Male: Today on Clubhouse Gas Doctor Joy Maxi talks about the relationship between inflammation related injuries and depression in children. Interesting to you, it was absolutely fascinating to me. So stay tuned to Clubhouse Gas.
Dr. Joy maxi joins us again. Dr. Maxi, thank you for joining us.
Dr. Joy: Thank you.
Male: Depression, you kind of see a little base element of depression especially in athletes. Is there anything you can tell us about why that is? How does a 12-year-old kid who has nothing to worry about and just played sports end up being depressed?
Dr. Joy: There is a big genetic component to depression. And let’s just define depression. Depression is not sadness because you lost your grandmother or you lost a big game or you lost something of great value. That’s sadness. And that’s a normal human emotion and a normal human response.
Depression is more and more being defined as a neurochemical abnormality of the hormone called serotonin that we find the brain that is responsible for many functions. A few of which were things like ability to remember things, how you hear and process things, your levels of appetite, your sense of being full once you’ve had an adequate meal and sleep. And so all of those sorts of things are regulated by serotonin.
There is—at university by the name of Andrew Miller who made an observation. And he made an observation that folks who had depression and folks who had sustained and acute sports injury of some sort had a lot in common in terms of their behavior.
Stop and think about the last time you twisted your knee or ankle case. See after you cried and went home and ask your wife to make it better for you, then you were sitting around and moaning and groaning and asking her to bring you a beverage out of the refrigerator while you were resting up with your icepack and then—
Male: Yeah and miserable. I'm a terrible patient.
Dr. Joy: Indeed. And so after that, you know if I were to talk to your wife, she’ll probably tell me that maybe you were a little grumpier than usual and you didn’t want to do anything and you just kind of want to sit around and you didn’t really want to interact with any of your friends. And so in those sorts of behaviors or the same sorts of behaviors that we see in depressed people and so Dr. Miller did the study. He did what you call PET scans which are a way of looking at brains as they function, brains at work. And he found that the patterns of the PET scans of folks we know have depression were very similar to the patterns of the folks who had sustained and acute sports injury.
Male: A lack of serotonin?
Dr. Joy: A non—of serotonin perhaps is a better way of looking at it. And so, after the injury was over with and healed and resolved, the folks that were sustaining of sports injury were back to their usual kind of baseline selves. They were back at it. They were active. They were their usual selves. But then the question becomes “why is this?” “What is it about an injury that would cause someone to have a brain that looks like somebody with depression?
And so in the sequence of events that the body goes through with inflammation, there is a chemical produced called “cytokinin” and this chemical is common to all venues of inflammation. So, if you have the inflammatory processes going on because you had a sports injury, because you have allergy—because you have reflux, because you have any other number of conditions that are chronic and ungoing, you are producing inflammation and therefore there is a lot of this chemical called cytokinin that floats around in your body and goes up into your brain. And we now know that this is the chemical responsible for changing the structure of your brain in terms of how it uses serotonin and functions with serotonin.
Male: So an inflammation injury produces a chemical that will suppress serotonin—
Dr. Joy: Or alter how it messages one way or the other. We don’t know if it suppresses it or if it alters it but it makes you function as though you have the disease depression.
Male: Where is that balance stop between someone who exercises a bunch that then got inflammation but because of the inflammation, the chemical is released but they’ve also got to exercise. Is that not balanced it out? Is it when it's a serious enough injury where you're not active anymore, is that when a depression kicks in?
Dr. Joy: Then what is really—the key is because you're absolutely why, exercise has massive health benefits for your brain in terms of the other hormones that your brain—we know about it in your brain for instance dopamine or epinephrine as well as serotonin and some of the others. Dopamine is sort of the happy chemical. That's the one that’s associated with pleasure and happiness and those sorts of things. And clearly, dopamine levels are increased in athletes.
And so, I think a lot of it is the whole concept of balance. In other words, you want to pick forms of exercise that are sustainable that you don’t necessarily have to do with a competitive level but you enjoy that will allow you to drive benefit from the good hormones that are produced by exercise.
And then at the same time for folks who have a lot of athletic ability and are competing in the competitive level, then the flip side of that is what do you do about injuries and how do you manage them. And in the past, we just talked about the physical mechanics of the part of the body that was injured whether if it's a knee, the elbow, the muscle, the ligament, what part. But now with this ongoing research, one of the things we’re looking towards is should we be doing some other things?
For instance, the NSAIDS, that’s like Ibuprofen and Naproxen. Those would be brand names like Motrin for Ibuprofen or Aliv for Naproxen. Those are mainstays of the recommendations we give to people for acute sports injury.
However, they do not address the issue of this new chemical we know about called cytokinin. They act to a lot of once the cytokinin is already been released, and so it doesn’t really help that part of the brain function from the sports injury. And so, we are looking at this research in doing further research in order to find out what medications are there that we might recommend to people in that situation of acute sports injury that work at a higher level in the chain of inflammatory responses to stop the production of cytokinin in the first place.
And so that's one of the new and exciting areas that we’re all in anticipation about over the next coming months. We will keep you posted here on Clubhouse Gas. But for right now, I think that balance is the keyword and if you’ve had a child that’s had a severe injury, you probably need to make sure that most of the inflammation is gone before you let this young lady or young man go back to competition.
Male: Thank you so much Dr. Maxi, great information once again from a fantastic doctor. Don’t forget to join us every Tuesday as we continue our series of medical shows. We will see you here next time on Clubhouse Gas
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