All disease begins in the gut – Hippocrates

In the clinic I see a lot of patients with varying forms of mood disorders. It could be primary depression or anxiety, where they are looking for alternative treatment options, or it could be secondary, a mental health condition that has arisen due to a longer term chronic condition. Depression and anxiety, for example, are particularly common in many patients with digestive disorders like IBS and IBD.

Regardless of the reason, I often find that treating depression and anxiety reminds me a lot of the children’s fairy tale, the three little pigs.

I’m sure, that like me, you’ve heard the story of the three little pigs at least once while growing up? If you haven’t, you’ve missed out on a vital piece of childhood education and should head on over to Youtube immediately to fix that. I’ll just wait here while you do.

In the fairy tale, each of the pigs builds a house out of different materials: straw, wood, and brick. When the big, bad, wolf comes to visit, the only house that stands is the one made out of brick. The others are blown down by the wolf’s mighty lungs.

A lot of mood disorders can be traced back to some sort of big, bad, wolf.

A lot of mood disorders can be traced back to some sort of big, bad, wolf. A defining moment, a traumatic, experience, a bout of illness or even just the accumulated daily grind of a demanding boss and the daily commute. But why do some people withstand these better than others? Or how do particularly resilient people seem to bounce back from just about any amount of stress or illness? Some even thrive despite the daily grind that can send others packing.

Like our three little pigs, the ability for us to withstand our big, bad, wolf moments will almost always come down to our building material choices. In the case of mood disorders, those building materials are neurotransmitters. Neurotransmitters are messenger chemicals released to help carry nerve impulses from one nerve to another and regulate a wide range of processes such as mental performance, emotions, pain response, and energy levels.

Mood disorders will result when there are insufficient of these neurotransmitters to help carry signals form one nerve to another. Neurotransmitters include:

  • Serotonin, deficiency can lead to depression, anxiety and obsessive thoughts and behaviours, carbohydrate cravings and sleep cycle disturbances.
  • Dopamine, common symptoms associated with low levels include cravings, loss of satisfaction and reactive addictive behaviours.
  • Noradrenaline, low levels are associated with lack of energy, focus and motivation.
  • Adrenaline, deficiency can lead to difficulty concentrating, making decisions, depression, poor recovery from illness and more.

When I treat patients with mood disorders, they are often surprised that one of the things I look at is what’s going on in the gut.

  • Is the gut functioning normally with regular, soft but formed bowel movements?
  • Are there signs and evidence of leaky gut?
  • Is the microbiome — the collection of bacteria in the gastrointestinal tract — healthy?
  • Is the gut transit time too short and nutrients are not being properly absorbed?
  • Are foods like artifical additives, refined sugars, gluten, and fructose damaging gut bacteria?

Many neurotransmitters are made in, or require other nutrients made in or absorbed in the gut. In much the same way as good bricks require a good furnace, good neurotransmitters require that we have a good gut and the right bacteria. Poor gut function, whether due to bacterial overgrowth, diarrhoea caused by IBS, or poor absorption from celiac disease, will all lead to reduced levels of neurotransmitters either directly, or indirectly.

It is gut bacteria that produce the mood-boosting neurotransmitters like serotonin, dopamine, and GABA. In fact, the greatest concentration of Serotonin is found in your intestines, and not in your brain. Not only will optimising gut health help improve mood and mental well being, it will also help treat and prevent neurodegenerative disorders such as depression, dementia, and alzheimer’s.

While there are certainly herbs, nutrients, and pharmaceuticals, that will help with the symptoms of mood disorders, these can be like trying to hold the door shut in a house made of straw.

No matter how strong you are, some sort of stressor will soon enough come along that will blow that house down. So don’t wait until that happens, instead, review your neurotransmitter levels and assess your gut function.