Intro
With the increasing amount of mental health concerns, there is a growing awareness surrounding the significant impact mental health disorders have. With efforts and awareness being focused on management techniques, this leaves the root cause of these mental health concerns unaddressed. Commonly, the root of mental health concerns is in the status of the gut! This post dives into the lesser-known contributors to mental health disorders!
Do you have depression, or do you have a symptom?
The single best way to approach mental health is to look at it for what is... a symptom. I certainly do not aim to downplay the severity of what some are experiencing, because I have experienced these myself, and I know how crippling they can be. A symptom is simply the way our body communicates with us to let us know something is off. Depression, anxiety and other mental health disorders are just that.
The best thing someone with a mental health concern can do is to change their vocabulary and perspective. Rather than saying "I have depression," try saying "depression is presenting." Separating oneself from a symptom leads to significant changes in perspective that are more congruent with healing. This is true for all symptoms; however, it is particularly important with mental health since this can influence one's mindset. The next step is to investigate what the symptom is rooted in.
Gut - Brain Connection
Starting simple, proper digestion is what allows the body to access nutrients from consumed food. If stomach acid is low, enzyme production is hindered, bile is not released and/or other forms of reduced digestion are present, then the body cannot efficiently absorb nutrients that are needed for mood, energy, hormones, neurotransmitters and more.
Amino acids are the "building blocks of life." They are what make up protein, and this is why protein is so important for good health. Once protein enters the stomach, stomach acid (HCL) and enzymes cleave it into smaller chains of amino acids. From here, the smaller chains move into the small intestines where they meet enzymes released from the pancreas to further break them down into individual amino acids. Finally, microvilli in the small intestines absorb these amino acids while other cells metabolize and use them locally. Chronically low stomach acid (from medication or otherwise), inadequate digestive enzymes and decreased bile production are common ways that disrupt this crucial process.
There are 20 amino acids, but only 11 amino acids can be synthesized by the body, and these are classified as non-essential. This leaves nine amino acids that cannot be synthesized by the body and therefore must be obtained from diet - these are called essential amino acids. Tryptophan, phenylalanine and histidine are particularly important essential amino acids as it relates to mental health.
Tryptophan - Tryptophan is needed to produce serotonin (a neurotransmitter for elevated mood) and melatonin (a sleep hormone and pancreas antioxidant). In fact, 95% of the total serotonin produced by the body is made in the gut*1. Tryptophan must convert to serotonin first in order to later be converted into melatonin. Additionally, serotonin is needed for efficient gut motility. Serotonin deficiencies are common with depression, insomnia/sleep disturbances and constipation. If tryptophan is not properly digested, then it can lead to a process called putrefaction where it essentially "rots" and is converted into indican. This elevation of indican not only robs the body of the building block for serotonin and melatonin, but also causes bloating, gas, anxiety, inflammation and other digestive distress.
Phenylalanine - Phenylalanine is the precursor to multiple catecholamines responsible for motor control, muscle contraction, cognition, emotion, memory processing, focus, endocrine modulation, motivation, pleasure, satisfaction and happiness. Improper digestion of this amino acid prevents all of these wonderful feelings and is commonly misdiagnosed as "depression, anxiety" or even being called "lazy."
Histidine - Histidine is important since it converts into histamine. Histamine is generally poorly misunderstood. While histamine is involved with allergic responses, it primarily functions as a neurotransmitter. Histamine has roles in regulating sleep-cycle and wakefulness, motivation, goal-oriented behavior, appetite, short-term memory, smooth muscle contraction of the respiratory tract, regulates immune responses and can stimulate inflammation. Imbalanced histamine has been found to be play a key role in addictive behaviors and degenerative disease such as Parkinson's and Multiple Sclerosis*2. Commonly, over-the-counter histamine blockers are used when histamine symptoms present, but consequently the benefits of histamine are lost.
Nervous System and the Gut
Neurons are cells found in the brain and nervous system that orchestrate signal transmission. The brain has 100 billion neurons and the gut has 500 million. These nerves are connected via the nervous system. The vagus nerve is one of the largest nerves that connects the gut with the brain and sends signals in both directions. Stress (elevated cortisol) inhibits the vagus nerve and leads to gastrointestinal dysfunction by disrupting this connection. Additionally, stress shifts the body out of the parasympathetic state (rest-and-digest) and into a sympathetic state (fight-or-flight). With this shift away from homeostasis, certain processes such as digestion, hormone production and immune function are suppressed. Not only does this result in a shift in mood and perspective, but chronic suppression of these systems has a negative influence on gut health.
