Natural considerations for depression & anxiety & How your gut can affect mood.

Depression, stress, and anxiety are very common symptoms experienced by the clients I see in clinic, particularly so during and after the strict COVID lockdowns in 2020/21. There are a variety of contributing factors to an imbalance in mental health and this article will explain many of them that you can positively influence with diet and lifestyle; with a particular focus on the role the makeup of the gut bacteria (the ‘microbiome’) can have on mental wellbeing.

I use the picture above to explain that mood balance is like sitting on a 3-legged stool: The legs are:

Lifestyle

One leg of the stool is lifestyle – positively influenced by a healthy eating, regular exercise, regular connections with friends and family (this was tough for some during the COVID lockdowns), practicing mindfulness or meditation, speaking with someone (preferably a professional like a psychologist, psychiatrist or counsellor) and having a healthy microbiome, which will be elaborated on shortly.

Other considerations are:

-limiting screen time (think Facebook, internet games, TikTok). The dopamine surges experienced in gaming and scrolling social media has a similar effect to the impact of alcohol and drugs.

-avoiding aspartame and artificial sweeteners in diet drinks

-Cutting out fried foods, alcohol, sugar, processed food, foods you are allergic or intolerant to (gluten especially can be a driver here) and high glyphosate foods (present in non-organic grains & legumes. It impacts neurotransmitter products by impacting manganese metabolism)

-incorporating plenty of fibre rich food (to feed the beneficial bacteria in the gut); adding fermented foods if tolerated (like sauerkraut, kefir and kimchi).

-optimising thyroid function and glucose metabolism (that means reducing glycemic load in the diet especially cutting out added sugar)

-address gut health – treat SIBO (small intestinal bacterial overgrowth) and only take proton pump inhibitors if absolutely necessary.

Brain Nutrients

The second leg of the stool is particular nutrients that support brain and neurotransmitter balance. Omega 3’s (fish oils and fish, especially small oily fish like sardines, herrings, salmon and mackerel) calm the cell membranes and address underlying inflammation. Magnesium (a good quality chelated form) also calms the nervous system, supports sleep and serotonin (our feel good hormone). B-vitamins are important in neurotransmitter production and dietary intake is often compromised on restricted diets, processed food and low grain eating programs. Extra zinc, iron, copper, chromium, manganese, Vitamin B6 and folate may be required and should be tested for using blood tests and  hair mineral analysis to help determine requirements. See: https://www.holistichealth.com.au/hair-mineral-and-heavy-metal-testing-why-how-and-what-do-i-do-with-the-information/ . All of these can be supplemented if dietary needs are insufficient. In recent times vitamin D has been shown to function as a neurosteroid, playing a critical role in neural health and cognitive function. Epidemiological research indicates that vitamin D deficiency is associated with a wide range of neuropsychiatric disorders including depression and anxiety. There is some recent breakthroughs in using specific strains of probiotics (nicknamed ‘psychoneurobiotics’), that have a positive impact on mood.

Targeted Support

The third leg of the stool is using specific  herbal formulae or medications to address symptoms and modify the ‘feel good’ neurotransmitters (important chemical messengers).  The traditional theory that depression is a chemical imbalance has been questioned (see https://theconversation.com/depression-is-probably-not-caused-by-a-chemical-imbalance-in-the-brain-new-study-186672

Common antidepressants that are prescribed by doctors are ‘Selective serotonin-reuptake inhibitors’ (SSRIs) that reduce the breakdown of the feel good hormone serotonin. St John’s wort works in a similar manner and is the first line treatment suggested in some parts of Europe. Caution is needed using St John’s wort as it affects the way some medications work e.g. oral contraceptives and anti-HIV medications and should not be taken at the same time as SSRIs unless you are well supervised by someone experienced in this area. However in order for SSRIs or St. John to work, you need adequate serotonin in the first place, which is one reason for non-response in a significant percentage of sufferers. Using ‘building blocks’ like adequate protein, SAMe, B-vitamins and magnesium are important to support the medication’s effectiveness. Saffron and Rhodiola are also helpful with low mood and there is some evidence Turmeric can assist through it’s anti-inflammatory action.

