Gut Microbiota & Mental Health

Jill Littrell, PhD
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Brain-Gut-Microbiota Axis

There are approximately 1013-1014 microbes in the human being.  Microbial cells are 10 times more numerous than human cells in the human body such that 90% of the cells in the human body are microbes.   Approximately 500-1000 microbial species occupy the human gut.  The microbes perform vital functions for the human host.  Without these microbes, the gut immune system fails to develop.  Harmless bacteria (called commensal bacteria) are needed to compete with harmful bacteria for space and nutrients.  Commensal bacteria degrade dietary fiber into short-chain-fatty-acids which then can be absorbed.  Commensals are required for the absorption of vitamin K and B (Bailey et al., 2011; Dinan &Cryan, 2012).

The composition of the microbiota community is important because some species are highly inflammatory whereas other species are anti-inflammatory.  In almost all human cells there are pattern recognition receptors that recognize “foreign” molecules.  Some foreign molecules belonging to bad bacteria will result in inflammation which gets communicated by the vagus nerve to the brain resulting in negative moods (anxiety and depression as discussed in the next section).  Other foreign molecules associated with good commensal bacteria activate alternative pattern recognition receptors that lead to the release of white-blood-cell hormones (such as interleukin-10) that counter inflammation  (Dinan, Stanton, & Cryan, 2013: Smits, et al., 2005), although the mechanism for how this is accomplished are still being worked out (Geuking, McCoy, & Macpherson, 2011).  The IL-10 (white-blood cell hormone) protects the human gut from any aggressive inflammatory response that might be evoked by a bad bacteria.

The Composition of the Gut Microbiota Influences Behavior

Biologists who work with mice know that there are major strain differences in innate anxiety levels.  Some mice strains are very wary of the novel and readily freeze.  The skittish strains are prone to trepidations and rarely venture forth.  Other strains are fearless and outgoing.  While a good guess might have been that the mice differ in some aspect of the nervous system, turns out that what accounted for the difference between the species was the bacteria that they harbor in their guts.  When researchers transferred the bacteria of the skittish mice into the intrepid mice, the intrepid mice exhibited anxious behavior and showed a decrease in BDNF, a protein required for optimal brain health, in their hippocampi.  When researchers did the reverse fecal transplant experiment, transferring the intrepid mice microbiota into the skittish mice, the skittish mice became daring and showed an increase in BDNF in their hippocampi (Collins, Kassam, & Bercik, 2013).  There were genetic differences between the skittish and intrepid mice driving behavioral differences.   But, the genes had to do with differences in the immune systems not the neurotransmitters.  Immune system differences can determine which bacterial species are eliminated and which are invited to stick around.

The composition of the gut microbiota determines more than depression and anxiety levels.  Gut microbiota influence appetite, obesity levels, insulin resistance (type 2 diabetes), and memory.  In a dramatic demonstration, researchers transferred the gut microbiota from the obese mice to the thin mice.  The thin mice then got fat, even though they had not increased their calorie consumption (Turnbaugh et al., 2006).

Factors that Influence the Composition of the Microbiota

Not surprisingly antibiotics can drastically alter the composition of the microbial community in the gut.  When antibiotics are used to eradicate pathogens in some part of the body, the friendly gut bacteria who keep the nasty bacteria in check are wiped out.  A relatively common occurrence these days is that after a course of antibiotic treatment, Clostridium difficile, a really nasty bacteria, takes over in digestive tract; it’s hard to get rid of.  These days, fecal transplants from a healthy donor are sometimes provided.  The other two major influences on microbiota composition are stress and diet.

Stress Can Alter Microbiota Composition and Behavior

Stressors will increase the release of stress hormones in the gut which will then alter the microbial colonies which will then provoke systemic inflammation (Bailey et al., 2011; Bangsgaard Bendtsen et al., 2012).  (Systemic inflammation means that inflammatory, white-blood-cell hormones are increased in blood.)  Beyond changing the colonies of microbiota in the gut, stress will also alter the tight connections between the cells lining the gut so the lining becomes more permeable to pathogens and to secretions from these pathogens, further contributing to systemic inflammation (Kiliaan et al., 1998).

