Introduction to the Gut-Brain Axis

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From Busy Philips’ trending Anxiety necklace (2018), Anne Hathaway’s “light it on fire” method, Selena Gomez’s psychiatric hospitalization, and Oprah Winfrey’s “near nervous breakdown,” discussions around mental health have become a conversational cornerstone in our culture.

It’s clear that the battle for our mental health is not over and the need for effective solutions has skyrocketed. In fact, preliminary data has estimated that depression rates have tripled since early 2020, and as of 2021, over 280 million people in the world suffer from depression, and 40 million adults report anxiety-- though it is highly unlikely that these numbers are correct as mental health incidence is in general, grossly underreported.

While the standard of care’s clinical practice guidelines continue to recommend a combination of psychiatric medications and counseling, alternative therapies have risen in popularity and according to the World Health Organization, over 80% of people seek alternative care.

Dominant alternative techniques touting the effectiveness of substitute therapies like meditation, breathwork, calming apps and social media detox as examples. These solutions are useful for many, but are insufficient for others. As such, the search for effective mental health treatments continues. With little help coming from the dominant medical model, desperate and creative sufferers have expanded their horizons and experimented with “off label” therapies like ketamine, magic mushrooms, and ayahuasca.

What’s needed is a treatment that works to relieve suffering, improve well-being, increase health, all while being cost effective, safe and accessible

Is that really too much to ask?

If this sort of therapy truly existed, it would take the world by storm, right?

The answer is: Not necessarily.

There is a solution. But the problem with the solution is it’s not a sexy gadget or an easy to swallow “One A Day” pill. In fact, for many, the answer is deeply personal, potentially embarrassing, and requires a bit of knowledge about science.

This blog is going to teach you all about how to get at the root of many mental health concerns. By going back to the basics of anatomy, physiology, psychology, and microbiology, we open a door to treatments that have the potential to relieve suffering, improve well-being, increase health, without breaking the bank.

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What’s The Gut Got to Do With It?

In 2005, I popped a Lexapro (a medication often used to treat depression and anxiety) and washed it down with a large mocha latte. Wondering why I was anxious, I hurried into the building of my graduate school for psychology.

We were studying cognitive behavioral therapies for the treatment of anxiety, depression, and other psychological diagnoses. At this time, mental health approaches emphasized the “thinking, feeling, and behaving dimensions,” of care. Graduate schools churned out leagues of bright-eyed therapists who were eager to change the landscape of mental health via the art of language analysis and emulate the brilliance of Dr. Aaron Beck (founder of cognitive behavioral therapy- aka CBT) and Carl Ransom Rogers (founder of humanistic psychology).

In the early 2000’s, psychobiology, also referred to as biological psychology, was not a part of the therapy colloquial language. But rather, this crossroad between the mental and physical realm of psychology landed in the turf of the dominant medical practitioners. Who, following medical guidelines, continued to lean on psychopharmacological solutions.

Meanwhile, a paradigm shift was beginning to take hold.

Avant-garde clinician, researcher, and writer James Greenblatt, MD was teaching about something called the “second brain.” He claimed that this second brain consisted of trillions of mood-modulating microbes and he even went as far to say that “psychiatric woes can be solved by targeting the digestive system.”

“We understand that the brain can affect the gut,” says Dr. Greenblat, “but even more fascinating is that the 3-4 lbs of bacteria in our gut actually directly impacts what is going on in the brain.”

I was in medical school when I first came across Dr. Greenblat’s work and I found myself seriously considering for the first time in my life that what I consumed might have something to do with my health. This realization, it turns out, marked the beginning of one of the most transformational journeys in my life.

Over the last twenty years, research has elucidated many fascinating facts about the gut-brain system, here are some of my favorites:

  • The gut-brain axis is a bidirectional highway linking the gut and the brain
  • There are over a trillion bacteria that live in your gut, which are collectively referred to as the gut microbiota.
  • The Vagus Nerve, otherwise called cranial nerve 10 (CN10) is the super nerve that carries communication of the gut brain axis.
  • Upwards of 90% of your mood-regulating neurotransmitter, serotonin, is actually made by the gut microbiota.
  • There is a form of probiotic, called a psychobiotic, that when consumed influences your microbiome and can improve your mood.
  • Your gut communicates via a series of neurons and neurotransmitters, called the enteric nervous system.
  • There are safe, natural, inexpensive and affordable solutions for restoring balance to your gut and improving your mood (we are going to talk about this topic a lot in this blog series).

The good news is that you have the power to change your mind and mood and it starts with the microbes in your gut.

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Neurologist, and integrative medicine expert, David Perlmutter, MD, FACN, teaches that mental health has a bidirectional relationship with the gut and your mood is in a large part dictated by what’s going on in the gut.

In his famous book, Grain Brain Dr. Perlmutter writes: “Brain dysfunction starts in your daily bread, and I’m going to prove it.”

Which in many ways, he has done. Widely recognized as a pioneer in the inner workings of the gut-brain relationship, Dr. Perlmutter’s work has contributed, and continues to contribute to incredible changes in the landscape of mental health care-- be sure to check out his upcoming book entitled Drop Acid, which explores the landscape of uric acid, metabolism and health.

Over a decade later, I still drink coffee, but have laid off the pumps of syrup and extra shots of caffeine. I’ve said “goodbye” to Chef Boyardee and Easy Mac and said “hello” to psychobiotics and lycopene-rich dark chocolate.

And my life has changed.

As I wrote in this section of the blog, “What’s The Gut Got to Do With It?” the melody of Tina Turner’s song, “What’s Love Got To Do With It” rang in my mind (and let’s face it, it’s still there, because it’s an earworm)….

The answer to the question of this chapter is the same as the one I’d give Tina Turner if she and I met.

What’s Love/The Gut Got to Do With It? Everything.

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