Episode 7: The Gut-Brain Connection

In this episode of the Get Your Gut Together with Dr. Arreola, I explore the fascinating link between our gut and brain and how understanding this connection can help us better manage both our mental and physical health. I share my own personal story of how I discovered this connection and I even give you the nitty-gritty scientific detail on how this all works in our body. And lastly, I go over some general tips on how you can improve BOTH your digestive health and mental health, at the same time. I hope that you found the information in this episode helpful and if you DO have any questions or comments for me, I would love to hear from you.Thank you so much for tuning in, and I hope you'll join me for the next one.

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Transcript

EPISODE 7 - The Gut-Brain Connection

• Hi everyone and welcome back to the Get Your Gut Together with Dr. Arreola Podcast. Today I want to talk about the intimate connection between our digestive health and our mental health, more commonly known as the gut-brain axis. Our gut is often referred to as our "second brain" due to the extensive network of nerves, neurons and neurotransmitters that line our digestive system. These neurons communicate directly with the brain, influencing our thoughts, emotions, and even behaviors.
  • This has become more and more evident in recent years due to new research proving this connection and it’s impact on our overall well being. And in addition to this, an increasing amount of evidence suggests that a disrupted gut-brain connection can actually increase a persons risk for mental health conditions, such as anxiety and depression.
• So, in today’s episode I want spend some time exploring the fascinating link between our gut and brain, and how understanding this connection can help us better manage both our mental and physical health. I’ll share my own personal story of how I discovered the impact of this connection and then of course I’ll give some solid scientific explanations as to how this works. I’ll also be sure to share some general tips on how to improve your digestive health and inevitably your mental health. So without further ado, let’s get right into it.
• I personally struggled with both anxiety and depression from a pretty young age. Of course, I didn’t realize that that’s what it was but looking back on those experiences with the knowledge I have now, it’s pretty clear. And as I mentioned in a previous episode, I also struggled pretty extensively with digestive health issues that were labeled as IBS. One of the most impressive changes I saw in my health when I started to address the dysfunctions in my gut, was the reduction in anxiety. In college, I regularly had panic attacks AND commonly woke up and went to bed feeling on edge. It was a scary feeling because I didn’t understand why I was feeling that way. I feel like nowadays, mental health conditions such as anxiety and depression are much more openly discussed. With new social media platforms like TikTok, it has become much more normalized to be transparent about the struggles of mental health disorders than it was just 5 or 10 years ago. But at the time I was struggling with it, I had no idea what was going on. I also regularly battled depressive episodes where simple tasks like making meals for myself or cleaning my room seemed like the equivalent of climbing mount everest. But when I began to address my digestive symptoms, my chronic anxiety and episodic depression began to slowly dissipate without me intentionally addressing it. And it was one of those things that I didn’t even notice until it was almost completely gone.
• I had tried several modalities to address my mental health such as SSRI medications and talk therapy. And although some of these helped, it was never quite enough for me to feel “normal” again. But once I started changing the foods I was eating and filling in nutritional gaps using supplementation and adding in mindfulness techniques like grounding and meditation - I feel like I became a different person.
• Now it’s important that I note that the information I’m providing in this episode is not meant to be a substitution for medical advice or medical care, but more to just share the knowledge that I wish I had then. I am not saying to get off of your medication if you are on it or to stop working with your therapist. Rather, I am providing you with an additional tool to add to your tool box. Or perhaps another approach to your mental health altogether that you may not have thought of. On that note, let’s transition over to the SCIENCE behind the gut brain connection.
• The gut-brain connection is a complex one and to gain a better understanding of how it all works, it's important to talk about the enteric nervous system (ENS). The ENS is a complex network of nerves, neurons, and supporting cells that line the walls of our digestive system. It is often referred to as the "second brain" because it can operate independently of the central nervous system ( also known as the CNS) but we more commonly know it as our brain and spinal cord.