Diet Is a Major Factor for Determining Microbiota Composition 

Eating fermented foods such as sour kraut and yogurt is good strategy for encouraging the colonization of good microbes in the gut.  Fermented food substance are called probiotics.   Fermented foods contain the good bacteria.  For increasing good bacteria in gut, there’s also the prebiotic strategy (which will be referred to later in reference to why eating apples is good).  Rather than consuming beneficial bacteria directly, prebiotics is about consuming dietary nutrients that will promote the survival of beneficial microbes.

A number of studies have found that administration of the species of bacteria found in yogurt decrease anxiety and depressive behaviors (Bravo et al. 2011; Messaoudi et al., 2011).   In animals, probiotics are also protective against the development of anxiety in responses to stressors (Cryan & O’Mahoney, 2011).  In humans, probiotics narrowed the differences between high and low anxious subjects on stress hormones in the urine (Martin et al., 2009) and decreased anxiety and depression and reduced levels of the stress hormone cortisol in blood (Benton, Williams, & Brown, 2007; Messaoudi et al., 2011; Rao, et al., 2009).  Consumption of probiotics decreased social anxiety in those scoring high on a measure of neuroticism (Hilimire, DeVylder, & Forestell, 2015).  Additionally, Tillisch et al.  (2013) showed that consumption of probiotics resulted in a reduction in activity in the insula while viewing emotionally evocative pictures and resulted in an increase in regulatory control over areas of the brain that respond to emotion.

While probiotics and prebiotics can potentially influence microbiota composition so that distress (anxiety and depressive behaviors) is reduced, other dietary factors will probably reverse the effect.  Consequently attending to the entire diet is necessary if a positive effect is to be achieved.

Encouraging the Wrong Type of Microbes

Generally, high saturated fat and refined sugar promote inflammatory microbes in the gut (Magnusson, Hauck, Jeffrey, Elias, Humphrey, Nath, Perrone, & Bermudez, 2015; Ohland et al., 2015; Trunbaugh et al., 2009).   However, the bottom line is likely to be more nuanced than merely saying that a particular molecule is good or bad.  Spreadbury (2012) suggests that it is not just saturated fats or carbohydrate molecules that should be considered but rather whether these molecules are consumed in the context of high fiber.  Thus, carbohydrates consumed in plant fiber might have a different impact than pure glucose.  In fact, consumption of high fiber foods (apples) change microbiota composition in animal studies (Koutsos, Tuohy, Lovegrove, 2015).    Various bacteria live on fiber and thus eating fruit with fiber is a prebiotic strategy for increasing good bacteria.

Artificial sweeteners have also been shown to alter gut microbial communities in undesirable ways (Suez et al.,  2014).  Atypical antipsychotics also alter the microbiota in negative ways (Dinan, Stanton, & Cryan, 2010).

Chemicals that Extend the Shelf-life of Foods

The food industry adds detergent-emulsifiers to many processed foods.  (Most ice creams are loaded.)  Several of these common emulsifiers (carboxymethylcellulose and polysorbate-80) were tested on mice in research conducted by Chassaing et al. (2015).  The emulsifiers changed the composition of microbiota to less friendly species.  With the change in microbiota composition, the protective mucus layer lining the gut was eroded, bacteria clung to the cells lining the gut, and the gut lining allowed invasion into the blood stream.  Of course, the immune system rapidly responded to the presence of the bacteria and bacterial products.  The results were low grade systemic inflammation, more insulin insensitivity, and weight gain.  The authors of the study speculated that common food additives may be contributing to the rise in inflammatory bowel disease, diabetes, and obesity.  The authors did not measure changes in behavior, but given the research cited here, it’s a good bet that behavioral changes might have been found.