Microbiome and the Gut
Healthy gut function is linked to normal central nervous system (CNS) function. Emerging studies focused on variations of microbiome and its effect on the CNS, have found that it can cause anxiety, depressive disorders, schizophrenia and even autism!*6 With the overuse of antibiotics and exposure to toxins, such as pesticides and herbicides, having a less-than-favorable microbiome is becoming "normal" in America. With this increase in dysbiosis, mental health disorders are becoming equally common.
The microbiome is home to trillions of microbes. Studies show that bacteria outnumber human cells by up to 10:1! More modest estimations put the ratio at 1:1. In either case, humans are at least 50% bacteria! With such a considerable amount of our make-up, their influence on health cannot be ignored.
The bacteria in our microbiome produce many beneficial chemicals that influence brain function; one in particular is a Short-chain Fatty Acid (SCFA), such as butyrate, propionate and acetate. These essential nutrients are the byproduct of bacteria in the gut when they consume fiber. SCFAs offer benefits such as being anti-inflammatory, immunoregulatory, anti-obesity, anti-diabetes, anticancer, cardiovascular protective, hepatoprotective and neuroprotective*3.
While beneficial bacteria play a role in our health, opportunistic and pathogenic bacteria play a role in disease. With chronic infection, or sub-clinical microbial overgrowths, the immune system is chronically burdened. This leads to chronic inflammation that is associated to brain disorders like depression and Alzheimer's*4. Also, gram-negative bacteria (generally recognized as "bad" when elevated), produce an inflammatory toxin called a Lipopolysaccharide (LPS). LPS causes hyperpermeability in the gut (leaky gut), which allows it to cross into global circulation where it can cause Blood-Brain-Barrier (BBB) hyperpermeability (leaky brain). Elevated serum LPS has been associated with type 2 diabetes as well as brain disorders such as severe depression, dementia and schizophrenia*5.
How to Heal
As you can see, mental health is much more complex than taking a medication, seeing a therapist, or meditating. While each of these offers benefits, many times the clinical presentation of mental health disorders is the result of something deeper. Targeted supplemental and nutritional intervention is a great way to find quick relief. Proper investigation with a Holistic Health Practitioner or Functional Medicine Practitioner will identify the cause of the symptom and provided a specific path forward to truly heal the body so that the symptoms (mental health disorder) cannot exist.
For relief here are some great options:
5-HTP - This is a precursor to serotonin and melatonin but is a metabolite of tryptophan. The benefit of supplementing with this intermediate metabolite is that it cannot be putrefied and converted into indican, but rather continues to be metabolized into serotonin then melatonin. This should help with improving mood and sleep.
GABA - Another amino acid that helps shift the body out of a sympathetic (fight-or-flight) state and into a parasympathetic (rest-and-digest) state. This usually improves calmness, mood, and focus.
L-Dopa (Mucuna) - This is another intermediate that is metabolized into dopamine and other catecholamines. This can help with feeling motivated and focused.
bifidobacteria longum 1714 - This is a specific bacterium that has been classified as a "psychobiotic," due to its role in supporting brain health and the gut-brain axis. In fact, a 4-week study of supplementing with it showed reduced stress, improved memory, reduced mental fatigue, and positive brainwave activity.
Conclusion
Mental health is much more complex than a serotonin imbalance. Many factors influence mental health, with gut health being a large contributor. To share my personal struggle with mental health, I struggled with depression, dark thoughts, suicidal ideology, panic attacks and more for years. Once I healed myself from Lyme disease, Lyme coinfections and mold illness, the completely disappeared!
If you are struggling with mental health concerns and would like to take a holistic and functional approach to resolve it, just know that there are answers and there is hope!
Source
Serotonergic Mechanisms Regulating the GI Tract: Experimental Evidence and Therapeutic Relevance - PMC (nih.gov)
Health Benefits and Side Effects of Short-Chain Fatty Acids - PMC (nih.gov)
The role of inflammation in CNS injury and disease - PMC (nih.gov)
Breaking down the barriers: the gut microbiome, intestinal permeability and stress-related psychiatric disorders - PMC (nih.gov)
Gut microbiota’s effect on mental health: The gut-brain axis - PMC (nih.gov)
Ryan. I love this article. Super informative and well written and easy to read and understand. As a person with chronic gut issues,bI appreciate your writing this article. Keep on writing and sharing your knowledge.