Are Allergies Making You Depressed?

From the WebMD Archives

Allergy sufferers who say symptoms like sneezing, sniffling, and red, itchy eyes make them miserable may not be exaggerating. Recent studies show an association between seasonal allergies and clinical depression. While researchers can't say that allergies actually cause people to feel depressed, it does appear that allergy sufferers are more vulnerable to depression.

“Most people who have allergies don’t have depression, and most people who are depressed don’t have allergies,” says Paul S. Marshall, PhD, a clinical neurophysiologist in the department of psychiatry at the Hennepin County Medical Center in Minneapolis. “But I think it’s accurate to characterize allergies as a risk factor for depression.”

Could it be a risk factor for you? Large-scale population studies suggest that allergy sufferers are roughly twice as likely to have depression as people without allergies.

In one such study, adults with allergic rhinitis (hay fever) were twice as likely to have been diagnosed with major depression in the previous 12 months. In another study, kids who had hay fever at age 5 or 6 were twice as likely to experience major depression over the ensuing 17 years.

More recent research also supports the allergy-depression connection.

In a 2002 study, a team of scientists led by Marshall found that people with hay fever experienced more sadness, apathy, lethargy, and fatigue in late summer, when ragweed season peaks. “That’s just the opposite of what we see in people who don’t have allergies,” says Marshall. Usually, people tend to have a more positive mood in summer, he says.

Making Sense of the Allergy-Depression Link

What’s going on? Some experts explain the allergy-depression connection in psychological terms, focusing primarily on the heavy emotional toll of chronic allergy symptoms.

There’s “no evidence that there is a causality between allergic rhinitis and depression,” says Richard F. Lockey, MD, professor of medicine and director of the division of allergy and immunology at the University if South Florida College of Medicine in Tampa. “But if you can’t breathe through your nose, if you have headaches, if you can’t sleep well at night, there’s a good chance you’re going to feel depressed.”

Continued

There is clear evidence that allergies can interfere with sleep, and sleep problems have been linked to poor concentration and depression. But there may also be a biological basis to the “allergy blues” that affect so many people with allergies.

“I am much more on the side of a biological connection,” says Teodor T. Postolache, MD, associate professor of psychiatry and director of the mood and anxiety program at the University of Maryland School of Medicine in Baltimore. Postolache led a 2005 study that found that peaks of tree pollen levels correlated with increased levels of suicide in women.

He says allergic rhinitis is known to cause specialized cells in the nose to release cytokines, a kind of inflammatory protein. Animal and human studies alike suggest that cytokines can affect brain function, triggering sadness, malaise, poor concentration, and increased sleepiness.

Sound familiar? “We’ve all experienced this syndrome to some degree,” says Marshall. “What individuals with severe allergies experience when reacting is similar to the general malaise you feel when you have the flu.”

Feeling Better Physically and Emotionally

No matter what the exact nature of allergy-depression connection, just knowing about it may help you. For one thing, says Marshall, it helps put negative emotions into context. “Knowing that allergies can cause sadness, malaise, and lethargy may help people from falsely attributing their symptoms to something else,” he says. What’s more, it can be reassuring to know that getting allergy symptoms under control may bring a welcome lift to a depressed mood.

Experts are quick to caution that this does not mean people battling depression should ignore treatment for the condition, such as psychotherapy and antidepressant medication. Nor should allergy suffers turn away from proven treatments for allergies.

In other words, people with both allergies and depression are likely to need to be treated separately for each condition. “You still treat depression as you normally would and treat allergies as you normally would,” says Marshall.

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Avoiding Allergens Comes First

Experts agree that the first line of attack against allergies should be to limit exposure to the allergens that cause them. Common allergens include pollen, dust mites, animal dander, and the molds that grow in soil and inside homes. Some helpful tips:

  • Stay indoors when pollen counts are high. Keep windows closed and the air conditioner on. If you must venture outdoors, shower and wash your hair before going to bed at night.
  • Keep humidity in your home below 50% to stop mold growth. If you use a dehumidifier, clean it frequently to keep it from becoming a source of mold.
  • Replace curtains, which collect allergens, with blinds, and stick with easy-to-clean floor coverings like wood or tile rather than rugs or carpeting.
  • Wash bedding frequently in water that’s at least 130 F to kill dust mites. Encase mattresses and pillows in allergen-impermeable covers. Don’t share your bed with the family pet.

When More Help Is Needed

Over-the-counter and prescription allergy pills, nasal sprays, and eye drops can be very effective. And when allergies prove especially severe or persistent, allergy shots (immunotherapy) are 90% effective over time.

People with allergies and depression should make sure that all doctors involved in their care speak with one another in order to coordinate their efforts. “It’s important for the allergist to speak with the psychiatrist,” says Postolache. “That is probably going to result in increased therapeutic control of both conditions.”

WebMD Feature Reviewed by Brunilda Nazario, MD on February 10, 2010

Sources

SOURCES:

Richard W. Honsinger, MD, clinical professor of internal medicine, University of New Mexico School of Medicine, Albuquerque.

Richard F. Lockey, MD, professor of medicine and director, division of allergy and immunology, University of South Florida College of Medicine, Tampa.

Paul S. Marshall, PhD, clinical neuropsychologist, Hennepin County Medical Center, Minneapolis.

Teodor T. Postolache, MD, associate professor of psychiatry and director, mood and anxiety program, University of Maryland School of Medicine, Baltimore.

Cohen, P. American Journal of Epidemiology, February 1998; vol 147: pp 232-239.

Hurwitz, E. American Journal of Epidemiology, November 15, 1999; vol 150: pp 1107-1116.

Marshall, P. Psychosomatic Medicine, July/August 2002; vol 64: pp 684-691.

Postolache, T.Molecular Psychiatry, October 2005; pp 232-238.

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