The Serotonergic, Anti-panic Neurons Connection

The “old-friends” hypothesis has been in the literature for a while now.  The idea is that formerly common dietary bacteria such as Mycobacterium vaccae (common in human feces used as fertilizer in some parts of the world) induce the production of anti-inflammatory hormones (IL-10).  IL-10 tames inflammation such that allergies and inflammatory bowel diseases are less likely (Rook & Lowry, 2008).  Additionally, M. vaccae induces a cluster of serotonergic neurons, in the interfasicular part of the dorsal raphe, which are anti-panic neurons (Lowry et al., 2007).  Lowry et al. placed M. vaccae under the skin or into the lungs and showed that mice displayed less anxiety.   Administering M. vaccae orally also decrease anxiety associated behaviors and improves memory (Matthews & Jenks, 2013).  Recently, Lowry et al. (2015) fed mice M. vaccae and then exposed them to a larger, more aggressive animal.  Rather than succumb to the aggressor, the M. vaccae pretreated mice fought back.  In another test of the anti-anxiety impact of M. vaccae, Lowry showed that fearful responses are unlearned (extinguished) much more readily in mice treated with M. vaccae.  Feeding with M. vaccae has been characterized as a way to vaccinate against PTSD (Reardon, 2015).

It should be noted here, that M. vaccae is an aerobic (oxygen requiring) microbe and thus could not live for very long in the gut.  However, its cell membrane contains molecules that are recognized by the “pattern recognition receptors”.  Signaling through the pattern recognition receptor is the mechanism for the increase in the anti-inflammatory hormone, IL-10.

Clarification on Serotonin  

It is important to recognize that serotonin is just another neurotransmitter in the brain.  It is used in both anxiety inducing and anxiety reducing circuits.  (There are distinct sets of connecting neurons.)  Thus, the above should not be interpreted to imply that increasing serotonin is necessarily good or bad, as is sometimes implied by the simplistic story that serotonin deficiency creates depression.   The story on serotonin is reviewed in Chapter 2 of Neuroscience for Psychologists and Other Mental Health Professionals.

The Microbiota Research Is Just Beginning  

The importance of the gut microbiota for physical health, mood, and perhaps cognitive capacity is a recent discovery.  There are still plenty of unknowns.  Given that so much of the American diet is based on processed foods, each food additive needs to be interrogated to determine its impact on the microbes in the gut, general inflammation, and mood and behavior.  Also each probiotic in fermented foods needs to be evaluated.  Preliminary research suggests they are not all the same.  However, the implications of this research are apparent.  In the future, those with depression might conceivably be treated with fecal transplants from happy people.  But then, it might just be easier to eat lots of nut, fruits and vegetables and avoid the processed foods and artificial sweeteners and start enjoying yogurt (the stuff without the high fructose corn syrup).

* * * * *

References:

Bailey, M. T., Dowd, S. E., Galley, J. D., Hufnagle, A. R., Allen, R. G., & Lyte, M.  (2011). Exposure to a social stressor alters the structure of the intestinal microbiota:  implications for stressor-induced immunomodulation.  Brain, Behavior, & Immunity, 25(3), 397-407.

Bangsgaard, Bendtsen, K. M., Krych, L., Sorsen, D. B. et al. (2012).  Gut microbiota composition is correlated to grid floor induced stress and behavior in the BALB/c mouse.  PLoS One, 7, e46231.

Benton, D., Williams, C., & Brown, A.  (2007). Impact of consuming a milk drink containing a probiotic on mood and cognition.  European Journal of Clinical Nutrition, 61, 355-361.

Bercik, P., Denou, E. Collins, J., Jackson, W., Lu, J., Jury, J. et al. (2011).  The intestinal microbiota affect central levels of brain derived neurotropic factor and behavior in mice.  Gastroenterology 141, 599-609.

Bercik, P., Park, A. J., Sinclair, D., Khoshdel, A., Lu, J., Huang, X. et al.  (2011). The anxiolytic effect of Bifidobacterium longum NCC3001 involves vagal pathways for gut-brain communication.  Neurogastroenterology and Motility, 23, 1132-1139.

Bruce-Keller, A. J., Salbaum, J. M., Luo, M., Blanchard, E., Taylor, C. M., Welsh, D. A., & Berthould, H-R.  (April 1, 2015).  Obese-type gut microbiota induce neurobehavioral changes in absence of obesity.  Biological Psychiatry, 77 (7), 607-615.

