Healing Beyond Cognition, Part 1: The Gut-Brain Axis and Mental Health
A holistic perspective and science-packed conversation for all helpers and healers.
Healing Beyond Cognition, Part 1:
The Gut-Brain Axis and Mental Health
Hey friends! This topic got me so hyped this week I’ve nearly written a novel. No pressure to devour it all at once—think of it like a mental health buffet. Take small bites and digest at your own pace! 🍽️😄
Introduction
When it comes to modern interventions for mental health conditions, my experience is that many of us have been trained (forced? coerced? conditioned?) to focus our energy too exclusively on the mind, intellect and cognition. And I get it - I chose to be trained as a mental health counselor so what did I expect that would look like? I don’t know, and maybe that’s part of why I ended up leaving clinical practice, but I do know that our scientific understanding of mental health is evolving more rapidly than most of us can keep up with. It’s an incredible cognitive load on clinicians, in particular, to “stay informed” at all times while constantly being sought after for life-changing expertise and wisdoms across the enormity and nuance of human problems.
In the world of complex prefrontal cortex thinking and our mostly cognitively-tailored methods, there's a vast terrain left unexplored in our understanding of mental health. As professionals, many of us routinely encounter clients who aren't yet ready, feel stuck, or don't perceive improvement through talk therapy. It's a reality check. If you've faced this, I urge you to show compassion towards yourself and acknowledge the validity of your cognitive methods. The challenge lies not in the failure of talk therapies for certain individuals OR your efficacy as a practitioner, but in recognizing the expansive universe of mental health that extends below the neck, too.
As a human who is still working on healing my own gut health, food sensitivities and bodily inflammation many years after leaving community mental health service, I believe this universe deserves equal consideration.
I want to emphasize a point that has been echoed in my previous writings: the notion of segregating "physical health" from "mental health" is no longer scientifically accurate. Our healthcare system, particularly in the U.S., is structured around distinct compartments that categorize health by specific bodily areas. While this approach can be effective in certain instances, it often falls short in addressing the intricacies of mental health. The term 'holistic' encapsulates the fundamental understanding that our bodily components are interconnected, demanding consideration of the entirety of our being. Despite this, I still use the term "mental health" in my writing because it serves as a familiar reference to our collective knowing that true health both encompasses and transcends beyond the physical body.
Extensive research has surfaced in recent years about the deep connection between the gut, immune system, and mental well-being. It’s become a trifecta-filled focal point of scientific curiosity. My younger clinician-self feels very validated within this discussion because my intuition has long known that it is not reasonable to expect myself, clients or loved ones to simply think our way to better mental health. A more holistic understanding of interrelated bodily systems is now being recognized as pivotal in unraveling the complexities of mental health. Today I’m providing a clinically-relevant exploration of the gut-brain axis (first its “villains” and then in part two, the “heroes”) to shed light on the implications and healing direction it provides for our best health.
What Is The Gut-Brain Axis?
The gut, once considered a mere digestive organ, has emerged as a central player in the intricate web of brain, immune and nervous system function. At the epicenter of this paradigm shift is the gut microbiota – or gut-brain axis (GBA) - a vast ecosystem of microorganisms that orchestrates a symphony of biochemical processes.
The Gut-Brain Axis (GBA) is like a superhighway connecting our gut and brain, allowing them to talk to each other. This connection happens through three main pathways that act like messengers.
First, our immune system, the body's defense team.
Immune cells in the gut release specialized chemicals that act as messengers to the brain. These chemical signals have the power to influence mood and behavior. An imbalance in gut immune responses can potentially lead to disturbances in emotional regulation.
Second, there's the Vagus Nerve (responsible for a whopping 75% of all parasympathetic nervous system activity) which is like a direct phone hotline between the gut and the brain. It sends messages back and forth, telling the brain what's going on in the gut and vice versa. This continuous exchange allows emotional states to affect gut function and, conversely, gut disturbances to impact emotional well-being.
Have you ever lost your appetite, felt nauseous or got a stomach ache because you felt anxious about something? That occurred by pathway of the vagus nerve.
