How Inflammation Sucks the Motivation From You: it’s all about the dopamine

by Russell Johnston, June 10 2019

tldr; Inflammation takes a lot of energy etc. So researchers are now saying that to free up that energy, the body make sure you don’t do a lot of other things. It kills you motivation by reducing dopamine levels in your brain until physical effort seems very difficult and nothing seems worthwhile, anyway.

Inflammation sucks a whole lot of energy and resources (nutrition) out of you. Whether the inflammation is a response to a poison (toxin), pathogens (virus or bacteria or fungus), injury or just a false alarm (such as Mast Cell Activation Syndrome.) The body takes these assaults by poisons and pathogens very seriously and is willing to spend whatever it has rather freely on you behalf. But what’s spent in one direction, can’t be spent doing something else. Therefore, many other body functions get short-changed while an inflammatory response is going on. Any inflammatory response.

I sometimes refer to this concept as “The Economy of the Body,” and although I haven’t heard anyone else using that exact phrase, this idea is in the medical mainstream by now. Nations have an economy to juggle, so do households, and so do bodies — they can’t do everything at once, there are always trade-offs. As economists put it, “Whatever is spent on guns can’t be spent on butter.”

An example? The oxygen, sugar, and minerals spent on all the various activities that mast cells trigger, that attack toxins and bugs can’t be spent on DNA repair, so less DNA repair takes place while inflammation is ongoing, and this provides an obvious explanation of the link between chronic inflammation and cancer. You’re not by any means certain to get cancer if you’ve suffered from inflammation for a long time, but it is more likely.

Of course, part of our inflammatory response is fatigue, and even depression. It makes sense that our body/brain wants to keep us out of trouble, particularly if it thinks we’ve encountered a toxin, and might bump into more of the same. But it’s also understandable that our body/brain just wants to conserve energy and nutrients while it gears up for a fight. One way to conserve energy is to lower motivation and get us to do less.

Dr. Charles Raison and Emory’s Dr. Andrew Miller of the University of Arizona have been following this train of thought for many years. They published an article entitled: “The evolutionary significance of depression in Pathogen Host Defense (PATHOS-D),” in the online journal Molecular Psychiatry in 2012. To quote from the UofA press release about that article:

“The basic idea is that depression and the genes that promote it were very adaptive for helping people — especially young children — not die of infection in the ancestral environment, even if those same behaviors are not helpful in our relationships with other people,” he said. “Moreover, significant data suggest that at least some depressive symptoms actually may help people avoid infection or survive it when it occurs.”

Raison serves as CNN Health’s mental health expert and frequently appears in other media outlets as well. He is the 2011 Chair of the U.S. Psychiatric and Mental Health Congress.

Co-author Miller said, “Most of the genetic variations that have been linked to depression turn out to affect the function of the immune system. This led us to rethink why depression seems to stay embedded in the genome.”

The theory provides a new explanation for why stress is a risk factor for depression, and also for the disruption of sleep patterns seen both in mood disorders and when the immune system is activated.

More recently, Miller, Treadwell and Cooper have sharpened the hypothesis. We know from previous research that the brain’s dopamine system, which creates motivation, is directly affected by chronic, low-grade inflammation, and in their May 2019 article in Trends in Cognitive Sciences, “Can’t or Won’t? Immunometabolic Constraints on Dopaminergic Drive,” they suggest that (in my words) our body/brains shut down dopamine in a section of the brain, sharply reducing our motivation to do anything at all, precisely in order to limit our energy and vitamin, etc, expenditures so that our bodies can devote themselves to fighting whatever injury, pathogen or poison (or false alarm) is underway.

In their words:

“the metabolic demands of chronic low-grade inflammation induce a reduction of striatal mesolimbic dopamine that in turn leads to a steeper effort-discounting curve because of reduced perceived ability (can’t) versus preference (won’t) for reward.”

The “mesolimbic pathway” refers to the parts of the brain that make up our “reward system.” Our motivation.

Of course, if you suffer from chronic inflammation, of which there is a lot these days (prevalence is exploding), your lack of activity, interest and effort is easily perceived, both by you and those around you, as a “character problem.” In fact, it’s a sign that you’re making a tremendous effort. But an effort that’s internal and invisible.

Tragically, it also seems that the majority of modern inflammation is also an unnecessary effort. In hEDS and MCAS (Mast Cell Inflammation Syndrome) there are a lot more false alarms than legitimate mast cell (inflammatory) responses.

Parkinson’s is another illness in which dopamine is even more unavailable. It gives us a clue that might lead us to one way we can counter a lack of dopamine. I’ll explain that in my next article.

Meanwhile, here are links to a couple more explanations of the dopamine hypothesis:

How chronic inflammation may drive down dopamine and motivation

How Chronic Inflammation May Hinder Dopamine, Motivation

My previous health article:
How Flickering Lights can Cause an Allergic (MCAS) Response

Full list of my health articles:
https://medium.com/@russjj