Anti-anxiety meds like benzodiazepines  act on the brain and central nervous system by increasing the calming effect of the brain’s naturally-occurring chemical messengers like GABA. The sedative and calming effects of benzodiazepines will relieve the symptoms of anxiety and promote sleep for most people, but ideally should only be used short term. Herbs like Valerian, hops, chamomile, passionflower, St John’s wort, Magnolia and Kava are all herbs that have been found to increase GABA levels. They are also traditionally used to effectively reduce anxiety, pain levels, insomnia and restlessness. It’s important to seek the advice of a qualified herbalist or Naturopath who can prescribe exactly what you need – either in an individually formulated liquid herbal blend or tableted formulae.

Stress is a significant concern with a large number of my clients. Working long hours; juggling kids, a house, a job, exercise and leisure time; pushing through when you’re tired or haven’t slept well; dealing with menopausal symptoms or  relationship conflict; unfulfilling work can create chronic stress leading  to overwhelm, compromised hormonal function (that leads to numerous other health issues), weight gain, brain fog, grumpiness, blood sugar imbalance and many other issues. Herbs come into their own here – they can support adrenal and thyroid function, and help with stress, energy, stamina & resilience. Examples are Rhodiola, Siberian Ginseng (I describe this herb as helping drowning rats swim longer before they give up), ‘Indian Ginseng’  also known as Withania or Ashwagandha,  and American Ginseng are examples of ‘adrenal supporting’, stress busting herbs. A good naturopath/herbalist can make an individualised ‘tonic’ or choose a pre-made formula to match your specific requirements.

Importance of the Gut Microbiome.

The gut microbiota plays an important role in maintaining normal mental processes and is therefore involved in the development of numerous imbalances in mental health . The microbiota (the composition of  the ‘bugs’ in our gut) can communicate with the central nervous system through signalling mechanisms, & have a direct influences on the brain. Gut microbial abundance and diversity (i.e. the variety of different bugs) has been reportedly reduced in patients with depression versus healthy controls. Chronic stress, antibiotic use, poor diet and an unhealthy lifestyle lead to gut imbalance; while a healthy diet, specific probiotics (particularly ones that target the brain) and prebiotics (food that nourishes the microbiome) are becoming an addition to the toolkit of strategies to consider in mood disorders.

A psychiatric journal describes the link between gut microbiome and major depression  https://pubmed.ncbi.nlm.nih.gov/31913980/

Another blog I wrote describes how to support microbial diversity – see:https://www.holistichealth.com.au/why-keeping-our-gut-microbiome-healthy-is-important-and-how-to-test-it/in summary eating a wide variety of fibre rich fruit, veg, fruit, grains, nuts, seeds and legumes is vital for a healthy gut and brain.

If you are following a ketogenic diet, you may be missing out on some of the prebiotic goodness found in legumes, fruits and grains. This blog explains how you can still improve your intake without compromising carbohydrate intake: https://www.holistichealth.com.au/keto-friendly-gut-health-tips/

Special Offer:

Magnesium and major depression. George A. Eby, Karen L. Eby, and Harald Murk. https://www.ncbi.nlm.nih.gov/books/NBK507265/

Link with Mental health and heart disease and useful tips: https://www.australiawidefirstaid.com.au/resources/mental-health-heart-disease?utm_source=active+campaign&utm_source=Newsletter&utm_medium=email&utm_medium=email&utm_campaign=february+newsletter&utm_campaign=Monthly+Newsletter+-+February+2023+%28VIC%29&utm_content=button+section+3&utm_content=First+aid+tips+for+the+season+of+love%F0%9F%AB%80

The Effects of Magnesium Supplementation on Subjective Anxiety and Stress—A Systematic Review Neil Bernard Boyle,^* Clare Lawton, and Louise Dye   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452159/

The role of the Gut Microbiome and Major Depressive disorder:  https://pubmed.ncbi.nlm.nih.gov/31913980/