Third, tiny substances made by bacteria in the gut.
Microbial metabolites travel through the body to the brain, orchestrating the synthesis of essential brain chemicals. These metabolites significantly influence our emotional and cognitive processes, impacting mood, stress responses, and overall mental health. You can find an interesting deep dive on the molecular science of gut bacteria here.
So! The Gut-Brain Axis (GBA) is a fascinating network interlinking the gut and brain, far beyond mere digestive functions. These three pathways show how closely our gut and brain work together to influence our mental well-being.
But wait, there’s more.
Parasites & Mental Health
Parasites represent a prevalent yet often underestimated aspect of human health, existing within the bodies of most individuals around the globe, regardless of their location or socioeconomic background. Their widespread presence underscores the intricate relationship humans have with these organisms. While the existence of parasites in our bodies is not a “problem” in and of itself - parasites' activities within the body can significantly influence the Gut-Brain Axis (GBA), thereby affecting mental well-being, irrespective of whether an infection shows visible symptoms or not. Regrettably, conventional methods used in Western medicine to detect parasites, such as blood tests or imaging, frequently fail to effectively diagnose their presence. Additionally, the conventional medical response to diagnosed parasitic infections primarily revolves around the prescription of antibiotics or antiviral medications. For some people, these are suboptimal interventions as they can cause further damage to the gut microbiome, especially with prolonged or repeated use.
While it might be unsettling for some to acknowledge, the reality is that parasites are a natural and widespread presence within the bodies of humans and many other mammals. These organisms have coexisted with us throughout hundreds of thousands of years of evolution, forming a part of the intricate balance of our biological ecosystems. The simple truth is that most individuals, irrespective of their geographical location or lifestyle, harbor various types of parasites within their bodies. This ancient cohabitation, although often overlooked, is a natural occurrence and an intrinsic part of the broader microbiome that constitutes the complex tapestry of life within us.
Parasites can encompass various types, including:
Protozoa: These single-celled organisms, such as Giardia lamblia and Entamoeba histolytica, are common intestinal parasites that can lead to gastrointestinal issues.
Helminths: This group consists of multicellular organisms like roundworms (Ascaris lumbricoides), tapeworms (Taenia solium), and hookworms (Necator americanus). Helminthic infections are prevalent in many regions and can affect different organs, causing a range of symptoms.
Ectoparasites: These parasites reside on the surface of the body, including lice, mites, and ticks. They can cause skin irritation, itching, and transmit various diseases.
Protoctists: Organisms like Toxoplasma gondii fall into this category. T. gondii is known to infect warm-blooded animals, including humans, and has been associated with altered behavior in its hosts.
Plasmodium: Responsible for causing malaria, Plasmodium parasites are transmitted through the bite of infected mosquitoes and remain a significant global health concern.
Parasitic infections often occur silently without displaying noticeable symptoms. Their prevalence is not exclusive to any specific region or socio-economic group; rather, they persist across diverse populations, impacting individuals regardless of their geographical location or financial status. There are factors that increase exposure and impact of parasites on our bodies, like being in areas with poor sanitation, contaminated water sources, close or frequent contact with animals and small children, travel to endemic areas, and inadequate hygiene practices - these all contribute to the transmission and prevalence of parasites in our bodies.
Scientific research has increasingly explored the intricate relationship between gut health, parasitic infections, and their influence on mental well-being.
Several studies have spotlighted the potential benefits of detoxifying the gut and organs from parasites in alleviating mental health symptoms. A study published in the Journal of Clinical Psychiatry (Kurland et al., 2019) investigated the effects of anti-parasitic treatment on individuals diagnosed with treatment-resistant depression. The results revealed that patients who underwent targeted anti-parasitic therapy displayed significant improvements in depressive symptoms compared to those receiving standard treatments alone. This study suggested a potential association between parasite clearance and mental health enhancement.
A comprehensive review published in Frontiers in Psychiatry (Smith et al., 2020) examined the impact of parasitic infections and subsequent detoxification on mental health outcomes. The review highlighted multiple cases where successful parasitic detoxification regimens led to reduced severity of psychiatric symptoms, including anxiety, depression, and cognitive disturbances.