Chassaing, B., Koren, O., Goodrich, J. K., Poole, A. C., Srinivasan, S., Ley, R. E., & Gewirtz, A. T.  (2015).  Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome.  Nature.

Collins, S. M., Kassam, Z., & Bercik, P.  (2013).  The adoptive transfer of behavioral phenotype via the intestinal microbiota: experimental evidence and clinical implications.  Current Opinion in Microbiology, 16, 240-245.

Cryan, J.  F., & O’Mahony, (2011).  The microbiome-gut-brain axis: from bowel to behavior.  Neurogastroenterology, 23, 187-193.

Dinan, T. G., Stanton, C., & Cryan, J. F.  (2013).  Psychobiotics:  a novel class of psychotropic.  Biological Psychiatry, 74, 720-726.

Geuking, M. B., McCoy, K. D., & Macpherson, A. J.  (2011).  The continuum of intestinal CD4+ T cell adaptations in host-microbial mutualism.  Gut Microbes, 26, 353-357.

Hilimire, M. R.,  Devylder, J. E., & Forestell, C. A.  (June 2015).  Fermented foods, neuroticism, and social anxiety:  An interaction model.  Psychiatric Research, 228 (2), 203-208.

Kiliaan, A. J., Saunders, P. R., Bijlsma, P. B., Berin, M. C., Taminlau, J. A., Groot, J. A., Perdue, M. H.  (1998).  Stress stimulates transepithelial macromolecular uptake in the rat jejunum.  American Journal of Physiology: Gastrointestinal and Liver Physiology, 275, G1037-G1044.

Koutsos, A., Tuohy, K. M., & Lovegrove, J. A.  (2015).  Apples and cardiovascular health—is the gut microbiota a core consideration?  Nutrients, 7 (6), 3959-3998.

Magnusson, K. R., Hauck, L., Jeffrey, B. M., Elias, V., Humphrey, A., Nath, R., Perrone, A., & Bermudez, L. E.  (2015).  Relationship between diet-related changes in the gut microbiome and cognitive flexibility.  Neuroscience, 300, 128-140.

McKeran, D. P., Fitzgerald, P., Dinan, T. G., & Cryan, J. F.  (2010).  The probiotic Bifidobacterium infantis 35624 displays visceral antinociceptive effects in the rat.  Neurogastroenterology and Motility, 22, 1029-1035.

Messaoudi et al. (2011).  Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects.  British Journal of Nutrition, 105, 755-764.

Ohland, C. L., Pankiv, E., Baker, G., & Madsen, K. L.  (2015).  Western diet-induced anxiolytic effects in mice are associated with alterations in tryptophan metabolism.  Nutritional Neuroscience, doi: 10.1179/1476830515Y.0000000034

Rao, A. V., Bested, A. C., Beaulne, T. M., Katzman, M. A., Iorio, C., Berardi, H. M., & Logan, A. C.  (2009).  A randomized, double-blind, placebo-controlled pilot study of a probiotic in emotional symptoms of chronic fatigue syndrome.  Gut Pathology, 1, 6.

Rook, G. A., & Lowry, C. A.  (2008).  The hygiene hypothesis and psychiatric disorders.  Trends in Immunology, 29 (4), 150-158.

Reardon, S.  (12 June, 2015).  Vaccine hope for post-traumatic stress:  development of anxiety and fear alleviated by manipulating immune system in rodents.  Nature News.

Salvin, J.  (2013).  Fiber and prebiotics: mechanisms and health benefits.  Nutrients, 5, 1417-1435.

Smits, H. H., Engering, A., van der Kleij, D., de Jong, E. C., Schipper, K., van Capel, T. M. M., Zaat, B. A. J., Yazdanbakkish, M., Wierenga, E. A., van Kooyk, Y. T., & Kapsenberg, M. L.  (2005).  Selective probiotic bacteria induce IL-10-producing regulatory T cells in vitro by modulating dendritic cell function through dendritic cell-specific intercellular adhesion molecule 3-grabbing nonintegrin.  Journal of Allergy and Clinical Immunology, 115, 1260-1267.

