The Link Between the Gut and Mental Health
Written by: Dr. Amber Cohen. PsyD, CPsych & Abraham Anjarkouchian, MSc, RD
Updated: December 7th, 2022
Understanding the Link Between Gut and Mental Health
Gastrointestinal symptoms have high comorbidity rates with generalized anxiety, health anxiety and depression. There is a strong connection between our gut and mental health. The neurotransmitters that help us feel calm and happy (i.e. serotonin and dopamine) are mainly produced in the gut. Therefore, if you struggle with a digestive condition, you will likely benefit from some mind-body activities that can help with your mental health.
What is the Stress Continuum?
There is a continuum of how mental health may be impacted by digestive conditions: On one end, you may have some mild stress responses, and on the other end, you may be experiencing health anxiety. Health anxiety is the experience of thinking about a threat to your health, which consequently triggers your anxiety response. A common trigger for health anxiety is having experienced a medical condition because the first, worst or most recent symptom flare up can act as a trauma experience. When we experience trauma, our brains kick in to protect us by scanning everything in our environment and bodies. This scanning helps warn us that the experience may be happening again so we can prepare to survive. With health anxiety, technically your brain is working correctly, but too much of anything is problematic. Too much body scanning and overthinking is no different – if you are always looking for a problem, you will find one.
Common Mental Health Symptoms Related to Gut Health
- Worry thoughts about your health are excessive to the reality of your medical symptoms.
- Worry thoughts are persistent despite negative test results or no symptoms.
- Worry thoughts persist despite reassurance from health practitioners.
- Worries lead to unhelpful behaviours such as excessive checking and reassurance seeking (i.e. from doctors, family, friends, or internet), or avoidance (i.e. of check-ups, doctors, health related information).
- Worries cause you significant distress.
- Worries limit your ability to go about your day-to-day life.
- Hypervigilant checking of your physical health/bodily functions.
- Triggering physical symptoms due to continual body scanning by misreading naturally occurring physical sensations as a medical flareup.
- Trauma symptoms related to experiences with physical health difficulties.
Functional Medicine as Related to Digestive Health
Functional medicine is a holistic person-centred approach to treatment that looks to identify the root causes of medical difficulties. This includes reviewing nutrition, exercise, stress, and your microbiome. Once triggers are identified, a person can work toward a customized healthy living plan.
The following are healthy living changes to consider:
- Digestion: This starts from the mouth and ends, when it leaves our body at anus as waste. We have small and large intestines, liver, pancreas, and gallbladder that are all included in the digestive process. Keeping your digestive system healthy can help you avoid and/or minimize digestive problems such as Irritable Bowel Syndrome, (IBS), Gallstones, Acid Reflux, GERD, etc. You can work on increasing your intake of foods that nourish and enrich your gut’s microbiome.
- Eating: By eating too quickly or not chewing food fully, our stomach and small intestine have to work harder to break those foods down and properly digest them. This can exacerbate digestive concerns.
- Exercising: Living a sedentary lifestyle can negatively impact the digestive system.
Further to the above, mindfulness and cognitive behaviourlal therapy can assist with managing your gut health, no matter where you lie on the stress/anxiety continuum.
Mindfulness and Cognitive Behavioural Therapy
Mindfulness is about training our brains to be in the current moment without evaluation or judgement. This allows us to move away from thoughts and behaviours that are exacerbating our symptoms and be in the here-and-now. CBT posits that our cognitions (thoughts), behaviours and emotions are all linked together. Unfortunately, we don’t have direct control over our emotions. Fortunately, we do have control over our thoughts and behaviours. By utilizing CBT coping strategies, we can shift and change our thoughts and behaviours in order to impact how we feel.
Thought Management
Thought management involves a combination of mindfulness and self-talk. Our thoughts are often on autopilot; we don’t notice them and then we end up in a difficult emotional space. Mindfulness is building nonjudgmental awareness of ineffective thought patterns, so that you can take yourself off of autopilot. Once you more readily notice your thoughts (i.e. “I don’t want to go to this party because what if I experience GI symptoms?!”), you can then begin to replace them (i.e. “I can go to the party and leave whenever I want.”)
Behavioural Management
Behavioural management techniques run a wide range. We often engage in behaviours that are diminishing our health, so CBT looks to identify ineffective behaviour patterns and replace them with behaviours clinically proven to help us feel better. Some examples of behavioural changes are:
- Practising meditation
- Boundary setting
- Gaining improved work-life balance
- Engaging in physical movement
- Engaging in hobbies
- Increasing our social connectivity
- Spending more time in nature
- Logging thoughts/journaling
- Decreasing avoidance behaviours
Decreasing avoidance behaviours can be a significant piece of work for many people. When we feel worried about something, we avoid the trigger so we don’t have to feel that way. For example, if I avoid seeing a movie for fear of having gastrointestinal symptoms, then I don’t have to worry about it. Avoidance is a perfect short-term solution to emotion management. However, as a long-term solution, it’s the pits. When we avoid, we don’t get to have experiences that may be in-line with our goals and values. Additionally, avoidance maintains difficult emotions. Usually, whatever we are avoiding is not as bad in reality as it is in our thoughts. So, if we engage in something we want to avoid, we will likely gain the evidence that it wasn’t so bad and next time we try it out it will be easier.
This resource was written by Dr. Amber Cohen, The Cohen Clinic