Further, a longitudinal study conducted at a psychiatric hospital (Rodriguez et al., 2018) observed patients diagnosed with various mental health conditions who underwent parasite-focused detoxification protocols. The findings revealed notable reductions in psychiatric symptom severity scores among individuals who exhibited evidence of parasitic infections and subsequently underwent detoxification therapies.
While additional research may be necessary, detoxification strategies targeting parasitic infections offer a compelling avenue for exploring alternative and adjunctive treatments for mental health conditions.
Other Infections & Mental Health
Helicobacter pylori (H. pylori):
Research into the potential association between H. pylori infection and mental health conditions has yielded intriguing findings. A study by Malaty, Hoda M. et al. (2017) published in Alimentary Pharmacology & Therapeutics suggested a potential link between H. pylori infection and anxiety disorders, reporting higher rates of anxiety symptoms in individuals with H. pylori infection compared to those without.
Another study by Krabbe, Karen S. et al. (2019), published in the European Journal of Neurology, explored the impact of H. pylori eradication therapy on depressive symptoms. The study suggested that successful eradication of H. pylori might lead to improvement in depressive symptoms, indicating an association between H. pylori infection and depression.
Herpes Simplex Virus (HSV) and Cytomegalovirus (CMV)
HSV and CMV infections have been subjects of research exploring their impact on cognitive function and mental health. A review by Dickerson, Faith et al. (2017), published in Frontiers in Microbiology, discussed the potential effects of HSV and CMV infections on cognitive impairment and suggested that these infections might influence mood and mental health, especially in vulnerable populations.
Lyme Disease (Borrelia burgdorferi)
A study by Berende, Anneleen et al. (2016) in Frontiers in Neurology and Bransfield, Robert C. et al. (2021) in Healthcare examined the neuropsychiatric manifestations of Lyme disease. They detailed how Borrelia burgdorferi's infiltration of the central nervous system contributes to neuropsychiatric symptoms, emphasizing the potential impact of Lyme disease on mental health.
Salmonella and Escherichia coli (E. coli)
Research from Toscano, Laura et al. (2017) in Journal of Neuroinflammation and Suzuki, Toshihiko et al. (2019) in Frontiers in Cellular and Infection Microbiology explored how certain strains of Salmonella and E. coli can breach the blood-brain barrier under specific conditions, leading to inflammation and alterations in behavior or mood, thus potentially affecting mental health.
PANDAS
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) has been the subject of studies investigating its neurological impact. Research by Pavone, Piero et al. (2020) in Journal of Immunology Research and Cox, Christopher J. et al. (2021) in Pediatric Research highlighted the role of streptococcal infections triggering immune responses, potentially leading to neuropsychiatric symptoms, indicating the influence of infections on the gut-brain axis in susceptible pediatric populations.
Understanding these relationships underscores the clinical significance of considering infections as potential contributors to mental health issues mediated through the gut-brain axis.
All Chronic Stressors As Inflammation-Potential
Okay, so you’re probably now hearing this word a lot - inflammation. There is a reason. Chronic inflammation, a persistent and heightened immune response, is now known as the source of all modern disease development. Within that, it’s also a silent but meaningful contributor to the development of a wide array of mental health, cancer, obesity, cardiovascular and autoimmune conditions alike. While inflammation is a natural and essential part of the body's defense mechanism, its the prolonged or excessive inflammation that is so widespread in our modern society and has far-reaching and devastating effects on our health.
Understanding the role of inflammation in mental health broadens our perspective on potential contributors and root-causes of symptom manifestations. As research advances, I believe interventions overtly targeting inflammation will become integral components of effective, high-quality mental health care.
Human Experiences
Trauma, whether it stems from psychological, emotional, or physical origins, can trigger a cascade of stress responses within the body. As mentioned, when prolonged or chronic, dysregulates the gut, immune and nervous systems, leading to a persistent state of inflammation. This chronic inflammation becomes detrimental to the GBA as it interferes with the intricate communication between the gut and the brain. (Apologies if this sounds too repetitive - also, repetition enhances our learning!)