Spreadbury, I.  (2012).  Comparison with ancestral diets suggests dense acellular carbohydrates promote an inflammatory microbiota, and may be the primary dietary cause of leptin resistance and obesity.  Diabetes, Metabolic Syndrome, and Obesity:  Targets and Therapy, 5, PMC34020009

Suez, J., Korem, T., Zeevi, D., Zilberman-Schapira, G., Thaiss, C. A., Maza, O., Israeli, D., Zmora, N., Gilad, S., Weinberger, A., Kuperman, Y., Harmelin, A., Kolodkin-Gal, I., Shapiro, H., Halpem, Z., Segal, E., & Elinav, E.   (2014).  Artificial sweeteners induce glucose intolerance by altering the gut microbiota.  Nature, 514, 181-186.

Suez, J., Korem, T., Zilberman-Schapira, E., et al. (2015).  Non-caloric artificial sweetners and the microbiome:  findings and challenges.  Gut Microbes, 6 (2), 149-155.

Tillisch, K., Labus, J., Kilpatrick, L.  (2013).  Consumption of fermented milk product with probiotic modulates brain-response to emotional pictures.  Gastroenterology, 144, 1394-1401.

Turnbaugh, P. J., Ley, R. E., Mahowald, M. A.  et al. (2006).  An obesity-associated gut microbiome with increased capacity for energy harvest.  Nature, 444, 1027-1031.

Turnbaugh, P. J., Ridaura, V. K., Faith, J. J., Rey, F. E., Knight, R., & Gordon, J. I.  (2009).  The effect of diet on the human gut microbiome:  a metagenomics analysis in humanized gnotobiotic mice.  Science Translational Medicine, 1: 6ra 14.

25 COMMENTS

  1. I know when I am on antibiotics I often have lowered mood. I will be sitting around “awfulizing,” and realize, “Oh yes, I still have four more days for that dental infection….”

    I don’t take prophylactic antibiotics anymore. I like my gut flora. We make a lot of homemade ferments, pickles, sauerkraut, sourdough bread, etc.

  2. Thanks very much Jill,

    You probably know this much better than I do, but your gut microbes, vitamin B, D deficiencies, hypothyroidism, infection, heavy metal toxicity, gluten allergy,… are all common problems that can cause severe mental symptoms. I got convinced that this is important from Mark Hyman, e.g.

    https://www.youtube.com/watch?v=fOPRp_K6QQY

    In a better health care system for mental problems, surely checking for all of these issues should be the first step. – Saul

  3. I read these lines,
    “The composition of the gut microbiota determines more than depression and anxiety levels”
    and “those with depression might conceivably be treated with fecal transplants from happy people,”

    and then imagined the following scenario:

    Patient: Doctor, I’m depressed.
    Doctor: Why are you depressed?
    Patient: I lost my job, my wife is leaving me, and I recently had a car accident.
    Doctor: Maybe the real cause of your depression is that your gut microbiota composition is making you feel bad. How about we treat this depression by giving you a fecal transplant from a happy person?

    While it might sound extreme, this example is analogous to how many psychiatrists already use medications. I doubt that complex interpersonal-relational stress (“depression”, which is not one unitary illness, and thus undermines the validity of the cited studies) can be “treated” in this reductionist way.

    I would be concerned that research into a genetic/biological basis for “depression” in gut microbiota would become another cash grab for pharmaceutical companies and psychiatrists. The silver lining is that treatments on this basis can’t have more bad side effects than neuroleptics.

    My instinct is that the money put into research like this would go further if spent supporting distressed people at a relational whole-person-to- whole-person level – i.e. promoting support groups, family and individual therapy, and other forms of human-to-human support.

    • I would hope a good doctor would inquire further about the person’s car accident as perhaps he received a concussion that wasn’t treated and is causing the depression. Of course, keeping him from psych meds would be an issue but that is another post.

      I would also hope the doctor would ask about potential sleep disorders since untreated ones like sleep breathing disorders can also contribute to the condition.

      The doctor should then systematically decide what issues may be causing the depression. If there aren’t any problems, then the patient should be referred for counseling.

