In the overview we cover the topic of depression, albeit from a different angle. The theory put forward in that paper is not too distant from today’s discussion on depression. Specifically depression and it’s associated conditions at altitude or places of lower pressure.
In today’s discussion we tighten the focus on the effect low oxygen has on mental health and how it relates to depression, anxiety, apathy and the striking difference in incidents of suicide at altitude versus at sea level. It all comes back to the familiar topic of oxygen and specifically oxygen pressure, the driver determining how much oxygen becomes saturated in our bodies.
Recently, a fascinating article came to our attention entitled:
The story was also covered by Sky News and their reporting can be found here:
These articles are linked in early in today’s article to encourage reading them. If you have only the time to read this article or those articles, pick them. They are of specific interest to us because of the striking common threads with our own articles on hypoxia and altitude:
What we didn’t cover in those articles, as we did in the overview, was mental health and depression. Accordingly we wanted to draw this into the spotlight in today’s discussion.
As we learned in previous articles, “Hypoxia not only stops the machine, it wrecks the machinery”, according to John Scott Haldane. This extends to the machinery behind mental health as well as other cellular biology.
The Steamboatpilot article cited above refers to a study done in 1963 on the subject, entitled “Hypoxia” by Edward Van Liere and J. Clifford Stickney.
This paper establishes that multiple symptoms can emerge over time, including irritability, anxiety and apathy following the initial euphoria associated with arriving at altitude, and it is all down to hypoxia.
“Whether it’s depression, anxiety, confusion or deep despair, those are alarms from our body that something is wrong,” she said. [Goodwin].
Also established, is that low oxygenation can negatively alter serotonin metabolism. As we well know by now, having discussed metabolism more than a few times, metabolic function is oxidative in nature. More oxygen accelerates it and less oxygen inhibits it. It follows then that a state of hypoxia has the potential to trigger depression as a result of improper serotonin metabolism and bring about the onset of symptoms including a sense of doom, sadness, apathy, anxiety and many more. Note: Serotonin is the chemical neurotransmitter responsible for a sense of happiness and well being and is often referred to as the “happy chemical”.
When we discuss altitude in this regard, we are referring to potentially relatively small changes in pressure having a marked effect. The difference between sea level and 5000 meters is just half an atmosphere as readers will recall from the altitude discussion. This is considerably less than we use to pressurise a hyperbaric chamber. This means that even relatively low pressure chambers such as discussed in the article on dosage and mHBOT can be effective. It then follows that even the low pressure fabric chambers could be very effective at treating altitude induced depression.
This is not to say ALL depression is as a result of lower pressures, but points to a potential contributor to this condition and a potential adjunct therapy which may help to manage it.
Recently, on a trip to the Isle of Man, I consulted with an expert in the field of hyperbaric medicine and the topic of light perception and seasonal depression, or seasonal affective disorder (SAD) came up. The role of light therapy and light perception was discussed and the answer was surprising to me. My colleague explained that it’s got less to do with the light and rather more to do with the fact that during the winter months the air pressure drops considerably, especially in northern hemisphere countries such as the United Kingdom where pressure can vary up to 10%. Correlation doesn’t necessarily prove causation in this case as we discussed. The fact that it is darker just happens to be a correlating coincidence.
Having had a brush with seasonal blues myself in the past, this stuck in my mind because from personal experience, I know that going for a dive (chamber or in water), and subjecting myself to higher pressure causes any symptoms present to completely dissipate. The effect is immediate as well and it lasts for most of the day. Fascinating to say the least. Even breathing air under increased pressure increases the oxygen pressure in that air. Clearly it increases it enough to positively alter serotonin metabolism. This indicates that hyperbaric oxygen therapy could well be a good therapy for certain types of depression. Certainly for those living at altitude, a pressure bag or mild hyperbaric oxygen fabric chamber would be immensely helpful.
In the cited sources above, it is established that the suicide rate at altitude, (along with the drug dependency rates), are far higher than at sea level as depicted in the graphic. Significantly so.
According to Edward Van Liere and J. Clifford Stickney:
“That’s according to hypoxia”, as stated in the 1963 study.
In an effort not to ramble, which regular readers will know can happen from time to time, I encourage further reading. Specifically the 2 short articles above, but also the longer paper on hypoxia.
If depression can be induced by reducing atmospheric pressure (and consequently the oxygen pressure and saturation), then it can surely be reversed by increasing the pressure and oxygen saturation. This is exactly what HBOT achieves. Certainly something to consider in a world where perhaps half the population live on selective serotonin re-uptake inhibitors (SSRI’s). If oxygen stimulates serotonin metabolism then why not give more oxygen? Since it is non-invasive and benign in nature it cannot make anything any worse and quite literally doesn’t hurt to try. If it helps 1 in 10 people to enjoy a better quality of life then that’s a win in our opinion. Its 10% less the patients the health system needs to manage.
Community based chambers, or simple single compartment chambers placed in GP surgeries could take some of the burden off the healthcare system since a technician can run a treatment for any number of people simultaneously, while a GP can see only 1 person at a time. Not to mention the negative side effects of SSRI’s.
It could also relieve the burden on individuals and lessen incidences of the “Big Black Dog”, which so regularly calls on sufferers of depression.