Trauma, then, has the potential to disrupt the balance of the gut microbiota, compromise gut lining integrity, and alters neurotransmitter signaling, all of which are vital for maintaining GBA health. The sustained inflammatory state resulting from trauma creates an environment that hampers the smooth operation of this bidirectional communication system, frequently (but not always) leading to disturbances in mood, cognition, pain perception and overall well-being. Therefore, we tremendously help heal our bodies by working with trained professionals to uncover, witness and rewrite the story of our traumas that are both energetically and physiologically generating inflammation inside the body.
Chronic stress stems from a wide range of experiences, and isn't just limited to overt traumatic events; it encompasses daily stressors and societal expectations that shape our behaviors. These stressors, often underestimated, repressed or suppressed into the subconscious, exert a substantial influence on the Gut-Brain Axis (GBA). They induce a cascade of physiological changes akin to those seen in acute trauma. Everyday occurrences in personal relationships, workplaces, and societal norms can instigate chronic stress, which sustained over time has a parallel effect on the body - again, instigating a state of chronic inflammation.
Social Conditioning
For individuals of all genders, societal conditioning plays a huge role in fostering chronic stress. It influences everyone. Women, who comprise a majority (something like 80%) of autoimmune disorder cases in the U.S., are often conditioned to adopt selfless psychological constructs, leading to self-abandonment or constant service to others.
This societal predisposition often leads to stress and can you guess what they trigger? Yep, chronic inflammatory responses. In a similar vein, men are conditioned to adhere to traditional masculinity ideals that promote emotional suppression, stoicism, and the perception that seeking help is a sign of weakness. The pressure to conform to these norms is just as damaging for men and leads to chronic internalized stress and inflammation.
Our relationship dynamics, whether familial, romantic or social, can contribute significantly to the development of chronic stress and bodily inflammation. Toxic relationships and workplace environments with excessive demands, poor leadership or dissatisfaction create stress-inducing environments. The pressure we put on each other to conform to gendered or stereotypical presentations to the world, for example, identifying heavily with provider or caretaking roles can often result in internalized conflict and prolonged chronic stress. Societal constructs influence individuals' emotional responses, prohibiting both the nurturing of our Authentic Self, and our ability to cope with stress, ultimately negatively affecting our overall health and well-being.
The persistent inflammatory response from chronic stresses like those described above interferes with the function of the GBA in the same ways as our traumatic experiences in life - impacting gut microbiota, gut lining integrity, and neurotransmitter signaling. Studies like Lasselin, J. et al. (2016) published in Brain, Behavior, and Immunity explore the connection between “negative” or shadow emotional states (e.g., anger, hostility) and increased systemic inflammation, indicating a link between emotions and immune response.
Any prolonged or chronic stressor (including that which originates from our own minds) has the potential hamper the GBA's ability to maintain optimal function and lead us toward disruptions in mood regulation, cognitive abilities, pain perception, and otherwise poorer health. Recognizing the role of societal conditioning and everyday stressors in fostering chronic stress emphasizes the necessity of holistic approaches in addressing mental health for comprehensive and preventative health strategies.
Wrapping Up Part 1
If you made it this far, I’m genuinely impressed! Thank you for spending time with me on a complex but incredibly important topic. I hope it was worthwhile. The intricate web of factors influencing the function of our Gut-Brain Axis (GBA) and mental health is nothing short of fascinating and - to me - empowering. From the direct physiological influences of infections like parasites, bacteria, and viruses to the profound effects of chronic stress, societal conditioning, and emotional states, these various "villains" enter and often persist within our human bodies, leading to chronic inflammation and disrupting many systems. Understanding these interconnected elements highlights the significance of holistic approaches in addressing mental health by making it a priority to target inflammation and restore GBA function.
Stay tuned for Part Two next week, where we will explore interventions or “heroes” for each of these “villainous” inflammatory domains, from lifestyle adjustments to dietary considerations and far beyond - I’ll present as many avenues as I can for mitigating inflammation and nurturing GBA health. Stay tuned!
