Gut Feeling: The Microbiome and Mental Health

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Cover courtesy of New Society Publishers
Long understudied, the gut is beginning to be understood as a key player in division between disease and health, leaving scientists to go back to the drawing board to refocus on mental health and autoimmune diseases.

The Secret Life of Your Microbiome (New Society Publishers, 2017), by Susan L. Prescott, MD, PhD and by Alan C. Logan, ND presents the scientific connection between our bodies and the microbial world and suggests that the health industry not neglect the symbiosis of microbial and human life. The book includes recipes for a healthy microbiome from “The Gut Girl”, Marlies Venier, a skilled fermenter, blogger, and certified health coach. The following excerpt discusses the link between the gut, disease, and mental health from the theory of dysbiosphere, first described by John Arthur Thomson (1861-1933) as “the way life (Greek: bios) that surrounds us like a living globe (Latin: sphaera),” or “life in distress” (The Secret Life of Your Microbiome).

Shifting Psyche in the Dysbiosphere

At all hours of the day and night, just as surely as birds migrate and the Earth rotates on its axis, massive juggernauts traverse national highways and city streets. These semi-trailer trucks — 40-ton transport vessels unimaginable just a century ago — are filled to the brim with cargo that is driving dysbiosis — life in distress. Flinging open the back doors for forensic examination, we soon see the stash that is eroding life and health. Sugar-rich foods and beverages, cigarettes, ultra-processed foods, high-calorie/low-nutrient foods far removed from nature, energy drinks, and the raw material for fast food that gets assembled by workers who don’t receive a living wage are making their way to a city near you. These are all markers of a system of personal, public, and planetary health run amok. Yet, all the while, they are also our desperate attempts for a healing balm for all that ails us, along with literally truckloads of antidepressants. Distress in life serves only to increase the bloated haul.

Close to 30 million tons of sugar are hauled around the United States annually. The markers of our sedentary life — 37 million new televisions, 160 million new smartphones — scurry over interstate highways. Many more are destined for households in westernized and developing nations alike.

Psychotropic medications are increasingly prescribed to children, teens, and adults. Although prescription drugs don’t weigh much, they represent one of the most valuable commodities transported on US highways and rail routes — $914 billion per year. Despite having a per-pill weight which is next to nothing, the haul still amounts to over 200 tons of antidepressants, anti-anxiety, attention deficit, and sleep-enhancing medications. We also turn to dietary supplements to soothe us and help fill in nutritional voids — $30 billion worth of approximately 30,000 different dietary supplements in North America alone. Just one small segment of this industry — omega-3 and other fatty acids — tells a story of the sheer volume of our desire to be fixed: 120 million tons of fatty acid supplements are moved around our global transportation systems.

Then we have energy drinks. Juggernauts deliver $43 billion worth of so-called energy drinks to keep up with global demand. Experts in business marketing describe it as an unquenchable thirst for more energy; they foresee a 40 percent growth in sales and profits galore by 2020. We, on the other hand, foresee an increasingly fatigued global population trying to prop themselves up and survive the demands of modernity via the contents of little plastic bottles or large tins of packaged stimulants. Each can and bottle is interconnected to so many other issues of our time. For example, Dr. Subin Park and colleagues have found that energy drink use is linked to sleep problems, depression, suicidal ideation, and stress. They found that consuming junk food magnifies these energy drink-neuro-behavioral-emotional links.

Visualize all that global locomotion for just a moment. The colossal movement of products, the energy it takes, the planetary fatigue it induces, the pressure it places on the biodiversity we are increasingly detached from. A core theme of Secret Life is the interconnectedness of life in promoting health, which therefore cannot be removed from the interconnected forces that threaten that vital force. One by one the semi-trailers pull up to the urban loading dock, which is essentially our own gullet. Heavily supported by prodigious promissory notes written by marketers who pledge us a better life, each load brings us further away from our ancestral past.

No Health Without Mental Health

In order to make our argument that all aspects of life — both seen and unseen — are connected to your health and vitality, and, by extension, the health of those around you, we first need to take a step back and take stock of where we are at, mentally, in westernized societies or so-called developed nations. We apologize up front if this might seem, for lack of a better word, depressing. However, as the messages of positivity break through, they will do so from the oft-overlooked vantage of mental health. This is an essential prism so that we can later crush the superficial dismissal of nature by many political leaders, institutions, and those in positions of power and authority. In many of these halls, nature, if on the radar at all, is viewed merely as a low-ranking variable in modern health. To illuminate our argument, we must first shine the optimistic, variegated light of our vis medicatrix naturae dialogue on the unsettling crises in our midst.

Although we will focus on health from the mental and emotional perspective, we do so with the understanding that emotional health is deeply connected to the epidemic of chronic, non-communicable diseases in our midst. Allergy, asthma, and autoimmunity are the barometers of change. These diseases are happening at increasing rates, especially early in life. Consider that pediatric inflammatory bowel disease has tripled in some countries over the last half-century. But careful study shows that rapid increases have occurred mostly over the last decade. Based on twin studies, genetics are not the issue, accounting for only about 20-30 percent of the causation. Also, although it’s tempting to dismiss this as simply increased awareness by doctors, the increases in pediatric type one diabetes are increasing along similar lines. Increases in type one diabetes aren’t a matter of physician awareness. It is fairly obvious, life-threatening disease and has been since doctors rode in a horse and buggy. The only rational conclusion is that something, or some things, have changed in our environment, lifestyle, or both.

