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Sad in the spring? Allergy-mood link is real

You know spring has sprung when hundreds of people daily turn to Twitter to vent about their itchy eyes, dripping nos...

Posted: Mar 23, 2018 1:31 PM
Updated: Mar 23, 2018 1:31 PM

You know spring has sprung when hundreds of people daily turn to Twitter to vent about their itchy eyes, dripping nose and uncontrollable sneezing and coughing.

Seasonal allergies, which affect about 36 million Americans, aren't just an annoyance; many doctors agree that there is a real connection between allergies and mood.

Experiencing an allergic reaction is a risk factor for developing depression

Antihistamines can also contribute to sleep disturbances and grogginess

Allergy shots are the only long-term option for nixing the symptoms of allergies

"'Cranky' is really the best word for it," said Katie Ingram, 30, of Alexandria, Virginia, a triathlete who has seasonal allergies. "I take a lot of medication for it, and that makes me sleepy. And I can't do a lot of the things that I like to do outside, so that makes me cranky. ... The wheezing part of it makes me feel tired."

In some people, such annoyances are more serious. Research has shown that there is about a 50% increase in the risk for depression in a person suffering allergies, and if you've been seen by an allergist, that about triples the likelihood of having depression, said Dr. Paul Marshall, neuropsychologist at Hennepin County Medical Center in Minneapolis.

Those are correlations found in scientific studies, but they don't show that allergies cause clinical depression. In practice, allergy-connected mood changes usually boil down to mild depressive symptoms, like feeling sad, lethargic and fatigued, Marshall said. Some people say they're more likely to cry during the allergy season. Allergies could make symptoms even worse in a person with clinical depression, experts say.

"It's important for people to understand that experiencing allergies can affect their mood," Marshall said.

That's not to say that all people with allergies have depression or that all people with depression have allergies. But experiencing allergic reactions does seem to be a risk factor for developing depression -- not necessarily the emotional side of the condition but more physiological symptoms such as low energy.

But is all of this in spite of the use of antihistamines or because of it? And is it the actual allergic reaction that causes these symptoms or just the sleep disturbances and general discomfort?

The biological response

An allergic reaction is an immune response that releases cytokines, protein molecules used in communication between cells. When they signal the brain, they induce the feelings of sickness, or being "mentally drained," that often accompany the flu. This cytokine release isn't as powerful in allergies, but it's still present, Marshall said.

A 2002 study Marshall led, published in the journal Psychosomatic Medicine, found that allergic reactions to ragweed pollen cause "significant fatigue and mood changes" in at least some patients. Research that Marshall collaborated on in 2000 found that such reactions could cause slowed speed of cognitive processing.

Dr. Teodor Postolache at the University of Maryland led a review published in 2008 of the association between suicidal indicators and allergies. Postolache's group noted a peak in suicide rates from April to June and the dramatic environmental change of pollen that occurs during that time. The researchers found correlations between depression measurements and allergy symptoms in relation to the seasonal severity of tree pollen. In women, the association is stronger between allergy, depression and suicide than in men, perhaps because allergy and depression are more common in women anyway.

Postolache's group has also explored cytokines that may be involved in triggering fatigue, hypothesizing that the allergic reaction is the direct biological cause of low mood.

This parallels what happens when stress gets you down too, Marshall says.

A side effect?

Alternatively, low moods during allergy season could be situational -- the result of all the sneezing or side effects from medication.

Studies show that people don't perform as well at school because of allergic reactions, and adults' performance at work suffers, says allergist Dr. Robert Overholt of Knoxville, Tennessee. These problems could exacerbate depressive symptoms, he said. That, combined with sleep disturbance, could make people feel unwell.

Overholt doesn't believe the allergic response inherently triggers depression but says it could circumstantially make existing depression worse.

"It would jump onto depression but wouldn't be the cause," he said.

Antihistamines themselves can also contribute to sleep disturbances and grogginess, he said.

Side effects of allergy medications can contribute to irregular sleeping patterns that increase irritability. The major antihistamines in pill form are now sold over the counter -- Allegra, Claritin and Zyrtec -- but they help only with sneezing, unless specified as the "decongestant" form. The added decongestant benefits come with a price, though. The same chemicals that ease your throat could lead to insomnia, put more stress on the heart and lead to prostate problems in some men, Overholt said.

Erik Fisher, a clinical psychologist in Atlanta, sees more people fatigued this time of year but isn't flooded with patients with allergy-fueled depression. He does see that allergies wear patients down, though.

"Once you realize what's causing your moods, it helps people feel less stressed out," Fisher said.

Children in particular are more susceptible to vast swings in moods and behaviors related to allergies because their bodies are more sensitive, Fisher said. In some kids, when allergies overwhelm the system, they have more temper tantrums and a harder time getting to sleep.

The bottom line, though, is that people shouldn't blame their allergies for deeper emotional issues, says Dr. Michael Silverman, assistant professor of psychiatry at Mount Sinai School of Medicine in New York. Even if some people have a direct mood response from allergies, that's not always the best explanation for feeling down.