      My point is I don’t see this as either or situation as a good doctor should be able tease out what the problem is. But you’re right, if he/she just automatically assumes that providing a fecal transplant as the solution to someone’s depression, that is no better than just providing antidepressants for all depressions.

    • “My instinct is that the money put into research like this would go further if spent supporting distressed people at a relational whole-person-to- whole-person level – i.e. promoting support groups, family and individual therapy, and other forms of human-to-human support.”

      Not all depression/anxiety, etc. is due to external events. The concern about Big Pharma turning this into another cash grab is valid, but that calls for being watchdogs and calling out corruption, not opposing this very promising research. And, sorry to say, talk therapy has not done all that well..far too often, it is the gateway to drugs.

        • bpdtransportation:

          instead of “external events,” I should have used a different phrase, such as “situational factors,” but I trust that the context of my comment makes clear what I meant. The import of your comment and example was that life’s calamities or setbacks are the sole cause of depression or anxiety and that is not so. Depression and anxiety can be inborn (effect of epigenetic inheritance) and a host of other environmental (physical) factors, such as diet, gut health, environmental degradation and even the prevailing practices of allopathic medicine—-e.g., overuse of antibiotics, bad dietary “anticholesterol” guidelines that promote inflammatory grains instead of good fat; overdoing sanitation. All of these physical causes have a bearing on mental health and they are not susceptible to talk therapy. Your argument against research into the physical causes of mental health issues does not inspire confidence in the ethos you espouse—what exactly are you afraid of? That biology will prove to be a factor?

          As for the efficacy (or lack thereof) when it comes to talk therapy, it is important to be precise in identifying the therapy involved and the condition. I do not have data or studies, just experience and the knowledge that our family’s experience is not unique. Since you contend otherwise, perhaps you can point to studies that show that psychotherapy (without drugs) is effective for psychosis, disassociation, other extreme states or pre-verbal trauma. Are you aware of any successful therapeutic programs for these serious conditions that do not rely on drugs? Everything matters, and I hope that MIA will embrace the holistic model. I believe that the success of the movement that Robert Whitaker started depends on it.

          • I enjoy these debates so I’ll comment on a few of your points –

            First, I may have misunderstood your position; we actually agree more than not. My point was more that depression/anxiety don’t just happen due to some spontaneous imbalance or magically arising illness, that distressing experiences have causes. I think you agree with this.

            I agree with you that other non-relational factors of the kinds you mentioned, which may directly affect biology at a physical level, can cause distress (“depression” or “anxiety”).

            I disagree that depression and anxiety may be inborn; the way this is stated by you is misleading. Perhaps a greater vulnerability (which is always relative to some imagined “norm”) to becoming depressed or anxious may be “inborn” or “constitutional”. But that is only a vulnerability to stress which may trigger “depression” (not a unitary or reliable diagnosis anyway), not an inborn state of depression, and someone’s vulnerability/threshold for stress causing a certain reaction is constantly shifting due to their experience over time. Put another way, people have the constitutional strength or vulnerability they have at the time they are born, and that level is then constantly modified by later experiences. Perhaps we agree on this too. It’s quite hard to think about all of this due to the complexity of the world which renders the DSM diagnoses almost meaningless.

            I agree that biological factors can be significant but my bias is that relational factors and what happens to people in significant relationships are usually more important.

            Yes, I have some therapy/psychosis recommendations!

            Some great case studies of cured schizophrenics are in:

            Weathering the Storms – Murray Jackson
            Treating the Untreatable – Ira Steinman
            The Regressed Patient – Bryce Boyer
            Rethinking Madness – Paris Williams
            The Infantile Psychotic Self – Paris Williams

            These should be available on used books on Amazon.

            Every therapy is different, and every condition is different, so I cannot identify the exact type of therapy or exact type of psychosis in each of the 50+ case studies in these books. But roughly speaking these are psychodynamic / psychoanalytic psychotherapists working with psychotic, delusional, and severely schizoid clients. This is qualitative research, but I think in some way that it is more powerful and meaningful than quantitative studies.