• The ENS communicates with the CNS via the vagus nerve, which is a large nerve that connects the brainstem to the abdomen. This bidirectional communication pathway allows the gut to send signals to the brain, and vice versa. For example, when we eat, the ENS sends signals to the brain to release digestive enzymes and prepare for food intake. Similarly, when we experience stress or anxiety, the brain sends signals to the gut that can halt digestive processes. The idea being that if you are dealing with stress and anxiety, your energy should be allocated to help address whatever the perceived danger is. This halt in digestion can trigger digestive symptoms, such as nausea or stomach pain. To give you a real-life example,think about a time you received bad news or got really nervous before speaking in front of a group of people and felt “gosh I feel sick to my stomach”. That sick feeling is the consequence of this gut-brain connection via the vagus nerve.
• But thats not all…the gut-brain connection is not JUST about communication between the ENS and CNS. The gut is also home to trillions of microorganisms, collectively known as the gut microbiome. The gut microbiome plays a key role in regulating the gut-brain axis because these microbes produce neurotransmitters, such as serotonin and dopamine. These neurotransmitters are associated with mood regulation and are commonly targeted by antidepressant or anti-anxiety medications. A healthy gut microbiome can help to produce optimal levels of these neurotransmitters, which can promote positive mood and reduce symptoms of depression and anxiety. Conversely, an imbalanced or disrupted gut microbiome can lead to altered levels of these neurotransmitters, which can contribute to increased anxiety and low mood.
• But in addition to that, these neurotransmitters also play a role in PHYSICAL digestive symptoms. So take serotonin, for example, one of our happy neurotransmitters. Serotonin is involved in the contraction and relaxation of the muscles in the digestive tract. So, imbalances in serotonin levels can lead to changes in gut motility, which can result in symptoms such as constipation, diarrhea, and abdominal cramping or discomfort. Dopamine, on the other hand, which is another neurotransmitter, is involved in the regulation of stomach acid secretion and the release of digestive enzymes, which help you break down and absorb your food. So imbalances in dopamine levels can lead to changes in digestive function and contribute to symptoms like bloating, abdominal pain, or indigestion.
• So as you can see, it's not surprising that disruptions in this complex ENS-CNS-Microbiome connection can lead to a range of physical and mental health issues that we may not have even thought of.But now I want to zoom in a bit on one particular health condition and more deeply examine its correlation with mental health issues and that condition is IBS.
• For those of you who don’t know, IBS stands for irritable bowel syndrome and is unfortunately used as a “catch all” diagnosis for those with digestive symptoms that their doctor could not find the cause of. IBS is characterized by symptoms such as abdominal pain, bloating, and changes in bowel habits. I personally don’t consider IBS a true diagnosis since it’s simply a collection of symptoms and the cause of them can be different for every person. But that’s a discussion for a different day. Today I wanted to go over the correlation between those who have a diagnosis of IBS and also deal with chronic anxiety and depression.
• Studies have found that up to 70% of individuals with IBS also experience mental health symptoms, compared to around 20% of individuals without IBS.This suggests that there is a significant overlap between the two conditions, and that addressing mental health concerns can be a crucial component of managing IBS symptoms and vice versa. And the science behind this again, brings us back to the gut-brain axis which we discussed earlier. Because stress and anxiety can trigger changes in gut motility, secretion, and even inflammation - this undoubtedly plays a role in IBS symptoms. But then dealing with these kinds of symptoms day in and day out, with no real answers as to why - can FURTHER exacerbate mental health symptoms like anxiety and depression. So really it can continue to be a vicious cycle unless its properly addressed. So how do we do that?
• Well before we dive into some tips on how to do this, it's important to note that the relationship between IBS and mental health is complex and multifactorial. AND I want you to keep in mind that not ALL individuals with IBS will experience mental health symptoms, nor will all individuals with mental health symptoms have IBS. However, taking both of these aspects of your health into account can really help to manage overall symptoms.
• Now doing this can include a range of interventions such as therapy, relaxation techniques, dietary changes and supplementation. So I’ll briefly go over some useful tips I’ve shared with my patients in the past.
• My first tip is to become more mindful of what you consume on a daily basis, and I’m not referring to food. In today's world we are constantly bombarded with news and information from a variety of sources, including social media, 24-hour news cycles, and online news outlets that can have a very heavy impact on persons mental and physical health. Unfortunately, majority of news sources are focused on ratings and those ratings go up the more jaw-dropping or disturbing the content they release is. Because of this, we are constantly being exposed to horrible, shocking stories of what is going on around the globe. This constant exposure to media can lead to a state of chronic stress, anxiety and feelings of depression which can lead to a cascade of physiological changes and negatively impact a person’s gut-brain axis. So if you are dealing with digestive symptoms or mental health symptoms, do yourself a favor and take a break from the news. There is definitely some truth behind the saying “ignorance is bliss” and although some people may consider it selfish to intentionally step away from whats going on in the world, sometimes being selfish is necessary to protect your peace and your health.