"There's so much stigma associated with mood disturbance and anxiety that patients try to grab on to anything they can to explain what's going on," he said. "Allergies could be aggravating a problem in their lives they don't want to deal with."

What to do?

Several types of medications are available to treat allergy symptoms, including pills, liquids, inhalers, nasal sprays, eye drops, skin creams and shots. Most work by modulating the body's response to the perpetrating allergen, either by blocking histamine -- a chemical released by the immune system during an allergic reaction -- or by reducing inflammation through the use of steroids, according to the Mayo Clinic.

Some are also combined with a decongestant, such as pseudoephedrine, to relieve nasal and sinus congestion.

Many allergy sufferers also find relief in over-the-counter products such as the neti pot and other nasal rinses for sinus problems.

But the only way to get more complete, prolonged relief from allergies is to undergo desensitization or "allergy shots," Overholt said. After an initial test to see what specific plants affect the patient, a doctor would administer small doses of the offending pollen or other substance under the skin over the course of three to five years.

At the end of that time, protection from allergies lasts another three to five years on average, with some people coming out allergy-free for life and others getting relief for only a year or two.

Ingram is considering allergy shots. In the meantime, she vacuums every day, takes more showers, washes the sheets more and keeps the windows closed. Her husband, who doesn't have allergies, brushes the dogs more in the spring.

"My allergies are so bad right now, I would happily claw my eyeballs out with toothpicks to make that feeling go away," Ingram wrote on her blog.

Indiana Coronavirus Cases

Data is updated nightly.

Cases: 614946

Reported Deaths: 9807
CountyCasesDeaths
Marion849231342
Lake45784693
Allen33103560
Hamilton29752316
St. Joseph27572383
Elkhart24496346
Vanderburgh19679255
Tippecanoe18150144
Johnson15234296
Porter14970172
Hendricks14550253
Madison11071223
Clark10852145
Vigo10819185
Monroe9496115
Delaware9193136
LaPorte9173164
Howard8325148
Kosciusko811485
Warrick683399
Hancock6783106
Bartholomew6659100
Floyd6522113
Wayne6194164
Grant6050118
Dubois559081
Boone557968
Morgan551996
Henry512365
Marshall507884
Dearborn488745
Cass487864
Noble476159
Jackson428747
Shelby423381
Lawrence395180
Clinton375845
Gibson375560
Harrison354046
DeKalb351365
Montgomery349754
Knox337839
Miami325244
Steuben315846
Whitley313126
Wabash306951
Adams303636
Ripley301646
Putnam299152
Huntington295760
Jasper293035
White275943
Daviess271776
Jefferson267738
Decatur249983
Fayette249949
Greene242763
Posey241828
Wells237551
LaGrange230363
Scott227939
Clay225032
Randolph215848
Jennings200937
Spencer193622
Sullivan193633
Washington189023
Fountain185227
Starke177044
Jay168723
Owen168338
Fulton165430
Orange161035
Carroll160616
Rush156418
Perry156129
Vermillion150034
Franklin149933
Tipton134433
Parke13098
Pike118826
Blackford112023
Pulaski97937
Newton92621
Brown88835
Benton87110
Crawford8099
Martin75013
Warren6867
Switzerland6695
Union6297
Ohio4967
Unassigned0375

Ohio Coronavirus Cases

Data is updated nightly.

Cases: 872918

Reported Deaths: 10856
CountyCasesDeaths
Franklin102616707
Cuyahoga868931154
Hamilton65148455
Montgomery43662420
Summit35411766
Lucas31794634
Butler31451232
Stark26247445
Warren19939144
Lorain19378229
Mahoning17561339
Lake16350161
Clermont16235113
Delaware1463881
Licking13453142
Fairfield1301782
Trumbull12980317
Greene12226144
Medina11798169
Clark11094266
Wood10507158
Allen10031128
Portage9514111
Richland9275134
Miami927273
Marion7512113
Tuscarawas7455186
Columbiana7433124
Pickaway735250
Muskingum714042
Wayne7140172
Erie6253130
Ross5589100
Hancock556292
Scioto545365
Geauga518955
Darke474395
Lawrence464658
Union459130
Ashtabula457973
Sandusky440462
Huron435541
Mercer435590
Seneca435366
Auglaize425166
Belmont423948
Jefferson423969
Shelby422923
Washington396340
Athens38619
Putnam379276
Madison359930
Knox358423
Ashland349638
Fulton341744
Defiance336188
Crawford327274
Preble323637
Brown318821
Logan314835
Ottawa297443
Clinton293944
Highland282219
Williams282267
Jackson266145
Guernsey259326
Champaign254628
Fayette241030
Morrow23594
Perry235518
Holmes227274
Henry222954
Hardin217033
Coshocton208023
Van Wert204445
Gallia200126
Wyandot198151
Pike180918
Adams179815
Hocking174024
Carroll158216
Paulding145521
Noble121040
Meigs110324
Monroe103433
Harrison89821
Morgan84531
Vinton71714
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