approach to treating depression.Mental disorders, writes Bullmore (Psychiatry/Univ. of Cambridge; co-author: The Diagnosis of Psychosis, 2011), the head of the Wolfson Brain Imaging Centre, can have their origin in the immune system. In a book previously published to acclaim in England, he makes the case for a link between inflammation and depression, delineating his argument with a "pioneering new field of research...called immuno-psychiatry or neuro-immunology." This new field "exists at the boundaries between immunology, neuroscience, psychology and psychiatry." Forcefully rejecting the Cartesian divide between body and mind--the immune system is now known to communicate across the blood-brain barrier, which was once thought to prevent this communication--the author outlines how the immune system triggers an inflammatory response to stress and how inflammation can cause changes in how the brain works, often leading to changes in mood and behavior. To illustrate, Bullmore refers repeatedly to a former patient with rheumatoid arthritis, an autoimmune and inflammatory condition, and depression, and he adds a personal touch with references to his own temporarily depressed mental state after undergoing a stressful root canal procedure. Besides explaining the biological mechanisms linking stress, inflammation, and depression, the author provides a lesson in medical history that likens present-day thinking about serotonin to the Hippocratic notion of black bile and concludes with the statement, "in short, depression after Descartes is in a sorry state." Bullmore's involvement with a research program at the pharmaceutical firm GlaxoSmithKline, an arrangement he is quick to acknowledge, may raise questions about his interest in the development of new anti-inflammatory drugs to treat depression, but his insights into depression and its treatments are impressive and valuable. The black-and-white illustrations vary widely in quality, from woodcuts and engravings to some rather amateurish original drawings.Aimed at the general public, highly readable, and more than a little provocative.

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