The link between seasonal allergies and mental health

Seasonal allergies can be miserable. The sneezing, congestion, and itchy, watery eyes can feel like a terrible cold that just won’t go away, especially as pollen seasons get longer and more intense.

Not only are the physical symptoms diminishing, but a growing body of research is also showing a link between allergic rhinitis – commonly known as hay fever – and mood disorders such as tension And depression.

The relationship between allergens and mood disorders “is really under-recognized, not just by the general population but even by health care providers,” said Dr. David A. Gudis, chief of the anterior base of rhinology and surgery at NewYork-Presbyterian/Columbia University Irving Medical Center.

But given that millions of Americans suffer from seasonal allergies, it’s an important link for both doctors and patients to understand, he added, to speak openly about any mental health concerns and to ensure the best possible treatments.

Why might allergies contribute to mood disorders?

Allergies often make us feel bad. They affect our sleep, energy levels, sense of smell, mental acuity and productivity — which in turn can affect our mental well-being, said Dr. Gudis.

“Anytime you don’t feel well, it’s a psychological stressor,” he added.

But because allergic rhinitis is a chronic inflammatory disease, experts believe so inflammation is also to blame.

For example, if someone is allergic to tree pollen and that pollen reaches the membranes of the nose, it triggers the immune system to release a cocktail of substances that can cause inflammation. in the airways of the body And brain.

“Among these substances are proteins called cytokines, which the body produces to fight certain infections,” says Dr. Todd Gould, a professor of psychiatry at the University of Maryland School of Medicine. “These cytokines activate parts of the brain that regulate depression and anxiety.”

It’s not possible to see direct evidence of this in a human study, so researchers have turned to rodents to get a better idea of ​​the mechanisms at play. In a study of mice and rats, said Dr. Gould and his collaborators repeatedly exposed the rodents’ noses to allergens and later dissected their brains. Not only did the rodents show signs of fear, but researchers also found an increase in the production of cytokines in their brains, as well as higher levels of a stress hormone.

What else has the research revealed so far?

While there is no evidence that seasonal allergies alone can cause mood disorders, experts around the world have repeatedly found one connection between the two.

For example, studies in the United States have suggested that there are people with allergies one and a half times as likely to have major depression, a link that is especially strong in women. Observational studies have found that allergic rhinitis is associated with a high risk of anxiety. And researchers in Taiwan have reported that allergic rhinitis was associated with a higher risk of psychiatric disorders in adults.

In addition one small number by studies to have suggested there can be one connection between high pollen counts and suicide risk, although this potential link is still poorly understood.

“We have to keep in mind that suicide risk comes with many different risk factors,” said Christopher Lowry, an associate professor of integrative physiology at the University of Colorado, Boulder, who has studied the link between mental illness and allergies. Future studies are needed to better understand the specific role allergens may play in influencing a person’s behavior, he added.

When should you see a doctor?

When your allergy symptoms are getting you down, it can sometimes be hard to know if you’re depressed or if you’re feeling “ugh, I feel so tired because my body is sick,” said Dr. Philip R. Muskin, a professor of psychiatry at Columbia University Irving Medical Center.

Talk to your allergist or your primary care provider right away if you don’t feel like yourself, he said. Be as specific as possible about your symptoms and their duration. For example, are you sleeping less or losing interest in things you used to enjoy? How long have you felt this way?

You should also talk to your doctor about any allergy medications you are currently taking. It’s important to treat your allergy symptoms so you can find relief, said Dr. Gudis. But you should also know that certain allergy medications can affect your mood.

The antihistamines used in NyQuil or Benadryl, for example, can be sedative and make people feel like they’re no longer there, said Dr. muskin. And oral corticosteroids such as prednisone, which are often used to treat severe allergies, can cause irritability and may increase your risk of developing symptoms of anxiety or depression. Nasal decongestants such as those in Sudafed and Sudafed can cause PE anxiety, nervousness and insomnia.

Patients should also be aware of the risks associated with the allergy and asthma drug Singulair. In 2020 the Food and Drug Administration added a prominent warning on the drug’s packaging about the potential risk of severe behavior and mood changes, as well as suicide, and determined that it should not be the treatment of choice for mild allergic rhinitis.