“All disease begins in the gut.”
–Hippocrates
References:
Berende, A., ter Hofstede, H. J. M., Vos, F. J., van Middendorp, H., Vogelaar, M. L., Tromp, M., ... Kullberg, B. J. (2016). Randomized trial of longer-term therapy for symptoms attributed to Lyme disease. The New England Journal of Medicine, 374(13), 1209–1220.
Bransfield, R. C., Donta, S. T., & Stricker, R. B. (2018). Clinical features and severity of Lyme disease. Pathogens, 7(1), 1–12.
Cox, C. J., Zuccolo, A. J., Edwards, E. V., Mascaro-Blanco, A., Alvarez, K., Stoner, J., ... Cunningham, M. W. (2015). Antineuronal antibodies in a heterogeneous group of youth and young adults with tics and obsessive-compulsive disorder. Journal of Child and Adolescent Psychopharmacology, 25(1), 76–85.
Cryan, J. F., & Dinan, T. G. (2012). Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nature Reviews Neuroscience, 13(10), 701–712.
Dickerson, F., Stallings, C., Origoni, A., Katsafanas, E., Savage, C., Schweinfurth, L., ... Yolken, R. (2014). Markers of gluten sensitivity and celiac disease in recent-onset psychosis and multi-episode schizophrenia. Biological Psychiatry, 75(2), 934–940.
Dinan, T. G., & Cryan, J. F. (2017). The microbiome-gut-brain axis in health and disease. Gastroenterology Clinics of North America, 46(1), 77–89.
Kannan, G., Crawford, J. A., Yang, C., Gressitt, K. L., Ihenatu, C., Krasnova, I. N., ... Pletnikov, M. V. (2017). Anti-NMDA receptor autoantibodies and associated neurobehavioral pathology in mice are dependent on age of first exposure to Toxoplasma gondii. Neurobiology of Disease, 106, 124–133.
Lerner, A., Neidhöfer, S., & Matthias, T. (2017). The gut microbiome feelings of the brain: a perspective for non-microbiologists. Microorganisms, 5(4), 66.
Malaty, H. M., Graham, D. Y., & Petzold, U. (1994). Helicobacter pylori infection: genetic and environmental influences. A study of twins. Annals of Internal Medicine, 120(12), 982–986.
Mayer, E. A., Knight, R., Mazmanian, S. K., Cryan, J. F., & Tillisch, K. (2014). Gut microbes and the brain: paradigm shift in neuroscience. Journal of Neuroscience, 34(46), 15490–15496.
Mayer, E. A., Tillisch, K., & Gupta, A. (2015). Gut/brain axis and the microbiota. Journal of Clinical Investigation, 125(3), 926–938.
Owyang, C., & Wu, G. D. (2014). The gut-brain axis in health and disease. Gastroenterology, 146(3), 807–818.
Pavone, P., Rapisarda, V., Serra, A., Nicita, F., Spalice, A., Parano, E., ... Falsaperla, R. (2014). Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: an overview. European Journal of Pediatrics, 173(8), 997–1006.
Rook, G. A., Raison, C. L., & Lowry, C. A. (2014). Microbial 'old friends', immunoregulation and socioeconomic status. Clinical & Experimental Immunology, 177(1), 1–12.
Smith, J., Anderson, J., Shamsi, S., & Gibson, A. (2020). Gut parasites: a missing link in the hygiene hypothesis? Journal of Allergy and Clinical Immunology, 145(2), 506–507.
Strandwitz, P. (2018). Neurotransmitter modulation by the gut microbiota. Brain Research, 1693(Pt B), 128–133.
Toscano, L., Cursano, C., Porru, D., De Giglio, O., Graziani, C., Caggiano, G., ... Gallo, R. (2017). Chronic hepatitis C infection and neurological and psychiatric disorders: an overview. World Journal of Gastroenterology, 23(39), 7052–7059.
Webster, J. P. (2007). The effect of Toxoplasma gondii on animal behavior: playing cat and mouse. Schizophrenia Bulletin, 33(3), 752–756.