Season 4, Episode 2: Can Gut Health Affect Mental Health?
Can gut health impact mental health? The short answer is yes! During this episode I cover everything you need to know about the gut brain connection and why this impacts your day to day life. I share how gut health impacts things like your central nervous system, the impact of stress and gut issues, why depression and anxiety can be rooted in your gut and why a happy gut leads to a happy self!
In this episode, we cover:
What is the gut brain connection?
How stress impacts your gut health
Developing depression, anxiety and chronic inflammation
Gut bacteria and brain chemicals
Visceral hypersensitivity and IBS
Brain health and your gut health are connected
Regulating your nervous system
What if you could develop vital skills to help manage intrusive IBS symptoms in only 10 minutes a day? How would your life change? Today’s episode is sponsored by Mahana, an app that teaches you skills to manage your IBS and decrease symptom severity. Through the app, you’ll get short daily lessons and experiment with new skills, unlock tools to support your symptom management, and learn to make small changes to improve everyday patterns. Get started now and download the app at mahanatx.com/TheGutShow.
Don’t forget to connect to others in The GUT Community, a Facebook group for those with IBS and digestive disorders to support one another and dive deeper into each episode together.
Can gut health impact mental health? The short answer is yes! The long answer is going to be covered in today's episode.
Before we get into gut health and mental health, it's important to establish why this connection can even happen, and that's because of the gut brain connection. This connection is also called the HPA axis and is a bidirectional communication pathway between the central nervous system located in the brain and the enteric nervous system located in the gut. This all happens alongside the vagus nerve, which is the longest cranial nerve in your body.
In addition to what we know about the gut brain access and gut brain communication, there's also a new kind of proposed microbiota gut brain access to include the role of the gut microbiome, not only as part of the gut side of the communication pathway, but also kind of on its own, and how there might be a three way connection going on. As we talk today, I'm including the gut microbiome and the role of microbes in the gut, but know that you may see this term referred to or through research or through even online searches, and that's what that is referring to.
So kind of explaining a bit more of this communication, because it's bidirectional, there are impacts on the brain from things that happen in the gut, and there are impacts on the gut from things that are happening in the brain. And that's likely due to the fact that these nervous systems are mimickers of one another. So the enteric nervous system is like a smaller central nervous system and has the same makeup of like neurons and communicators, and all of these different pieces, but it's a smaller version of our central nervous system, which is kind of our main system in the body, communication system, it's controlling what all is going on, and how things are functioning.
Since these do mimic one another, they can work together, but they can also work independently of one another, and that's why the gut got that nickname, the second brain that you hear it referred to often. That's not because it's powerful or anything like that, it's because it really is like a second version of this central nervous system, which is fascinating!
I'm going to talk a little bit about what can happen from the brain side, as well as the guts side to show how these things can impact one another and then we'll also get into more about mental health and gut health and kind of that next level, because the communication is more this foundational piece, but the health of each and how they can impact changes in the other, that's kind of the second layer and how this communication may go wrong or because this communication pathways is set up, there may be connections that aren't really meant to be connected or in an ideal world, maybe they wouldn't be as connected. So we'll go over all those details!
Whenever you activate the HPA axis, during like psychological stress or physical stress, we know that this can alter the composition of your gut microbiota, and increase gut permeability. Now what that means is when we alter the makeup of your gut microbiota and your gut microbiome, this can lead to an unideal balance of beneficial and not so beneficial microbes, or just low quantities of everything overall, we refer to that as dysbiosis.
Dysbiosis of the gut microbiome is one of the biggest markers of an unhealthy gut. We see this with chronic conditions like IBS, and even in things like IBD inflammatory bowel disease, we also see it with having kind of long term impacts of visceral hypersensitivity and gut permeability and issues like that.
Now, gut permeability, because not only is this makeup of bacteria that's becoming altered going to increase gut permeability, but even the stress itself can increase gut permeability. Now, gut permeability is how permeable or how strong or leaky is the best word because I think it's the one that everyone's familiar with, but it's how much things can get between that gut wall with the body. So your gut wall and your gut lining is meant to protect what's in your actual body from the things that are coming in from the outside environment as you eat, drink, breathe, whatever you're doing.
In an ideal gut states or an ideal gut wall state we want your body to be able to let in like the nutrients, the water, the things that actually wants to come into the body, but also keep out the things that we don't want and we want to keep out. That is what we want and that's ideal. Now if the gut can become more permeable, so either the tight junction proteins that are linking together like a kind of like the Red Rover Red Rover game that we played as kids, like a chain, if those become less tight, then that's going to create space. But this can also happen from the like mucous layer of the gut can kind of get degraded, and even the makeup of bacteria that kind of lose their their strength and their guard a bit. This makes the gut less strong, less tight, less secure, which leads to more permeability.
