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Summary
Summary
As seen on "CBS This Morning"
Worldwide, depression will be the single biggest cause of disability in the next twenty years. But treatment for it has not changed much in the last three decades. In the world of psychiatry, time has apparently stood still...until now with Edward Bullmore's The Inflamed Mind: A Radical New Approach to Depression .
A Sunday Times (London) Top Ten Bestseller
In this game-changing book, University of Cambridge professor of psychiatry Edward Bullmore reveals the breakthrough new science on the link between depression and inflammation of the body and brain. He explains how and why we now know that mental disorders can have their root cause in the immune system, and outlines a future revolution in which treatments could be specifically targeted to break the vicious cycles of stress, inflammation, and depression.
The Inflamed Mind goes far beyond the clinic and the lab, representing a whole new way of looking at how mind, brain, and body all work together in a sometimes misguided effort to help us survive in a hostile world. It offers insights into how we could start getting to grips with depression and other mental disorders much more effectively in the future.
Author Notes
Professor Edward Bullmore, MB, PhD, FRCP, FRCPsych, FMedSci, trained in medicine at the University of Oxford and then at St Bartholomew's Hospital in London. After working as a physician in London and at the University of Hong Kong, he trained as a psychiatrist at St George's Hospital and the Bethlem Royal and Maudsley hospitals in London, and as a clinical scientist at the Institute of Psychiatry, King's College London. He has been a professor of psychiatry at the University of Cambridge since 1999 and is head of the Department of Psychiatry and director of Wolfson Brain Imaging Centre in the Department of Clinical Neurosciences. Since 2005, he has worked part-time at GlaxoSmithKline and is leading an academic-industrial partnership for the development of new anti-inflammatory drugs for depression. His other books include The Diagnosis of Psychosis and Fundamentals of Brain Network Analysis.
Reviews (3)
Publisher's Weekly Review
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. (Dec.) c Copyright PWxyz, LLC. All rights reserved.
Kirkus Review
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 researchcalled 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 mindthe immune system is now known to communicate across the blood-brain barrier, which was once thought to prevent this communicationthe 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. Copyright Kirkus Reviews, used with permission.
Library Journal Review
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 Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Table of Contents
| List of Figures | p. ix |
| Preface | p. xi |
| 1 Daring to think differently | p. 1 |
| Root canal blues | |
| Neuro-immunology and immuno-psychiatry | |
| What does an inflamed mind look like? | |
| The revolution will not be televised | |
| 2 The workings of the immune system | p. 20 |
| Inflammation and infection | |
| Fig 1 Immune cells | |
| Fig 2 Inflammation | |
| Location, location, location | |
| Communication: the medium is the message | |
| Fig 3 The immune system | |
| Rapid rebuttal and learning | |
| Auto-immunity: the flip side | |
| 3 Hiding in plain sight | p. 43 |
| It's depressing being ill | |
| The cogito, God, and the machine | |
| Fig 4 A lady trying to explain the pineal theory of the human mind and body | |
| A long shadow | |
| Mrs P is not alone | |
| A bona fide blockbuster | |
| The Cartesian blind spot | |
| 4 Melancholia after Descartes | p. 69 |
| From black bile to MDD | |
| A cross to beat Super-shrink | |
| Fig 5 Freud's first draft of the ego | |
| Dancing in the sanatorium | |
| Fig 6 First prophet of pharmaceuticals | |
| The golden age | |
| Fig 7 Scenes of joy at the dawn of ami-depressant | |
| Fig 8 The seer and the synapse | |
| Farcical serotonin | |
| Bereft of biomarkers | |
| 5 How? | p. 112 |
| Extraordinary claims demand extraordinary evidence | |
| A stubborn fact | |
| Causes must come first | |
| The Berlin wall in the brain | |
| Fig 9 What I was taught at medical school - and what we new know | |
| Fig 10 Nervous reflex control of inflammation | |
| Inflamed brains | |
| 6 Why? | p. 146 |
| What could make you inflamed (and depressed)? | |
| Flaming stressed | |
| Causal chains and cycles | |
| Ultimately, the answer must always be Darwin | |
| Fig 11 Emotional faces and emotional brains | |
| A savannah survival story | |
| 7 So what? | p. 176 |
| Medical apartheid | |
| Fig 12 The vicious cycle of stress, inflammation and depression - and ways to break it - an artist's impression | |
| Could it be different already? | |
| Market failure | |
| Beyond blockbusters: better but not bigger than Prozac | |
| Alzheimer's disease and the yin and yang of microglia | |
| Schizophrenia and auto-intoxication | |
| References | p. 221 |
| Acknowledgements | p. 229 |
| Disclaimers | p. 230 |
| Index | p. 231 |
