Carmine Pariante may be the most important scientist you’ve never heard of. He is a professor of biological psychiatry at King’s College, London, as well as being warm, charming, Catholic by upbringing and an Italian originally from Naples. For the past decade, his research has been at the cutting edge of the science of happiness. In particular, his work on the links between inflammation and depression is fascinating for those, like me, who have a history of anxiety.
The jury is still out as to the exact causes of depression, but some scientists like Prof Pariante are questioning the simplistic explanation that blames “a chemical imbalance in our brains” and low levels of serotonin in particular. While serotonin has some role to play, exactly what is happening when we succumb to the Black Dog may be more nuanced and different for each of us and is now thought to affect the whole body rather than just the brain.
One new explanation is that those who suffer from low mood may also experience high levels of chronic inflammation throughout the body as well as in the brain. This new explanation is particularly encouraging for the 30 per cent of patients who do not respond to currently available antidepressants, as they may benefit the most from novel antidepressant treatments that decrease inflammation. Prof Pariante is examining a range of such potential new treatments in his research programme.
Processed foods and trans fats increase inflammation and create more fatty or adipose tissue, which is also a source of inflammation – a vicious cycle. Stress can be to blame for inflammation too: studies show that if you stress mice, for example, you also create a stressed and inflamed digestive system.
Evidence from animal studies suggests that when our guts are inflamed it can affect our mood. Some of the compounds produced by the bacteria in our gut can also increase inflammation, and if too many of them escape into the rest of the body from the gut, they may cause inflammation elsewhere, eventually leading to depression.
Yet there may be a delightfully simple nutritional answer. Prof Pariante’s study in 2014 followed 152 patients who were at risk of depression because of the high levels of inflammation. He found that omega-3 fatty acids reduced the rates of depression.
Prof Pariante says: “It is now established that increased inflammation plays a role in causing depression in at least a subgroup of patients. Our study of people at risk of depression for their high levels of inflammation shows that even a short course of a nutritional supplement containing one type of omega-3 fatty acid (EPA) reduces the rates of new-onset depression to 10 per cent, as opposed to the rate of 30 per cent we usually see in this group.”
He adds: “We believe that this nutritional intervention restores the natural protective anti-inflammatory capabilities of the body, and thus protects patients from new-onset depression when inflammation occurs.”
Research like this is so compelling that Prof Pariante and others scientists are studying anti-inflammatory drugs to treat depression.
There are other nutritional changes we can make to reduce inflammation. One way is to encourage healthy bacteria to flourish in our digestive systems. It is thought that an increase in the levels of unhelpful or ‘‘bad’’ bacteria that emit chemicals can compromise the lining of the intestine. Given the inseparability of good mental and good physical health, looking after our digestive systems should be a priority for all of us who worry.
It has become so for me: for the past five years I’ve worked with the nutritional therapist Alice Mackintosh to improve my mental health, and benefited from the research of the likes of Prof Pariante. As we both sit sipping green juices at the Wolseley café on Piccadilly, we discuss in more detail how to eat for happiness. I am clearly preaching to the converted.
Prof Pariante agrees that we should sweep our kitchens clean, eliminating processed foods and focusing on “real foods” instead, especially those rich in omega-3s such as oily fish, walnuts and broccoli. As we learn more about the links between staying calm, inflammation and a healthy microbiome – otherwise known as gut flora – it makes sense to increase the amount of probiotics and fermented foods we eat.
A modest portion of creamy yoghurt so thick that it stands up in the bowl suits me well. Women given yoghurt containing probiotics were found to have a calmer response to certain stimuli, according to a 2013 study reported in the journal Gastroenterology.
The professor, now a youthful-looking 50, was born in Naples in 1966, but grew up in Rome. Educated at the Collegio San Giuseppe – Istituto De Merode by the Brothers of the Christian Schools, he went on to study medicine at the Agostino Gemelli University Polyclinic in Rome.
He arrived in England in 1997 to work at the Institute of Psychiatry, Psychology and Neuroscience at King’s College. He credits his honesty, work ethic and solidarity to the teaching of his Catholic school, although he does not go to church regularly today.
I ask if his work with the brain ever makes him ponder the mysteries of the universe and if God is at work.
“As all scientists who are confronted by the complexity of life and nature – from the millions of stars in the sky to the millions of cells in our brain – I cannot avoid feeling humbled and wonder how this has developed over the history of the universe,” he says. “But I try not to confuse the complexity with the need for a transcendental agent.
“I believe in the importance of spirituality and that we are more than just transient beings on earth, but not necessarily that the spiritual dimension requires God as a hands-on maker of the universe.”
Is it important to have faith if you are a doctor working closely with life and death?
“It is important to remember that all lives are meaningful and also to understand what does ‘meaningful’ mean to the individual patient, especially in the delicate balance between quality and duration of life. Also, we need to help patients to maximise the chance to fulfil their spiritual needs of spending time with, and saying goodbye to, the people they love.”
As someone who was helped by my faith when recovering from two serious bouts of depression, I was intrigued as to whether Prof Pariante felt that faith can be important to some people when recovering from mental illness.
He says: “More than faith, I would say spirituality and a spiritual dimension: recognising the beauty in oneself, and aspire to healing and recovery also through practising goodness and helping others. This dimension could be strengthened if it was accompanied by faith in recognised religion, but can also be based just on moral and ethical values.”
My own experience is that attempting to help others – or “practising goodness”, as Pro Pariante puts it so delightfully – as an ambassador for Sane and Rethink has helped me. Changing what I eat has helped too. I still rely on the consoling power of poetry, exercise, bits of mindfulness and other strategies in my toolbox-approach to staying calm and well.
But I suspect that as more scientists like Prof Pariante make the case for a new understanding of mental illness over the next few years, nutrition will prove among the most powerful tools of all – and I wouldn’t be surprised if the name of Pariante became a household one. You read it here first.
Rachel Kelly’s The Happy Kitchen: Good Mood Food is available from Amazon. She will be discussing her new book with Pratima Singh, consultant psychiatrist at the Maudsley Hospital, at St Stephen’s Church Hall, London W2, on February 22 at 6.30pm. For more information, call 0203 176 7907 or visit https://goo.gl/J6OKd0. Follow her on Twitter @RachelKellyNet or visit rachel-kelly.net
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