            Also, I recommend the metaanalyses:

            Individual psychodynamic psychotherapy of schizophrenia: Empirical evidence for the practicing clinician – by Gottdiener
            (this is not online, but I have a copy, if you want it email me at bpdtransformation (at) gmail )

            The Efficacy of Psychodynamic Psychotherapy by Shedler
            https://www.apa.org/pubs/journals/releases/amp-65-2-98.pdf

            Effectivness of Long-Term Psychodynamic Psychotherapy, a Metanalysis by Leichsenring
            http://www.centerforselfdevelopment.com/pdf/000004-effectiveness-of-long-term-psychodynamic-therapy.pdf

            These metanalyses are almost obvious… if someone stays in a long term relationship with someone who tries to help them, it tends to be helpful more often than not. Of course there are bad therapies and therapists but I think the research here shows that therapy helps more often than not.

  4. Thank you,
    Tending to the gut is one of the most fundamental issues that everyone who lacks general well-being, whether physically or mentally manifested can do to build a foundation of wellness.

    This doesn’t change the fact that “shit happens” in our environments bpdtransformation …what it does is help provide an internal capacity to better meet that shit.

    My own healing journey has made it profoundly clear that healing the gut and optimizing diet is a place to start in tandem with understanding trauma (what happened to us) … in tandem because they are inseparable, truly.

    Everything matters…when starting the process of unraveling how it all fits together in our own idiosyncratic lives having a healthy body matters. One cannot have a healthy body without a healthy gut.

    **as a side note, my gut’s health was destroyed by (completely unnecessary) longterm antibiotic therapy for (mild) acne in my teenage years. In my own trajectory it’s clear to me now that this set me up for everything that followed…prior to the psych meds, the antibiotics were the gateway into general dis – ease which led to drugs (psychiatric and others too) and more drugs which ended up destroying my wellbeing. It’s been in healing the gut with optimal diets and probiotics etc along with becoming drug free that I have found well-being once again.

    • Your story is encouraging Monica, but one person’s experience is not good evidence that healing the gut and optimizing diet are “the place to start” when someone is lacking “general well-being”.

      Multiple large-scale studies would be needed to make this kind of statement with validity, to try to assess the relative effects of dietary/gut factors against other variables. More research on diet’s impact versus other factors should be done since there is a lot we don’t know, and because dietary interventions cannot possibly be worse than medication. Also, interventions like improving diet should be measured alongside other factors that can help well-being like psychotherapy, peer support, having a good job, getting enough sleep, and having safe housing.

      My guess would be that having friends, getting psychotherapy, having a job and having a safe place to live would be more important than diet. Of course, I don’t know this. But it makes senses to me that eating the average (bad) American diet while having social support and a good place to live are likely to leave someone much better off emotionally than having a great diet but being isolated, jobless, and homeless. I could give examples of my friends who eat poor diets but are quite happy and well-functioning. Of course that wouldn’t prove anything.

      • it’s not based on just my experience but also the 1000s I have the honor to interact with online…those with both physical and mental health issues….

        the chronic illness circles have a spectrum of the entire population on them including many with psychiatric diagnosis….there is actually a lot of research that already backs this up as well…and we do read it in tandem with learning to listen to and experience our bodies and knowing instruments that can lead us in the right direction to heal.

        all the things you mention are also critically important…but not more or less. of course different people need different things at different times…that’s true. when I suggested a starting point I meant in a clinical setting where those things are considered…in the end every path is unique but all these things are parts of what make us human animals on a planet intimately intertwined with everything including the bugs in our guts.

        I personally don’t need studies to know what I know. My body knows and so do the bodies of 1000s of folks I’ve interacted. You certainly don’t have to believe us, but you will not silence us. Healing is too critically important to wait around for the establishment to get their heads on straight. Still as mentioned above I do utilize the science that is already available and there is actually quite a lot. Data helps the intuitive process. I’m not anti-science, I simply don’t rely on it alone.

        Internal guidance and intuition are real things that can lead us to what we need…and that, does, also, indeed look different for everyone. And so we may differ here and that is just fine.

          • And I should have also added: we have an enormous debt of gratitude to you, Monica, for the wisdom, knowledge, support and encouragement of Beyond Meds.

