Why, oh why, do some IC patients struggle with depression?? Certainly lack of consistent sleep could be a cause along with intense, persistent pain. Having a doctor tell you that you have an incurable disease (an outdated and incorrect conclusion) is certainly upsetting. But what if there was a physical reason for that depression?
Researchers at Duke University made a rather remarkable discovery, that inflammation in the bladder is converted to neuroinflammation in the central nervous system, which then can trigger depression.1 In other words, depression can be the result of injury and long-term inflammation in the bladder driven, perhaps, by a daily cup(s) of coffee, drinking soda or smoking. Only recently have we come to realize the long-term toll of junk food.
Understanding Inflammation
Inflammation is a process your body uses to fight injury or infection. When your bladder suffers an injury or infection, inflammation is a normal part of the healing process. If, for example, you get a UTI, your bladder wall may turn red, swell and physically hurt. If your bladder was red during a cystoscopy, odds are that inflammation was present. Yet, once the UTI is treated, that inflammation usually resolves. Patients with Hunner’s lesions suffer from severe inflammation. With several studies now implicating viral infections as a cause of some Hunner’s lesions, this makes complete sense.
There is another, more devastating, type of inflammation. Chronic inflammation has been linked to many life threatening health conditions, including: type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), cardiovascular disease, cancer, depression, autoimmune diseases, neurodegenerative diseases and others. The triggers for chronic inflammation are: physical inactivity, (visceral) obesity, intestinal dysbiosis, diet, social isolation, stress, poor sleep and exposure to toxins (air pollutants, hazardous waste products, industrial chemicals and tobacco smoking). Chronic bladder infection could also contribute to chronic inflammation.
Neuroinflammation occurs when there is an inflammatory response within the brain or spinal cord, often after a traumatic brain injury, infection or autoimmune dysfunction. Neuroinflammation has been linked to depression and several brain diseases, including Parkinson’s, Alzheimers, ALS and Huntington disease.
Clearly, inflammation can persist throughout the body. In the typical IC patient also struggling with depression, this research team encourages doctors to treat underlying inflammation to bring both urological and psychological relief. This is where we, the IC patient, can take firm action to help reverse inflammation and reduce depression. To fight inflammation, we have to simplify our diet and lives, focusing on better food, less stress, fulfilling relationships and sleeping well.
How can we reverse inflammation?
1. Eat anti-inflammatory foods
Your food choices can protect you against inflammation. Eat more fruits and vegetables and foods containing omega-3 fatty acids, including leafy greens (spinach, kale), cruciferous veggies (broccoli, cauliflower), nuts and seeds (flax, almonds, chia, Kind Bars), fruits (low acid Gala or Fuji apples, berries), fatty, cold water fish (mackerel, tuna, salmon), olive oil and some spices (ginger, rosemary and turmeric).
2. Quit smoking
Why is smoking the #1 cause of bladder cancer? Because the bi-products from smoking, vaping and chewing accumulate in your urine, where they bathe the bladder wall with irritants. For the unlucky, these toxins trigger the development of bladder cancer. But did you know that children exposed to secondhand smoke can develop urinary symptoms similar to IC? The toxins are irritating their bladders too. Please note that while vaping has been considered healthier than smoking, recent studies have found high levels of certain carcinogens in their urine too.
Did you know that children exposed to secondhand smoke can develop urinary symptoms similar to IC?
3. Limit alcohol
This isn’t a stretch for most IC’ers given that alcohol can trigger flares but for those of us who can tolerate alcohol, it’s important to note that alcoholic beverages are inflammatory.
4. Cut back or eliminate inflammatory foods
Inflammatory foods include red meat and anything with trans fats, such as margarine, corn oil, deep fried foods and most processed foods. Air frying is a much better way to prepare your fries and other favorite foods.
5. Control blood sugar
Did you know that food companies have added sugar to many of our common foods to trigger an addiction response because they want you to buy more of their product. Yes, they want you to become addicted and they have refused to consider the long-term harm that their sweetened foods have caused. Limit or avoid simple carbohydrates, such as white flour, white rice, refined sugar and anything with high fructose corn syrup. Opt for “whole grain” rather than “white” breads. Ezekiel bread (made by Food For Life®) is a much better whole grain choice that is high in protein, lower in carbs and tastes great.
6. Make time to exercise
Regular exercise decreases stress, improves digestion, maintains good muscle mass and bone structure. Every week, try to focus on 150 minutes of cardio (walking, biking, swimming, hiking, dancing, etc.) and two strength training workouts. That’s about 30 to 45 minutes of aerobic exercise and 10 to 25 minutes of weight or resistance training four to five times per week.
7. Manage stress
Stress has been my middle name in the last few years, especially with the loss of my parents and a breast cancer diagnosis. It’s incredibly important that we release stress from our body. I do this by talking walks in my local park, spending time with friends and family, painting, reading and lots of crafts. I usually listen to several books on tape each week that are happy and filled with laughter and love.
The ICN has several free guided relaxation tapes designed specifically for pelvic pain. Meditation, yoga, biofeedback can work too.
8. Improve sleep habits
Seven to nine hours of sleep per night is highly recommended. It’s helpful to go bed and wake up at the same time, to sleep in a cool, dark room and to avoid using your iphones an hour before bed. This, my friends, may be the most difficult challenge of all.
Conclusion
Have you considered why so many diseases have increased exponentially after WW2? That’s when manufactured foods became established and we now face a reckoning for the toll that they have taken on our bodies and, yes, our minds. If I could go back in time, I wouldn’t have picked up the sodas, tasty Oreos and Twinkies of my childhood. I am sure that that diet intensified my urinary and bowel symptoms over time. Throw in the wicked levels of stress we have endured in the past several years due to the pandemic, politics and war, it’s no wonder that so many are struggling with their health.
It’s time to simplify. I’ve cleaned up my diet substantially and am eating much less red meat and many more veggies and fruits. As much as I love a good cinnamon roll, I’m saying no to pastries and have chosen not to drink alcohol this year. Dismayed by some weight gain during COVID, I’m determined to stay fit and now exercise 5 or 6 days a week, walking through a local park where I say “Hi” or “Good Morning” to almost everyone I see. It’s nice to see those smiling faces.
I haven’t watched TV in weeks, other than checking the weather, because I refuse to be a pawn of media companies that drive their profits by keeping us all upset. The more upset we are, the more we watch and the more money they make. Enough!
Social media is showing its dark side too now as more platforms seek to drive dissension rather than compassion. I’d rather watch a good mystery or read a great book. Actually, I’m also really enjoying these new adult “paint by numbers” projects… they are almost meditative and a great way to end the day.
I hope that as the year progresses, we will all be able to get back into nature. Watching hawks fly, listening to birds sing, getting out into the sunshine, throwing a ball to your children, and/or sitting on a beach is healing for our body, mind and spirit.
References
1. Hughes F, et al. Why Are Some People with Lower Urinary Tract Symptoms (LUTS) Depressed? New Evidence That Peripheral Inflammation in the Bladder Causes Central Inflammation and Mood Disorders. Int J Mol Sci. 2023 Feb; 24(3): 2821.
