How Do Stress, Emotion, and Diet Affect the Gut?

Stress, Emotion, Diet and the Gut

dietstressgut

photo by Shira Gal

The Gut – Brain Connection

It has becoming more accepted in the psychiatric literature as well as in the functional medicine that there is a bidirectional connection between the brain (central nervous system) and the gut (the gastrointestinal tract) through endocrine pathways.

Stress Affects The Gut

Stressors of various nature, either psychological or physiological, can alter the gut microbiota’s composition and the changes in the microbiota, represented through metabolic activities can influence the brain response.1

Emotion and the Limbic System

The limbic system plays a central role in regulating emotion and also is the center of the gut control.2 The generation of emotions and attached physiological reactions are most likely generated at this brain level (a very primitive part of the brain).

Depression and The Gut

In more recent scientific communications it has been suggested that depression can promote intestinal permeability as a result of chronic inflammation leading to a condition known as ‘leaky gut’. Leaky gut is another name for intestinal hyper-permeability that allows different substances (such as toxins, microbes and undigested food particles) to pass into the blood stream.

Diet and the Gut

Diet plays an important role in addressing the condition, such as ingestion of probiotics and prebiotics. Probiotics are beneficial forms of gut bacteria that helps the intestine to function properly. Examples of probiotic foods include: yogurt, kefir, sauerkraut, dark chocolate, microalgae, miso soup, pickles, tempeh (made from soy, a great source of vitamin B12 too), kimchi (an Asian form of pickled sauerkraut), Kombucha (fermented tea). For those who don’t find any of these appealing, tablets of probiotics are also good.

Prebiotics and the Gut

The prebiotics are enzymes that help the good bacteria to grow in the intestine. They are found in asparagus, Jerusalem artichokes, bananas, garlic, onions, oatmeal and legumes. They are also available in forms of supplements.

Non-Celiac Gluten Sensitivity

Another source of interest in affective disorders as well as in autism, and schizophrenia has been the Non-Celiac Gluten sensitivity (NCGS). The literature and studies are limited on the subject but it has been suggested that there is a relationship between the NCGS and neuropsychiatric disorders. Some studies point at the inflammation triggered by the gliadin in people sensitive to it and the ‘leaky gut syndrome’ associated with it.  The IgA detected in affected individuals suggest an inflammatory response to the gliadin that is found in wheat, barley, rice, and an exclusion of these products could reduce the neuropsychiatric symptoms associated with the “leaky gut” (migraines, Irritable Bowel syndrome, tiredness, chronic fatigue, etc).3

Listen To Your Body

Because research on diet and gut is still in it’s infancy it is important that you monitor how you feel after you eat certain foods. Obviously, if a food makes you feel bad you can reduce or eliminate it and see how you feel.

Integrative Treatment in Psychiatry

We take an integrative treatment approach with all our clients because we believe that any treatment that we recommend should be based on a very thorough history, questionnaires, targeted laboratory testing, and results from a physical exam.

Examples of core imbalances we assess for include:

  • Structural, boundary, and membrane imbalances
  • Genetic Mutations
  • Psychological and Spiritual
  • Hormonal and neurotransmitter imbalances
  • Oxidation-reduction imbalances and mitochondrial dysfunction
  • Detoxification, neurotoxicity, and biotransformation imbalances
  • Immune imbalances (Cytokine hypothesis)
  • Inflammatory imbalances
  • Digestive, absorptive, and microbiological imbalances

If you like this article on How Do Stress, Emotion, and Diet Affect the Gut, or have questions, schedule your first session by calling us at 713.426.3100

 

References:

1 Inflammation:Depression Fans and Flames and Feasts on the Heat: Kiecolt-Glase PhD, and colab, Am J Psychiatry, 172:11, November 2015, pg 1075-1091

2 Brain–gut connections in functional GI disorders: anatomic and physiologic relationships: Jones, MD and colab, Neurogastrointestinal Motil, 2006, 18, 91-103.

3 Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders,  Catassi and colab, Nutrients 2013, 5, 3839-3853.

Taking Care of Your Brain: What Does It Mean

Brain and Mental Health

Indisputably the brain is the master organ of the body, which holds the mapping of our daily functioning. Psychiatry treats the mental illnesses that result from its malfunctioning. There is an interesting relationship between the brain and the mind, so complicated that science can’t quite explain it the way it does with other organs of our body. The liver’s function as complex as it is, offers less unanswerable questions regarding its massive role in metabolism and digestion. The brain- mind connection is far less understood.

As complex as the issue is, one fact is certain: a physiological malfunction of the brain’s circuits produces alteration of the mind processes. We do know that if the norepinephrine, serotonin or dopamine driven circuits don’t work properly, people end up feeling sad, depressed or anxious, having negative thoughts, beliefs and outcomes.

