Can We Improve Mental Health By Understanding the Gut-Brain Connection?

Have you heard the chatter recently about “gut health” or your “gut microbiome?” You probably know somebody who has to manage autoimmune or stomach issues through diet or medicine. But did you know that our gut health can affect anxiety, depression, and PTSD? Research on the connection between our gut and our brain is gaining research and interest, and we’re paying attention to the mental health implications. This post is designed to be a primer for those interested in more about the gut-brain connection and the role it plays in stress, digestion, and mood. A TED talk, sources, and more resources are linked below.

In therapy we discuss the important pillars of physical health as well as social support, mission and purpose, sleep hygiene and substance use. Together these pillars make up the whole picture of well-being. When one of these pillars is shaky, as so many people with digestive issues or autoimmune diseases know, it makes everything harder.

What gut disorders are connected to those we associate with mental health?

Gut disorders are commonly associated with anxiety due to pathogenic bacteria and inflammation. Since the gut is our largest immune “organ” (70% of all immune cell are in the gut), it is also our first line of defense.

Some examples:

Autistic children have high rates of GI problems, and symptoms are associated with less microbial diversity.
People with schizophrenia and bipolar disorder have increased immune responses to food .
People with schizophrenia have about 5 times the rate of celiac disease.
Early childhood stress is a risk factor for gut disorders because during this important window we are it “programming” our neuroendocrine stress response.

Can a diet that considers the importance of gut microbiome diversity improve our mood and mental health outcomes?

The research points to YES.

We think it’s important for those with gut disorders to address both mind and body, and those with mental health disorders to be sure they aren’t neglecting their nutrition which could improve their mental health symptoms. Information in this post is taken from a fantastic training in Berkeley given on the Gut-Brain connection by Dr. Christopher Lowry at the University of Colorado, Boulder.

The primary goals of a mind-body approach to manage gastrointestinal and mental health symptoms are:

Break the cycle of stress of and inflammation
Strengthen our ability to cope and improve the way we care for our mental health

So what is the “gut-brain” connection?

Think of it as a wellness superhighway that can go “top down” (how your mental state affects your gut), or “bottom up” (how your gut affects your mood). <—- This latter direction is primarily the one that is new and interesting to those of us working in mental health!

There are several examples of how this works. Pathways that detect pain, stress and coping responses are connected via the gut-brain. Another example is that this pathway controls our appetite. A balance between signals from “head factors” and “gut factors” influence what we eat and when.

Top Down Examples: (the mind affecting the gut)

Stress increases the permeability of the gut and aggravates the “visceral hypersensitivity” (increased pain) associated with inflammatory bowel syndrome and heartburn.

Bottom Up Examples: (the gut affecting the mind)

Nerves carry information related to digestive function, satiety, pain, inflammation etc. to the brain.
Gut microbes travel in the blood from signal hormones released from cells, cytokines released from immune cells etc.

What is the gut microbiome, and why is diversity important for better health?

The gut has trillions of microbes, more than tenfold the amount in the rest of the human body. Most gut microbes are friendly. They make vitamins, ferment things we can’t digest, and collaborate with our gut immune system (70% of the immune system is housed in the gut!)

These microbes influence brain development, including stress responses starting when we are children. For example, animals born without gut microbes have learning and behavior deficits that can be reversed with exposure to microbes. Some autistic children see behavioral improvement with fecal transplants which increase the diversity of bacteria in the colon. These are the same microbes seen as benefit to vaginal deliveries (as opposed to C-sections, because babies are exposed to microbes in the birth canal), and for those who have pets in the home. Exposure to microbes is a generally positive thing and associated with lower levels of asthma and allergies.

Low microbial diversity is associated with gut inflammation, metabolic syndrome, and pathogenic bacteria.

A plant rich diet with a variety of foods (30+ per day) increases the diversity of the gut microbiome. It is not about quantity, but about variety. Dr. Lowry personally blends 30 plant foods (herbs, greens, vegetables) in a blender and drinks a small glass every day!

Stress and Its Impact On Our Guts

Have you ever gotten so nervous that you gave yourself diarrhea? (What is that about?) The gut is especially sensitive to stress and inflammation. Stress interacts with the gut in a top-down/bottom-up way as well. Gut stress increases brain stress and vice versa, which can lead to a vicious cycle.

Chronic stress can take the immune system off track. By increasing inflammation in the body, it can increase pain, depression, and cognitive impairment. It can also increase GI symptoms and supress immunity.

So what to do if you have a gut issue, or a mental health issue?

If you have a gut disorder, autoimmune disorder, or other physical symptoms related to digestion, seek consultation with a physician, follow their recommendations, and manage your stress and mental health. Seek therapy that teaches mindfulness, stress management, and cognitive behavioral therapy. Find social support, and meditation and other protective activities.

If you have mental health issues or a desire to reduce mental health symptoms like stress or anxiety, consider educating yourself about how to improve your gut health. Talk with a GI doctor about gut health, and read up — some resources are linked below. If you are otherwise in good health, perhaps a greater diversity of plants in your diet will improve your mood and reduce occasional anxiety, since it seems to lessen inflammation.

The best diets for gut health generally:

Limit refined sugar and refined carbohydrates

Include foods with lots of fiber (only plant foods have fiber, and especially beans and vegetables).

Look into foods with anti-inflammatory properties: ginger, garlic, curcumin (turmeric), and colorful foods — which often have the same substances that serve as pigments.