• My second tip is to begin practicing mindful eating. It’s become SO normalized to eat on the go or while multitasking, such as eating lunch at your desk or eating breakfast on the commute to work or even watching tv with dinner. And doing this can really dilute your body’s ability to properly digest food. Now that you have the knowledge behind the gut-brain connection, hopefully it’s much more clear how eating in stressful situations like these can truly impact your health. This is a lot easier said than done, so I ask my patients to aim to have at least ONE mindful meal a day, with the goal of eventually working their way up. It includes removing distractions, so putting the phone away and turning the tv off… and taking a few deep breaths before they take their first bite. I also encourage them to eat slowly, really chew their food and turn their attention to the entire experience of eating. How do the flavors taste? How does their body feel? Etc… it doesn’t have to be complicated to be effective. But making this a habit around meals can be quite the game changer.
• My third tip is to consume a diet that is going to support a healthy gut microbiome. So this means limiting foods that are highly processed and made with inflammatory oils or ingredients and bringing in more foods that are going to increase the number of GOOD bacteria in the gut and foods that are going to FEED that good bacteria. So what does this mean exactly? Foods that are going to increase the number of good bacteria include fermented foods. So for example: kimchi and sauerkraut which are both forms of fermented cabbage, are excellent additions to a diet that supports a healthy gut. Other options include things like yogurt, kombucha and miso. All of these fermented foods are going to help you keep your microbiome balanced. And you don’t need much, literally a few tablespoons of a fermented food on a daily basis is plenty. Now to make sure that these good bacteria thrive, we want to give it food. So you need to increase your intake of FIBER, because thats what they like to eat. So eating more fruits and vegetables that are high in fiber like berries, broccoli, cabbage, cauliflower and so on are excellent ways to keep those good bacteria happy and healthy.
• And lastly, my 4th tip is to add in stress-reducing techniques into your daily life. Too many people wait until they are incredibly stressed out before they implement stress-reducing habits…But an ounce of prevention is worth a pound of cure, guys! Whether we like it or not, just given the current state of the world right now, we are ALL stressed in some capacity. And we need to take that more seriously by addressing it, rather than suppressing or ignoring it. So begin to reduce stress on a daily basis, by letting some steam out of the pot. It doesn’t have to be this big, complicated thing, in fact while starting out I advise against doing something too involved or you just won’t stick with it. Keep it simple and doable. For example, if you want to try meditation - begin a 5 minute meditation practice. So everyday, commit to meditating for 5 minutes only. No more, no less. You can find hundreds of guided short meditations on youtube or you can put some calming music on and just set a timer and breathe, whatever works. But stick to it for a few weeks and see how you feel. Another thing you can do is spend MORE time outdoors, in nature. So if you’re not an outdoorsy person, you don’t have to go all out and camp in the woods…something as simple as taking a 10 minute walk outside on your lunch break or after dinner, WITHOUT being on your phone can do wonders for stress relief. Another thing to try is to make time to truly connect with a loved one. Whether that be calling a family member or friend that you don’t see often and just checking in on how their doing OR sitting on the couch with your significant other, phone and tv off, and connecting face-to-face. I’m telling you these things seem simple, but they work.
• Hopefully you found these tips to be helpful and you’ll consider trying one of them. This was not a comprehensive list of all the possible things you can do to improve the health of your gut-brain axis but it is a good place to start.
• And there you have it, as a summary, in today’s episode we explored the fascinating link between our gut and brain, and how understanding this connection can help us better manage both our mental and physical health. I shared my own personal story of how I discovered this connection and I even gave you the nitty-gritty scientific detail on how this all works in our body. And lastly, I shared some general tips on how you can improve both your digestive health and mental health, at the same time. I hope that you found the information in this episode helpful and if you DO have any questions or comments for me, I would love to hear from you. That brings us to the end of our show today, so thank you so much for tuning in, and I hope you'll join me for the next one.