The mind on the other hand can influence the way that people ‘navigate’ through the darkness of mental illness because the brain –mind connection, is a double way street: a positive mind setting

speeds up the recovery from a depressive or anxiety episode, and a healthy brain produces a healthy mind.

So, what can people do to keep their brain as healthy as possible?

  1. Exercise, especially aerobic releases body manufactured substances that improve the sense of wellbeing, increase energy, improve cognition, stimulate brain regeneration process ( BDNF,
  2. endocannabinoids, endorphins, different regenerative stimulating growth factors) .
  3. Healthy diet provide the right kind of proteins ( vegetable type protein), fatty acids, vitamins and amino acids that are needed in rebuilding the brain cells;
  4. Medication that have a targeted action at the receptor levels serotonin reuptake inhibitors, serotonin/norepinephrine reuptake inhibitors, etc
  5. Light therapy can help some forms of depression, such as the Seasonal type of Affective Disorders
  6. Neuromodulation: depressed patients who do not tolerate the medication side effects could achieve relief through Transcranial Magnetical Stimulation, ECT or vagal nerve stimulation.

So what can people do to keep their mind healthy or to heal from anxiety and depression?

  1. Meditation helps to give the brain a break from daily worries triggered by real or perceived problems;
  2. Spirituality helps by making people feel part of the bigger universe, relieving them from mundane struggles;
  3. Positive programing, i.e. NLP techniques helps by replacing negative expectations with positive ones through reframing;
  4. Therapy: cognitive, insight oriented, individual therapy, etc helps addressing the cause or the pathological responses to the stress

The possibilities of creating an individualized approach and treatment are multiple when the individual needs of the patients are taking into account. The best way to create a successful treatment program is to seek professional help from a psychiatrist or licensed therapist as soon as symptoms appear (sadness, irritability, inability to enjoy life etc). Waiting too long makes it more difficult to get to a remission state.

If you like this article on taking care of your brain, or have questions, schedule your first session by calling us at 713.426.3100.

Effects of Lying on One’s Health

Can Lying Affect Ones Health?

What’s lying? And what is the price that some frequent liars will pay, in health cost from lying way too often. The research shows that more one lies, more frequent lies he’ll say. Why? Because it takes many more lies after the first one to be able to provide a good cover-up that would be one explanation… Or, because a bad habit is hard to break…

Telling the truth is part of the Moral Development, along with no stealing and other rules that should be well defined in one’s ethics by adolescence…Quoting Lawrence Kohlberg stages of moral development, most adolescents have developed to stage 3 – the social conformity orientation, when most individuals have a sense of what ‘good boys’ and ‘ nice girls’ do and the emphasis is on living up to the social expectations and norms.

When a frequent liar says…well, “truth is relative”, the question is what truth do we refer to? Most commonly, and by no philosophical stretch, we are referring to the truth that the immediate and larger community of an individual accepts as truth based on the community’s rules.

Where does the stress of lying comes from? From the lying itself, the actual making of the lie, or the construction of the whole deflecting shield supposed to cover-up the lie? I tend to believe is the latest one.

There have been people looking at this scientifically by researching a group of poker players that were hooked to polygraphs, analyzing the changes induced by the stress of ‘ bluffing’ an accepted form of lying in poker. The polygraph tool looks usually at a wide range of physiological phenomena such as person’s heart rate, breathing rate, blood pressure and skin conductance, while a person is questioned.

The results of the test were impressive in my view. The research team was able to identify high stress situation with 82% accuracy and detect lying with 71% accuracy. Here we go…lying, even in a highly structured environment (like a poker game, where bluffing is accepted and encouraged) is a very stressful situation for the human body. (Michael Sung and colab)

If we expend this knowledge to people that make a habit from lying, could we extrapolate, on how the stress would influence their health? Stress is defined by Dr. Lazarus, as “…any event in which environmental demands, internal demands, or both tax or exceed the adaptive resources of an individual, social system, or tissue system…”

When an individual perceives the stressor as a challenge of his control of the situation, the body releases norepinephrine (the ” fight hormone”) and epinephrine (the “flight/anxiety ” hormone.

If the stress is prolonged, the individual becomes distress and defeated and his hypothalamus gets activated, which through a chain of reactions, releases cortisol from the adrenal cortex (of the kidney). The “flight” and “fight” responses causes the heart to beat faster and harder and releases more free fatty acids into the blood. The “defeat

“Response pathway can lead to lipogenesis (fat creation), visceral obesity (deep abdominal obesity), and breakdown of tissues and suppression of the immune system.

