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Symptom cluster

Mood and neuropsychiatric symptoms

Depression, anxiety, and sleep changes with biological roots. Not simply a reaction to being unwell. This page covers: Depression, Anxiety, Elevated neuropsychiatric risk (incl. reported suicidality), Insomnia / sleep disruption, Post-traumatic stress (esp. post-ICU).

What causes it

The leading explanations, each with its evidence grade and audit status.

Neuroinflammation / microglial activation produces Depression.

grademoderateauditwell-founded-mechanism
sources: S124, S125

Gut-serotonin axis produces Depression.

grademoderateauditwell-founded
sources: S125

HPA-axis / circadian cortisol dysregulation produces Depression.

gradelow-moderateauditcontested
sources: S123, S126, S128

Neuroinflammation / microglial activation produces Anxiety.

grademoderateauditwell-founded-mechanism
sources: S125, S127

Dysautonomia / autonomic dysfunction produces Anxiety.

grademoderateauditwell-founded
sources: S128

What has been tried

No treatment is approved. Each row shows how strong the evidence is, what it was measured on, and any safety or conflict flag.

Antidepressants / SSRIs relieves Depression.

gradelow-moderateauditthinendpointpatient-reported-outcome
sources: S129

Treat the biological substrate (anti-inflammatory, sleep, POTS, pacing) manages Elevated neuropsychiatric risk (incl. reported suicidality).

gradelowauditthinendpointpatient-reported-outcome
sources: S129

CBT / CBT-I (supportive) manages Insomnia / sleep disruption.

grademoderateauditwell-foundedendpointpatient-reported-outcomesafetysupportive not curative
sources: S129
Under review

Mood symptoms are predicted by neuroimmune pathways. Supportive CBT is well-founded; curative-framed CBT carries the manufactured-authority and contraindication flags.