Follow Your Gut To Know What Is Causing Your Depression
Today almost 20% of South Africans are suffering from depression and anxiety – and although the word is commonly used in day-to-day conversation, depression is not a disorder to be taken lightly. In fact, if unresolved it can snowball into a far more severe health problem. Recent research in this field has proven to be very interesting – and is revealing a new treatment angle that may come as quite a surprise to you: treating your gut health first.
While we all may feel sad or low in energy at times, depression is not a variation of one’s mood, but an illness. It has been conventionally described as a chemical imbalance, or, more specifically, a particularly low level of serotonin (the happy hormone) in the brain. And this could be a serious problem: out of approximately 40 million brain cells, most are influenced either directly or indirectly by serotonin – it impacts our mood, sexual desire, sleep and memory.
The World Health Organization has classified depression as the leading cause of most disabilities. For the last 50 years, the most conventional forms of treatment recommended by the psychiatric “bible”, the Diagnostic and Statistical Manual of Mental Disorders (DSM), involve a combination of psychotherapy treatment and antidepressant medication. Today, “selective serotonin reuptake inhibitors” (SSRIs) are considered the most popular antidepressant drugs; they work by recirculating serotonin in the brain to stabilise the mood. SSRIs do have their downside, often inducing drowsiness, weight gain and reduced sexual desire; they have also been found ineffective for 30% to 40% of patients, according to an article on treatment-resistant depression published in BioMed Central Psychiatry in November 2014.
Antidepressants can create necessary stability for some people, but what about the underlying problem? Dr Nicola Buchan, an integrative medicine GP from The Wellness Station in Cape Town, explains that there can be emotional, physical, biochemical, hormonal, nutritional and situational influences contributing to the person’s state of mind. “I personally believe there’s a place for antidepressants in my practice, but it is important to remember that depression has many etiologies, faces and outcomes,” she says. “I work with patients to find a treatment that feels right for them.”
Dr Marion Weston, a Cape Town-based holistic GP and homeopath, observes that whatever the contributing factors, her patients all have one thing in common. “When I look at my patients with depression, there is always an extremely depleted gut biome; there are hardly any bacteria left.” Research is now discovering the influence of our gut bacteria on our mood.
The Brain-Gut Link
Having a “gut feeling” may be more literal than one may think. Our digestive system and our brain are linked through a powerful pathway known as the gut-brain axis, made up of nerves, hormones and the immune system. There are about 100 million neurons in the digestive tract, known as the enteric nervous system (ENS), or “second brain”. The ENS has more firepower than all of the nerves in the spinal cord and body put together; apart from digestion, their job is to be a highway of communication between the belly and the brain.
“It has now been shown that 90% of the fibres in the vagus nerve (major gut-brain nerve) carry information from the gut to the brain, not the other way around,” says Buchan. Research shows that hundreds of mood-controlling neurochemicals used in the brain, including the famous serotonin, are actually produced and regulated by the gut microbiome. In March 2011, the journal Neurogastroenterology & Motility stated: “The ability of gut microbiota to communicate with the brain and thus modulate behaviour is emerging as an exciting concept in health and disease.” Not only do low levels of gut bacteria diminish the supply of happy chemicals to the brain, but this imbalance also creates inflammation in the intestinal walls.
Depression is now considered an inflammatory disorder. Globally renowned American neurologist Dr David Perlmutter adds: “We now understand that stress, infection, drugs, toxins and diet can lead to the damage within the microbiome and the intestinal wall. This creates gut permeability (leaky gut syndrome), allowing various proteins like gluten to leak into the bloodstream, stimulating immune cells and creating inflammation.” These immune cells also produce inflammation in the brain, causing depression, according to the article “From inflammation to sickness and depression”, published in Nature Reviews Neuroscience in January 2008.
On top of this, gut inflammation can trigger a process called “serotonin steal”, where tryptophan (the amino acid behind the making of serotonin) is diverted away from the brain, increasing anxiety, insomnia and depression. Exciting new areas of scientific investigation suggest that reversing inflammation and balancing the microbiome may be a pivotal point in the global epidemic of depression and other mental disorders.
Changing The Gut
“Creating a healthy gut microbiota is being investigated as a viable treatment strategy for serotonin-related brain-gut axis disorders,” noted Behavioural Brain Research in January 2015, while Buchan adds: “Supplementing with probiotics has been shown to provide a multitude of health effects.”
Healing the gut is not an overnight process; one needs to create the correct environment for probiotics to be cultivated, otherwise they simply pass through our body as if in a hollow tube. Yet simple adjustments, including eating cultured (probiotic) food such as sauerkraut and kefir, can begin to lay a good foundation for change.
Whatever the individual health story is, researchers and doctors are clear: professional psychological, nutritional and biochemical support are imperative and essential to the healing of depression. Understanding inflammation and the gut certainly shines a whole new light on depression.
Although it is only one component of a bigger story, nourishing our gut can take us one step away from being victims to our own brain chemistry, and a step closer to mental and emotional well being.