Increased secretion of cortisol increases the risk of cardiovascular disease, by increasing the BMI and decreasing the HDL cholesterol levels. Psychological distress has also been associated with an increased susceptibility to infections and possible cancer. Chronic stress apparently reduces the cellular as well as the humeral immune responses.

Exposure to chronic stress increases the risk for depression. About one – half of the individuals who are clinically depressed have an excess of cortisol in their blood.

If the chronic lying creates documented high body stress responses, through the autonomic nervous system reactions, could we safely conclude that frequent liars are more predisposed to cardiovascular events, increased abdominal obesity and increase predisposition to infections?

If you like this article on can lying affect health, or have questions, schedule your first session by calling us at 713.426.3100.

PTSD Impact on Relationship

Post Traumatic Stress Disorder, like any other psychiatric illness affects not only the
identified patient but also the relationship with the family or significant other.

Symptoms of PTSD

The experience of a life threatening event as a direct participant or an observer, or even the perception of that event as a life threatening one could shatter somebody’ s sense of self sometimes forever. In most situations, the immediate effects of the disastrous experience, the anxiety, the insomnia, the numbness, the hyper vigilance tend to go away on their on within the first four weeks after the event. That would describe the ‘Acute Post Traumatic Stress Disorder’ that’s almost an expected reaction. Surviving a natural disaster, an act of terrorism, an motor vehicle accident can live a person wandering about and question his safety.

The age of exposure has its own play in the equation of how symptoms develop in accordance to the psychological issues that each age encounters. In the mind of survivors there will always be this question, sometimes unconscious, ‘ am I going to be safe next time I cross the street’ with different variations on the safety theme. Sometimes dreams about the event follow the person in their sleep, making him or her fearing the bedtime, avoiding the reliving of the trauma even in the imaginary land.

Sometimes the fear is extended to anything in the patient’s life that used to be known as stable before the traumatic event, even things or situations that have no apparent relation to it. I remember one of my patients saying “doc, as I’m sitting here talking to you, I wonder if your book stand will crumble on top of me before the end of the session”. This man used to successfully mind his life, family and business till the day a tragedy struck him.

Veterans with PTSD

After four weeks, most symptoms are gone, but for at least thirty percent of people witnessing the traumatic assault on their life or others, the symptoms can linger for years. Sometimes, patients suffer from an extreme avoidance, emotional and physical, of situations that even remotely remind him of the trauma. That can significantly impair their ability to function socially or in their family. Veterans avoid war movies, can’t live by airports, can’t stand crowds, for example. A former marine, while studying in law school told me that he always had to stay on the last row of the amphitheater, so his back wouldn’t be exposed. I knew that from other veterans, of the Vietnam, Persian Gulf and now Iraq or Afghanistan. Years after returning home they still ‘ have to watch their back’. A profuse sense of mistrust and watching for danger changed their personality.

How does all of that impact the ‘others’ in their patient lives? When I used to run a Vietnam PTSD group at VA, I was surprised at the number of failed marriages and the relationships that these men went thru. The patients suffering with PTSD are mostly consumed with the after trauma effects, the anxiety and the ‘ be on guard ‘ feeling. The level of mistrust and ‘ waiting for the other shoe to fall’ or the bookcase to crumble affect dramatically the relationship with the significant other. Patients start withdrawing from the intimacy of the relationship, withholding and not trusting. Sometimes patients have to make life changes that affect their family. My patient who on the way home ran over somebody who decided to end his life by jumping in front of the freeway traffic, never recovered from that. He had to move to a different part of town, sell the car and start all over. Sometimes the life partners can’t adjust to these changes.

Some of the PTSD symptoms are very often overlapping with those of Major Depressive Disorder. Irritability, loss of appetite, interest and libido, indecisiveness, passive or active thoughts of suicide, impaired concentration and insomnia affect patients ability to function, to be the partner they used to be. Unless they get professional attention, sometimes combined psychopharmacology and individual and couple therapy, their relationship can’t survive.

The ability to develop the emotional bonding the interpersonal interactiveness necessary for a healthy relationship is altered. We also have to keep in mind that more often then not patients who have a previous history of personality disorder are more prone to develop PTSD, due to most likely poor coping skills.

Treatment of PTSD

The best way to determine the appropriate treatment is to consult a psychiatrist or therapist earlier in the process. A variety of treatments are available besides medications, such as TMS (Transcranial Magnetic Stimulation), EMDR (eye movement desensitization and reprocessing) or CBT (cognitive behavioral therapy) involving prolonged exposure (PE) to trauma related stimuli.

If you like this article on  PTSD impact on relationship, or have questions, schedule your first session by calling us at 713-426-3100.