Onwards then, to the current psyche in developed nations. As defined, the term “developed” might infer that nations like Australia, Canada, the United Kingdom, and the United States are all grown up and fully mature. When it comes to dealing with infectious disease, early-life mortality, and the delivery of advanced healthcare, these and other G12 countries are certainly wise beyond their years. But not so much when looking at them through the filter of what actually defines health.

Health, as Thomson made clear and as the World Health Organization (WHO) has now formally defined, is not the absence of disease but rather a state of complete physical, mental, and social well-being. WHO has more specifically defined mental health as the ability to reach one’s potential while coping with the normal stresses of life. Of course, defining what, exactly, are the “normal” stressors of life in our increasingly complex, urbanized, technological, nature-detached world, is a bit of a challenge. However, we can all understand that, just because someone doesn’t meet the checklist criteria for a mental disorder, doesn’t mean they are thriving. Nor does it mean they are healthy.

Beyond the Borders of Disorders

The international statistics on mental health in developed nations are troubling to say the least. In the United States 25 percent of the adult population reports having a mental illness in a given year, and 50 percent of adults over the course of a lifetime. Those are actual disorders. Primary interventions — pharmaceutical drugs and cognitive- behavioral therapy — can be powerfully effective. They just aren’t effective enough for everyone. Plus, they are often used after months or even years of suffering. Prevention of mental disorders desperately needs to be prioritized.

Since our focus is on mental health, we won’t enter the debate about whether or not there is a more recent epidemic of defined mental disorders. Although some studies have shown major increases in diagnoses of depression and anxiety in recent years, others have not. Whatever the accurate percentage of westerners that currently meet various criteria for depression and anxiety disorders may be, we can all agree that it is unacceptably high.

There are untold numbers of people who sit just below the threshold of diagnostic criteria for depression and anxiety disorders. In medical jargon the individuals who look good from afar, but are far from good, are labeled as having subsyndromal, subthreshold, or subclinical conditions. Psychological distress, fatigue, sleep difficulties, and other symptoms associated with subclinical mental health disorders are commonly reported in primary care settings. Only eight percent of people show up to their doctor to discuss mental health issues like depression, anxiety, alcohol problems; they are much more willing to talk about physical ailments. But when prodded just a bit, it turns out one in three are actually experiencing emotional symptoms that they were reluctant to discuss.

Only in recent years, have researchers started to get a handle on the true suffering, unrealized quality of life, and difficulty performing daily activities, experienced by those who sit just below diagnostic cutoffs. Historically, scientists and clinicians have been hyperfocused on individuals that meet highly-debated criteria for various mental disorders; the consequences of this are now clear — many suffering individuals have been overlooked. We think it is an important part of the discussion because living on the borderland around “nearly” having major depression and/or anxiety disorder(s) sets one on the path to a higher risk of other chronic diseases, and, most certainly, impaired quality of life. The physiological and metabolic changes — oxidative stress and inflammation — that lead to damage to cells are there on either side of the line.

In fact, scientists discovered recently that individuals with sub-threshold depression experience loss of grey matter and increased mortality. That’s code for the reality that the mind-body interface really isn’t interested in diagnostic manuals: moving along the mental state continuum in the direction away from vitality damages cells and can shrink your brain and shorten your lifespan. We describe in Secret Life how recognition of the interconnectedness of life and lifestyle can provide an antidote to the erosion of health. Provide a sea wall to protect your grey matter.

The Resonance of Stress

Shifting mental health can also be gleaned from perceptions of stress. The vast majority of international academic studies and surveys conducted by various mental health organizations show significantly higher reporting of psychological distress within the last few decades. In fact, never mind decades, they show significantly more distress in the last few years. If youth and adults of all ages are reporting higher levels of perceived stress — and perception is reality when it comes to thoughts and feelings — then we have a clear roadblock to the realization of mental health.

Very telling are the increases in cases involving symptoms of depression, anxiety, and stress fielded by the employee assistance departments of major global companies. For example, one survey involving 100,000 employees located in Europe, Asia, and the Americas reported a 27.4 percent increase in such cases from 2012 to 2014. Similar findings from an Australian employee assistance firm covering 600,000 employees has shown a 15 percent uptick in stress-related sickness and cases of flat-out AWOL from work due to stress in re- cent years. There are many legitimate reasons why this might be the case, often pinned on horrible bosses, modern workplace culture, and excessive demands. However, our children, teens, and university students are also experiencing the same trends.

New research from Dr. Jean Twene shows that compared to their peers from 1980, North American teens are much more likely to report symptoms of distress such as trouble sleeping, shortness of breath, diminished cognitive focus, and memory recall. Also in the last few decades, young adults in university are more likely to report feeling overwhelmed. Recently, Canadian scientists from the Centre for Addiction and Mental Health found that the number of teens reporting moderate to serious psychological distress has increased since 2013. Meanwhile, rates of disability due to mental or neurodevelopmental conditions has increased by 21 percent over the last decade. It’s an upward creep of stress, especially among our youth.

Recipes from The Secret Life of Your Microbiome:

Reprinted with permission from The Secret Life of Your Microbiomeby Susan L. Prescott, MD, PhD and by Alan C. Logan, ND and published by the New Society Publishers, 2017.