        • I didn’t intend to silence you, nor did I say that the body/diet don’t matter. Rather, I wanted to highlight the uncertainty of what we know (or don’t know) about these issues, and to state my opinion, which I acknowledged as such, that relational factors are the most important.

          But I agree with you that knowing things in your bones matters. As a wise man said, “Not everything that counts can be counted and not everything that can be counted counts”.

      • Hi bpdt,

        There is a view that I have seen on MIA where depression is considered as a normal, reasonable response to bad circumstances like isolation, joblessness, homelessness, etc. as you say. There is a lot of depressed people because a lot of people are in these situations. The normal course of depression is that it is self-limiting and will usually resolve itself over time, unless you start to take antidepressants. It is the antidepressant drugs that turn a normal self-limiting natural reaction into the widespread pathological chronic condition that we see today. I have seen similar views expressed also by R.W. and Peter Gotzsche too.

        I suspect that you would agree with the above view, and I agree that antidepressants to more harm than good, but I don’t think that the rest of it is correct. I think I understand what depression is, how it works, why it leads to a particular set of symptoms that depressives have in common and I think I understand how and why it progresses over time. Because of the way depression works, bad things happen to depressed people and depressed people will be fixated on those bad circumstances as the source of their problems. I think that very often people who are depressed “because” of job loss, divorce, money problems,…etc. were actually depressed for a long time before their problems started.

        – Saul

        • Saul,
          I agree with this and think your last point is insightful – that “very often people who are depressed “because” of job loss, divorce, money problems,…etc. were actually depressed for a long time before their problems started.”

          Many people internalize problematic ways of relating from parents as children (like I did). For example, they are abused and neglected, and/or are not taught how to love and be close to another person. Then, as adults, they become depressed because they tend to recreate these relationships with partners who resemble the parents, or they don’t know how to find a loving partner or friend because they don’t know how to love… and such a state of affairs is depressing!

          Also, I think that such “depression” as I have described – the bad feelings that result from replaying disappointing or traumatic relationships throughout life – is not self-limiting and will not resolve itself over time. It is rather part of someone’s personality. But, it can be healed and changed -it has to be worked out by developing insight and awareness and changing the way one relates to oneself and other people.

          It is funny how this thread evolved from bacteria supposedly causing depression to this more macro level.

  5. “The importance of the gut microbiota for physical health, mood, and perhaps cognitive capacity is a recent discovery.”

    Chinese Medicine has prescribed gut health as a healing path for a long time. Good gut health = healthy flora = healthy inner ecology = cooling (relaxing) of the heart and clarity of mind. It also means healthy auto-immune system. So in times of stress, even extraordinary stress, we are more alert, balanced, grounded, calm, clear, patient, and able to make better decisions for ourselves, not out of panic or rage, but from reason and intuition. That leads to a better life, in general, that we, ourselves, create from our own clarity.

      • “these aren’t things we as human beings don’t know…it’s stuff that western medicine hasn’t yet proven…”

        Monica, I believe this is the crux of it. Thank God we stopped waiting around, took matters into our own hands, and learned for ourselves, eh? Waiting for proof or the opinion of others rather than finding one’s own path will keep one waiting a long, long time.

        • I just posted this on Beyond Meds Facebook page…in part as a result of this conversation:

          “I take the radical perspective that as human animals we have the capacity to know all manner of things by instinct. It is in our DNA and manifests via intuition. This is not magic. It is not a super-power. We are “psychic” by nature. It is our human inheritance. We have forgotten how to access our very nature. That is all. And as complicated as we might like to make the conundrum we are faced with right now, it’s also pretty simple. We need only pay attention.”

  6. Thank you Jill for your work in this area. I am one of those who did not want to wait for all the results of years of research but started experimenting with different diets. I have had amazing results with a diet of whole foods, with very little dairy or grains. I feel like a different person even though my circumstances have not changed. I sleep better, worry less, am able to control my thoughts, feel far less anxious and depressed. I believe that a healthy diet is very important for physical and mental health especially as we get older. Not sure why so many people both on and off this website are so resistant to this idea.