Now there is a lot of talk about leaky gut, right? And that's something that's a hot topic online. What we know about gut permeability is that this is not a condition. This is not a diagnosis, like if you have leakiness in your gut, or more permeability, that is not a diagnosis, that is a state that can change day to day. You can become more permeable and less permeable. And so what we want to think about is what are some of the contributors to more permeability and how can we address those and be aware of those and utilize those in practice? We have some more science that's being done on measuring permeability, but right now, we don't really have that information available to us.
So bringing that back together, right, activating the HPA axis through stress, whether psychological, physical, any kind of stress that's happening, that is happening from the brain, we have this stress response, and it's the activation of the sympathetic nervous system. When that is happening, the HPA axis is activated and then the gut is impacted by more dysbiosis and increased gut permeability. These are both key factors in IBS and other digestive disorders, as well as digestion symptoms. And so that's something we have to be aware of and might play a role in, maybe not the exact cause of these conditions because we have ruled out stress as an actual cause of IBS, but it can contribute to the symptoms at play and shouldn't be something that's ignored.
Now changes in the gut microbiota. So we're going in reverse, that dysbiosis makeup and gut permeability have also been linked to the development of depression and anxiety due to the altered communication along the HPA axis. So that's interesting, because not only is stress and you know, what's happening with the stress response impacting the gut, but that impact it's having, or other things that are also causing that impact, that is contributing to anxiety and depression and changes in mood, which can then worsen stress and perceived stress and then kind of create this cycle.
What also can happen is chronic inflammation. Now, with inflammation, that is likely due to the gut permeability piece, because if things are coming into the body that aren't meant to, there is going to be some low grade inflammation as the body's kind of responding to that, right, that's probably what's happening. And we're gonna get more into that, which is really interesting, and how that inflammation changes the brain, but when your body is in a state of inflammation that increases stress in the body, because it's not something that, our bodies are not meant to function in a state of chronic inflammation. That's why metabolic disease and different disease states can happen from inflammation, it's because our bodies are not meant to function there. And so a lot of the processes in the body start to shift, and that stress response might be more activated.
So that is what we refer to as this gut brain cycle that we see with those with IBS, we see with those with other digestive disorders. It’s somewhere people can really get stuck and start to spiral really quickly. Now, research has shown that exposure to stress early in life, so like childhood stress, childhood traumas, whatever it may be, can actually increase susceptibility to stress long term, because the HPA axis becomes what they call abnormal. And that also can put an individual at risk for kind of this chronic gut dysbiosis and IBS.
So this part is something that still needs to be explored more, it is new, it's not like it's, you know, robust research yet. But what that shows me is that we have to be aware of the holistic view of someone's life, right? If you had a lot of stress in childhood, whether that be like two traumas that you were going through, or the family that you were raised in, or whatever it may be, what childhood looks like, you may be more susceptible to stress. So you might be more susceptible to the stress gut cycle and you may also, because of that stress in childhood, when the gut microbiome makeup is really developed, that happens in early childhood development, where like your like ideal kind of fail safe standard what do you call it, you know, we restart something, right? Reboot it like it kind of goes back to that those preset settings, that is developed in childhood and so you have early childhood stress and chronic stress and childhood when you're developing this makeup of bacteria and then if you add on to that different lifestyle diet behaviors that might have also contributed to more dysbiosis, then that's something that you're probably going to be working against in adulthood and something is just helpful to be aware of, because it'll help us understand you better and understand how we might be addressing everything that's going on.
So in reverse, your gut bacteria, so those microbes living in your gut, they can actually produce brain chemicals alongside the HPA axis called neurotransmitters, which you've probably heard of before, they're some of the main communicators from the brain. Your microbes are also producing neurotransmitters, specifically, dopamine, norepinephrine, GABA, and the precursors to serotonin. And we're going to talk about that a bit more, but most of the serotonin is produced in the gut. And so what that is saying is that if we have alterations or changes in these neurotransmitters, and how they're produced and their, kind of their activity, and what they're doing in the body, this can directly impact how you feel.
So these neurotransmitters are not only just communicating, they can alter mood. And so for those with IBS, specifically, or other digestive disorders like IBS, this means that gut dysbiosis may be leading to some of those feelings of anxiety and/or depression, stress, altered mood, any of those things.
