depression, chronic stress, and the brain / gut connection

According to the same website, Depression, “is one of the most common mental disorders in the United States. An estimated 16 million adults aged 18 or older in the U.S. had at least one major depressive episode in the past year, with women being 70 % more likely than men to experience depression during their lifetime.”  Many would say this incidence of 7% is far too low.  For instance, the CDC puts the incidence of Depression at 9%.  Even the NIH’s NMIH seems to contradict itself by revealing that, “A report tracking antidepressant use among Americans from 2005-2008 found that more than 1 in 10 Americans ages 12 and older report taking an antidepressant medication.”  If you add CHRONIC PAIN, TRAUMA, or CHRONIC INFLAMMATORY DISEASES to the mix (DEPRESSION ITSELF is considered “Inflammatory”) —- issues that doctors commonly prescribe Antidepressants for — the numbers are staggering.

By far, the most common medical approach to treating DEPRESSION involves prescribing ANTIDEPRESSANTS.  Not only are there any number of problems and side-effects with this class of drug, but according to research, they frequently do not work.  The blog post (Antidepressants: A Complicated Picture) of NMIH director, Dr. Thomas Insel, carried some telling statistics regarding this little known fact.

“Mild depression tends to improve on placebo so that the difference between antidepressant use and placebo effect is very small, or at times, absent. In more severe forms of depression, antidepressants show greater efficacy. It is important to note that these clinical studies have primarily focused on reducing the symptoms of depression and not on a broader range of potential outcomes (such as changes in everyday functions, cognitive abilities, quality of life, etc.). In addition, because clinical trials are conducted in a controlled environment, they do not necessarily reflect the way actual clinical practice operates. And even under research conditions, clinical trials for antidepressants use rating scales that may be weak or imprecise indicators of efficacy.”

Truthfully, this sounds like a whole lot of beating around the bush.  This sort of mumbo jumbo begs the question of how effective Antidepressant Drugs really are.  Wait no more because Insel reveals this information later in his post.  Near the end of the post he states that, “The bottom line is that these medications appear to have a relatively small effect in patients broadly classified as having depression.”  Wait; that’s more mumbo jumbo.  Insel is referring to a 2008 meta-analysis published in PLoS Medicine (Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration) that hac this to say……  (To read more about “UNPUBLISHED STUDIES“, you can follow this link or click the previous link above)

“Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance….   Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.”

How’s that for EVIDENCE-BASED MEDICINE?  Am I the only one who finds it appalling that one of the biggest and most lucrative segments of the DRUG INDUSTRY is built on lies and outright fraud?  The good news is that there are things you can do to help heal your brain.   The starting point is to realize that your GUT ACTS AS A SECOND BRAIN, and that there is an intimate relationship between your health and your MICROBIOME (the type and number of bacteria living inside of you).  Anything that throws these ratios of bacteria off (ANTIBIOTICS, MEDICATIONS IN GENERAL, or even TOO MANY VITAMINS OR PROBIOTICS) can foul the Microbiome, leaving one susceptible to any number of health problems, as 80% OF YOUR ENTIRE IMMUNE SYSTEM is found in the Gut.  This is why GUT HEALTH is imperative as far as overall health is concerned (HERE).

One of the things we already know from the peer-reviewed research is that people with Depression typically have issues with their Microbiome (HERE).  But it doesn’t stop there.  Any number of forms of stress, including Separation from one’s mother, are also known to cause problems in this area (Maternal Separation as a Model of Brain-Gut Axis Dysfunction).

This Irish study, performed at the Alimentary Pharmabiotic Centre of the University College Cork, concluded that, “Early life stress has been implicated in many psychiatric disorders ranging from depression to anxiety.  Essential aspects of the brain-gut axis include spinal pathways, the hypothalamic pituitary adrenal axis, the immune system, as well as the enteric microbiota. Accumulating evidence suggest that stress, especially in early life, is a predisposing factor to IBS. The separated individual is characterised by alterations of the intestinal barrier function, altered balance in enteric microflora, exaggerated stress response and visceral hypersensitivity, which are all evident in IBS.; Thus, maternally separated animals are an excellent model of brain-gut axis dysfunction for the study of disorders such as IBS and for the development of novel therapeutic interventions.”  In other words, stressful events that occur in the very young, can foul the Microbiome (enteric microflora) causing problems such as IBS, Hypersensitivity Reactions (GLUTEN could certainly fall into this category), LEAKY GUT SYNDROME (altered intestinal barrier function), ADRENAL FATIGUE, DIABETES, and HYPOTHALAMUS DYSFUNCTION.

A study from the March, 2011 issue of Brain, Behavior, and Immunity (Exposure to a Social Stressor Alters the Structure of the Intestinal Microbiota: Implications for Stressor-Induced Immunomodulation) revealed a similar link later in life.  Some of the things we learned from this study include…

• WE ARE FULL OF BACTERIA:  The bodies of most animals are populated by highly complex and genetically diverse communities of microorganisms. The majority of these microbes reside within the intestines in largely stable but dynamically interactive communities that positively interact with their host.

• STRESS DOES BAD THINGS TO THESE BACTERIA:  Studies from this laboratory have shown that stressor exposure impacts the stability of the microbiota and leads to bacterial translocation. 

• STRESS INCREASES INFLAMMATION (CYTOKINES) — AN IMMUNE SYSTEM COMPONENT:  Mice were exposed to a social stressor called social disruption (SDR), that increases circulating cytokines and primes the innate immune system for enhanced reactivity.

• STRESSED, ANTIBIOTIC-TREATED MICE HAD LESS AMOUNTS OF TWO TYPES OF CYTOKINES:  Because Inflammation is a component of your Microbiome; killing off these bacteria with Antibiotics diminished the amounts of two different (inflammatory) cytokines.  I will warn you that the net benefit from Antibiotics is not anti-inflammatory. 

In yet another similar study (this one published in the October, 2012 issue of PLoS One) called
Gut Microbiota Composition Is Correlated to Grid Floor Induced Stress and Behavior in the BALB/c Mouse, researcher found some similar features concerning stressed out mice.  When mice were put through “stressful” events such as being exposed to noxious stimuli, being hung by their tails, or others, there were changes in their Microbiomes.  Links from my site are added into the conclusions.

“From birth the mammalian gut slowly gets inhabited with a wide range of bacteria that primes the cells of the immune system during the postnatal period [HERE]. Throughout life, the gut microbiota (GM) remain an important factor in development of diseases, such as inflammatory bowel diseases, asthma/allergy, colon cancer, type 1 diabetes, HIV and obesity [HERE, HERE, HERE, HERE, HERE, and HERE]. It is evident that diseases of both body and mind worsen in response to stress, and interest in the so-called gut-brain axis consisting of neural, immune and endocrine pathways has increased, e.g. due to clinical experience with patients suffering from irritable bowel syndrome (IBS), in which a higher incidence of psychiatric illness has been acknowledged [HERE].”

What’s truly mind-bending is that this study goes on to talk about the relationship between certain kinds of diseases and INFLAMMATORY HEALTH PROBLEMS, also spending significant time dealing with the fact that when certain kinds of bacteria are added back to the ill host (often via FECAL MICROBIOTA TRANSPLANT — FMT) disease symptoms and inflammatory sequelae are alleviated or eliminated.  Although PROBIOTICS are never as good as FMT (HERE), we have a great deal of evidence that Probiotics can at the very least, make a beneficial difference.  Allow me to show you some studies.