Chronic Inflammatory Response Syndrome + Mental Health
What is CIRS?
Chronic Inflammatory Response Syndrome (CIRS) is a complex, multi-system illness triggered by exposure to biotoxins, such as mold, bacteria, or other environmental toxins. CIRS occurs when the immune system remains activated and is unable to return to normal after the initial exposure, which can lead to persistent inflammation throughout the body.
Research suggests that inflammation is important in the pathophysiology of mental disorders (Anderer, 2024; Ouabbou et al., 2020) People with certain genetic predispositions are more vulnerable to CIRS because their immune systems struggle to clear biotoxins effectively. The syndrome can result in a wide range of symptoms affecting the nervous, endocrine, immune, and musculoskeletal systems. Common symptoms include fatigue, brain fog, joint pain, headaches, and respiratory issues, though it can vary from person to person.
CIRS is typically diagnosed through a combination of patient history, symptom evaluation, and specific laboratory tests, like those for inflammation markers and immune function. Treatment often involves removing the source of exposure, detoxification, medications to reduce inflammation, and supportive therapies like nutritional support and, sometimes, hormone balancing.
CIRS + Mental Health Manifestations
Chronic Inflammatory Response Syndrome (CIRS) has significant links to mental health, as chronic inflammation affects the brain and can lead to or exacerbate various mental health issues (Dantzer et al., 2011). Because CIRS leads to an ongoing inflammatory response that impacts neurotransmitters, hormone balance, and brain function, it’s common for individuals with CIRS to experience mental health symptoms, including:
Depression: Chronic inflammation can disrupt serotonin production and receptor function, both of which are linked to mood regulation (Dantzer et al., 2011; Lee & Giuliani, 2019). This often results in depressive symptoms, which can include persistent sadness, low energy, and feelings of hopelessness.
Anxiety: Ongoing inflammation may heighten the body’s stress response, making individuals more prone to anxiety. They may feel a persistent sense of unease or panic that is difficult to control. Won & Kim(2020) stated that, “stress-induced changes in the immune system, which lead to neuroinflammation and consequent brain alterations, have been suggested as possible neurobiological substrates of anxiety disorders, with previous literature predominantly focusing on panic disorder, agoraphobia, and generalized anxiety disorder, among the anxiety disorders”.
Cognitive Issues (Brain Fog): Inflammation in the brain affects memory, concentration, and other cognitive functions and can the progression of neurodegenerative diseases. (Cunningham et al., 2005). This can lead to symptoms often referred to as “brain fog,” such as difficulty focusing, forgetfulness, and slow processing speeds.
Chronic and Relapsing Fatigue and Sleep Disorders: Chronic inflammation often disrupts the body’s natural circadian rhythm, leading to insomnia, non-restorative sleep, and chronic fatigue, all of which can worsen mental health symptoms (Clayton, 2015).
Mood Instability: Due to neurotransmitter imbalances, people with CIRS may experience mood swings and emotional instability, making it difficult for them to regulate emotional responses. Maes & Carvalho, (2018) stated that there is significant evidence that a substantial subset of individuals with MDD and BD exhibit an activation of the immune-inflammatory response system (IRS), as indicated by an increased production of macrophagic M1 and T helper (Th)-1 pro-inflammatory cytokines, interleukin (IL)-6 trans-signaling, positive acute phase proteins (APPs), and complement factors”.
Post-Traumatic Stress and Emotional Distress: Since CIRS can lead to physical and emotional debilitation, it can induce stress that may develop into trauma-like symptoms over time, especially if symptoms persist or intensify.
Rage & Irritability: Brain inflammation and the psychological toll of CIRS can contribute to feelings of irritability and sometimes rage.
How CIRS Can Contribute to Mental Health Issues
Neuroinflammation
The inflammation associated with CIRS often extends to the brain. Neuroinflammation can disrupt neurotransmitter balance, particularly those related to mood and emotional regulation, like serotonin, dopamine, and glutamate. This imbalance can make people more prone to irritability, aggression, or episodes of rage.
HPA Axis Dysfunction
Chronic inflammation can lead to dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis(Silverman & Sternberg, 2012), the system responsible for regulating stress hormones like cortisol. With prolonged activation, the HPA axis can become dysregulated, leading to unpredictable spikes in cortisol. These fluctuations are linked to mood swings, irritability, and heightened emotional responses, including anger.
Amygdala Activation
The amygdala, the brain’s emotional center, becomes more reactive when inflammation is present. This heightened amygdala response can lead to a “fight-or-flight” state, where people are more prone to anger or aggression as an instinctual response to perceived threats. Muscatell et al., (2015) examined the associations between neural and inflammatory responses to an acute laboratory-based social stressor. The results of the study indicated that the participants who showed stronger coupling between the amygdala and the dorsomedial prefrontal cortex also showed a heightened inflammatory response to the stressor (Muscatell et al., 2015).
Fatigue and Cognitive Impairment
CIRS often causes fatigue, brain fog, and impaired cognitive function. When people struggle to think clearly and are chronically exhausted, they can become more easily frustrated. This can lower emotional resilience, leading to intense reactions like rage in situations that might otherwise be manageable.
Mood Disorders and Depression
The chronic stress and physiological toll of CIRS can lead to mood disorders, including depression and anxiety, which can manifest as irritability or anger. These symptoms are often compounded by the frustration of dealing with a condition that’s hard to diagnose and treat, adding to feelings of anger.
Managing Rage with CIRS
Addressing the underlying inflammation is essential, often through lifestyle changes, avoiding triggers (e.g., biotoxin exposures), and medical interventions such as binders or anti-inflammatory supplements. Supporting mental health with integrative therapies like mindfulness, stress management, and possibly even magnesium or adaptogens, can also be effective in reducing rage and irritability.
HLA-DR Gene
The HLA-DR gene, part of the human leukocyte antigen (HLA) system, plays a critical role in immune function and is closely linked to susceptibility to Chronic Inflammatory Response Syndrome (CIRS). Specifically, HLA-DR genes encode proteins that help the immune system recognize foreign invaders. However, certain variants of the HLA-DR gene can impair the immune system’s ability to recognize and remove biotoxins, which can lead to chronic inflammation.
Individuals with specific HLA-DR gene variants, particularly those associated with poor biotoxin clearance, are more likely to develop CIRS after exposure to mold, Lyme disease, or other biotoxins.
These genetic variants can hinder the immune system from effectively tagging and removing biotoxins, causing the body to enter a cycle of persistent inflammation. As a result, biotoxins continue to circulate and trigger chronic inflammatory responses even after the initial exposure has ended (Saghir & Ansari, 2024).
In people with CIRS, testing for HLA-DR haplotypes can provide valuable insights into their susceptibility to the syndrome. Knowing a patient’s genetic predisposition can guide treatment, including more targeted detoxification strategies, inflammation management, and lifestyle changes to minimize biotoxin exposure.
CIRS treatment oftentimes includes addressing inflammation. Addressing inflammation on the brain and body are critical for mental health improvement. Treatments often focus on a combination of biotoxin removal, reducing inflammatory responses, and supportive mental health therapies, such as psychotherapy, cognitive rehabilitation, and sometimes medication.
Here at Well Mind Body we treat from a bio-individual approch. We understand that many mental health manifestations have a root cause. We are committed to helping out clients better understand how the mind and body are interconnected and help them improve overall quality of life.
Thank you for being here!
Resources:
Book Recommendation: Mold Illness: Surviving and Thriving: A Recovery Manual for Patients & Families Impacted By CIRS.