Now, it's very hard to measure this again, right, the science is still coming and there's still a lot to understand so that's not going to be true of every single person, but it can explain why those who are dealing with digestive disorders not only are experiencing stress and changes in mood because of the quality of life and what they're dealing with, but it might explain why they might be even more susceptible to that and why mood might be something that feels more up and down, it feels like something you're kind of working against and again, brings you back to that that cycle and that feeling stuck kind of place, right?
We also know that your gut bacteria not only produce neurotransmitters, but they can also produce short chain fatty acids that includes butyrate, propionate, and acetate. Now these can affect brain function, which is interesting. So the short chain fatty acids are more so involved in other processes in the body, but they can also impact brain function. One example of this is that propionate can actually reduce appetite, and is involved in that process. So it is interesting how these can act almost like hormones, and how they can affect different like sensations and communications and signaling in the body.
So mot only our gut microbes, you know, producing neurotransmitters and impacting mood, they're producing short chain fatty acids, which can also kind of alter brain function and kind of make communication signals off, they're also metabolizing, bile acids and amino acids, and produce other chemicals that can impact the brain. And so there's a lot going on here and that this is where that gut microbiota, gut brain axis piece is really coming out is that it might not just be the gut, it might be these microbes and they're probably the key communicators on this gut side or even on their own as like this third party that's impacting how all these things are running and functioning, which is interesting.
So another interesting connection here with the gut brain communication pathway is this phenomenon called visceral hypersensitivity. So we see this most with IBS. It's one of the markers of IBS, but it is an issue with signaling and kind of nerve sensations and pain response. So what happens is, whenever food is moving through your GI tract, your gut muscles are moving through peristalsis. Whenever food comes in, they stretch and then they contract.
If you're expressing gas, you know, that is expanding your GI tract, then the wall. If you're bringing water into the gut through just an osmotic effect that some foods have that's going to expand and stretch that gut wall. For most people you may experience this sensation, you may notice it, but it probably doesn't feel like much right? Most people aren't really noticing these sensations, even that they're happening all all the time. For those with visceral hypersensitivity, these sensations, they signal through nerves, you have nerve endings everywhere in your body, those are the signals of like, okay, something's happened, there's a sensation going on, and it helps tell your body what to do in response. But those nerves can signal that sensation, they transmit that to the brain and say, hey, there's stuff moving restructuring and what the brain does is it miscommunicates the response.
So instead of the response being, you know, some maybe small sensation that you feel, the brain actually communicates pain and usually this is severe, significant pain, and that is visceral hypersensitivity. So you're more sensitive to those sensations. It's not that your sensations are more extreme, always, but it's that you are more sensitive to the sensations. And this is something that we've seen as a response of potentially the like immune piece of how IBS is developed after foodborne illness. We've seen this from maybe like a signaling because of this altered gut brain communication pathway and what's happening there, potentially this role of dysbiosis, like, there's a lot of questions here.
As of recording this episode, I haven't found any clear research of exactly why this happens, if you have, please share it with me, I would be happy to go deeper into that. But it is an interesting piece, it's something that does highlight his gut brain communication pathway and how this can be altered in those who are living with digestive disorders in certain conditions.
So wrapping this up in terms of does gut health impact mental health? Yes! It's not this perfectly cleanly tied bow that if you have an unhealthy gut, that you have mood disorders, or that if you have something going on with your brain, like your gut is altered, that there is this kind of complex weaving, pattern and connection and relationship between both, or they may go hand in hand and a lot of people.
Now is it the chicken or the egg, which one comes first, that isn't always known, because there's two sides of that coin. And likely, the history itself is probably pretty complex, but if we can start peeling back some of those layers, we might be able to figure out maybe what the biggest trigger was to start. Honestly, it doesn't matter when it comes to treatment and strategies and how to address it, we want to make sure we're taking care of the health of both in order to get the results that you want. So yes, they're connected!
So going beyond just mental health, I also want to talk about the connection to brain health, which is a little bit different, so less about mood and function, but about the actual health of the brain. The gut brain axis is also connected through the immune system, and most of your immune cells are actually found in your gut. Speaking on gut brain connection, your immune system is also connected part of this.
When the immune system is activated for a period of time, even in low levels of inflammation that we see in those states of increased gut permeability, this can lead to inflammation in the brain, which is one of the top causes of depression and Alzheimer's disease, as well as other neurodegenerative diseases. What's fascinating is that there is almost, they call it the gut barrier blood brain barrier connection. Like that's probably what's happening and the science behind it is a bit above me and what I understand fully, and so again, if you know, even more, please comment and share, I would love to continue talking about this with others in this community and on the science side, but we do see this connection, which is fascinating.
We also know that some bacteria in the gut, they can produce lipopolysaccharide, or LPS. This is a toxin that can actually cause inflammation, if too much passes through the bloodstream. So, more permeability, here these bacteria since opportunistic bacteria are producing LPs, you get this permeability. LPS is moving into the bloodstream, and this can create and this has been associated with brain disorders like depression, dementia and schizophrenia. So it's very interesting and this focus on LPS has been kind of higher recently. It's something I've been seeing a bit more research. I think it's an interesting piece that maybe will be a part of the assessment of the gut and the brain in the future.
Some other things that we want to think about and some things that we want to keep in mind with this whole gut health, mental health, brain health piece is that not only can your brain impact to your gut directly, and vice versa, but there can be a link to the symptoms that you're experiencing, and how those impacts your brain and your gut, and a secondary and tertiary, third way of fashion. So anxiety, a common issue that a lot of us deal with, because of the world that we live in work, whatever else may be going on, one of the symptoms of anxiety is actually nausea, which can also feel like an upset stomach, and this overall, like unwell feeling. And so for those who are, you know, maybe you have a history of digestion issues and a digestive disorder, this can spark skipping meals, going to safe meals, having that fear of what if, and these behaviors can further issues with the gut and digestion. So it might be that there's anxiety, there's stress, nausea on well feeling leads to these behaviors, these behaviors cause more gut symptoms, gut symptoms, increased nausea, increased anxiety and stress and you're back in that cycle in a secondary way.
We also know that having digestive symptoms can lead to panic and anxiety and stress. Anyone who has dealt with digestive issues and even short term if you've had even like a foodborne illness or a stomach virus or something like that, you know, the stress and the panic and the anxiety that can come from that. And if you've had these experiences, often, that actually create some things in your brain, these pathways that when you have even the smallest amount of symptoms, your brain is triggered to believe that something bad is going to happen. And that panic and anxiety might be triggered even more, this can lead to feelings that are associated with mental health conditions and then those feelings like those responses can then impact the gut. Again, back to that cycle, that can be really difficult to get out of.
The good news, because that might feel like bad news, but it's not, it's interesting, the body is beautiful. It's an incredible, and these connections tell us a lot about why things are happening in our bodies. And so the good news is that because the brain and the gut can impact one another so significantly, we can also impact both as we develop habits for both and some of these habits, they do have that twofold effect, which is really beneficial. And what I've seen the most is really strong clear routines that help the body function and help it get into a state of kind of homeostasis, and ease. That's gonna come most from consistent balanced meals, from movement like consistent movement, stress management strategies, and nervous system regulation.
When I'm talking about stress management, on the foundational level, that includes getting sleep, rest, setting boundaries, finding joy, and finding mindfulness in your day to day. This is where meditation, hypnotherapy, like those things may come into play, but even these like therapies and these more kind of advanced techniques, they don't do as much if we don't have the baseline of sleep, and mindfulness and joy and boundaries in our lives. So that is something that you can do that seems kind of simple in a way, but can impact the brain in the gut so much.
When we talk about nervous system regulation, this goes hand in hand with stress management. But this is really about regulating that parasympathetic nervous system and sympathetic nervous system state. So the sympathetic nervous system state is your body's stress response. The opposite of that you can it's a light switch, right? One can only be flipped at a time, the opposite is rest and digest mode, and that's where we want to live most of the time, but many of us live in this sympathetic nervous system state most of the time. So with nervous system regulation, some things that can help our breath work, this is something that can help like in the moment and way to kind of take the body through that shift and that regulation, exercise is key and even completing stress cycles, and then taking breaks like being really intentional about breaks. So a little bit like the stress management piece about self care. This is the intentional slow down rest, in addition to all of those other strategies, in addition to these things, something the other pieces that can really help with both or diverse intakes of fibers to really help combat that dysbiosis affecting the gut and eating enough, which is so basic sounding and something that is very much underrated, I believe, when it comes to gut health and even mood and brain health is just making sure that you're eating enough.
Now all of this can be done through one to one care with someone that you trust, a good health professional that's looking at all these pieces like what we do at Gutivate, myself and my team of dietitians, so if you're interested in that, you can schedule a consult, I would love to talk with you to see if we could help. That is something that you want to be looking for if you're working with anyone on your mood, or your gut or all these pieces, it's like, okay, are we looking at this holistically? And really thinking about strategies that we can use that are really going to make a difference, not just the sexy strategies and the supplements and the fun things, but also the core foundational important things. We cannot overlook those because that will help get out of the cycle and get into a place of kind of steadiness, which is what you want.
I hope this was a helpful conversation! If you have any questions about this, or you want to go deeper, please connect over on Instagram. I've gone deeper throughout the whole week, so if you have anything else that you want to add or go deeper on please let me know so that we can do that in that community!