If you are one of the many fighting the continued downward drag of depression and anxiety you will know how overwhelming and difficult to it can be to manage these conditions on a daily basis. For some there may be a known trigger but for others those feelings can be relentless and seem to creep in from nowhere.
According to a recent article published in The Medical Journal of Australia (MJA), Australia has one of the highest rates of anti-depressant use in the world, with ongoing studies showing that the increased use of anti-depressant medication as a sole treatment for depression is not as effective as first thought (1).
So, it does make you wonder, what is going on? Why are so many people now having to resort to medication in order to feel like their normal selves? Could it be due to our fast-paced lifestyles and financial pressures? Or perhaps due to highly processed modern diets lacking in essential nutrients needed for a happy and balanced mood?
Whatever the causes they will be varied and complex, however for some, the answers may actually be found within the gut, more specifically with the microbes residing within the gut. Known as the 'microbiome' the digestive tract is home to over 100 trillion resident micro-organisms which are now known to have a powerful impact on many aspects of health including mood and behaviour (2)
This emerging area of research has now identified specific types of probiotic bacteria found within our gut are able to produce important calming and mood balancing chemicals (3). Some of these you may be familiar with include;
serotonin - necessary for a stable mood and positive outlook, also involved in sleep and appetite regulation,
gamma-aminobutyric acid (GABA) - Extremely important inhibitory neurotransmitter for reducing anxiety levels and inducing relaxation and,
dopamine - responsible for motivation, seeking reward and pleasure and movement.
What has also been discovered is that any changes that impact the diversity and healthy balance of the microbiome does in turn affect mood and behaviour in a negative way including increased anxiety-type behaviour and depression (4).
So will probiotic supplementation be the newest approach to anti-depressant therapy?
According to the research, it certainly is looking like probiotics may soon be recommended for psychological conditions including anxiety and depression (5). It is an exciting and new direction in the treatment of these mood disorders however there is no need to take a wait-and-see approach.
Doing what you can to encourage a diverse and well balanced microbiome may be key to finally feeling like your old self again, however the microbiome is extremely susceptible to both an undesirable internal environment and external factors including;
A diet high in sugar and refined carbohydrates will encourage the proliferation of opportunistic microbes including Candida albicans. This is extremely common and causes a wide array of signs and symptoms including thrush and other chronic fungal infections of the nails and skin.
Being born by C- section - during a natural labor as you pass through the birth canal your are naturally inoculated with your mothers microbiome. However with a c-section the first bacteria you are exposed to can be vastly different and is often bacteria found on the skin (through being held/breastfed) which can drastically change the composition of the microbiome for years to come.
Stress – when we are constantly in ‘fight or flight’ mode, blood flow and energy is directed away from the digestive system, altering the pH of the gut and reducing the secretion of protective digestive juices allowing opportunistic microbes to flourish.
Many medications including antibiotics which wipe out beneficial bacteria, and acid neutralizing medications including proton pump inhibitors. The acid levels in the stomach have a number of functions including acting as a protective mechanism against infection with pathogenic microorganisms. Proton pump inhibitors increase the pH levels (decrease acidity levels) in the gut above levels that would normally keep pathogenic microbes from flourishing (6).
Low fibre diets - the typical modern diet is low in vegetables, fruits and other plant foods which provide essential fibre needed for healthy gut flora balance. Certain types of fibre will encourage growth of healthy gut flora while also preventing constipation.
Reduced exposure to micro-organisms especially during childhood - One theory known as 'the hygiene hypothesis' proposes that the effects of growing up in a more hygienic environment with the increased use of antibiotics and anti-bacterial cleaning agents has reduced our exposure to many beneficial micro-organisms which has in turn had a long lasting negative impact on our microbiome (7)
Eight Steps You Can Take to Encourage a Balanced Microbiome
1. If you suffer from chronic digestive issues then consider a full 'gut cleanse' known as a 'weed, seed and feed' protocol. Using professionally prescribed herbs and nutrients, the gut flora can be modified and will often resolve many long standing digestive issues.
2. Manage your stress levels effectively by implementing stress management techniques including getting out into nature, regular exercise, yoga, meditation or regular massage. When you do find yourself feeling frazzled and overwhelmed, taking 5 minutes to do some deep breathing exercises is one of the most effective methods of calming the nervous system and switching off that acute stress response known as the 'fight or flight' response.
3. For most people increasing your intake of fermented foods and drinks including sauerkraut, kimchi, kombucha, kefir, miso and natural unsweetened cultured yogurt will be of great benefit, however for some it may worsen digestive issues and indicates the need for a gut cleanse.
4. Avoid the use of antibiotics unless absolutely necessary and always follow up with a good quality broad spectrum probiotic supplement. Different strains can have different benefits depending on your needs however Lactobacillus helveticus, Bifidobacterium longum and Lactobacillius rhamnosus have been shown to improve mood and reduce anxiety (8). Saccharomyces boulardii is a beneficial yeast that is clinically proven to reduce antibiotic associated diarrhoea so is a good option to take alongside a course of antibiotics.
5. Reduce your intake of sugars and refined carbohydrates. These foods increase your blood sugar levels and will feed yeast in the body creating a Candida imbalance. If you struggle with reoccurring fungal infections, feel itchy, are diabetic or insulin resistant, suffer from chronic sinusitis or feel worse after fermented foods and alcohol then you may have a Candida imbalance. This can also be rectified with a 'weed, seed and feed' protocol.
6. Be sure to include a wide variety of vegetables, fruit and other plant foods in the diet on a daily basis as they provide fibre, Specific types of fibre known as prebiotics are indigestible types of fibre which pass through the digestive tract and encourage growth of good bacteria within the bowel. Some foods naturally high in prebiotics include;
Jerusalem artichokes, garlic, onion, leek, shallots, spring onion, asparagus, beetroot, fennel, green peas, snow peas, sweetcorn, savoy cabbage.
Beans and legumes including chickpeas, lentils, red kidney beans, baked beans and soybeans.
Fruits include nectarines, white peaches, persimmon, watermelon, grapefruit and pomegranate.
Dried fruit such as dates, and figs in small amounts (due to high sugar content)
Barley, oats (however these do contain gluten), cashews and pistachio nuts.
If you suffer from indigestion and re-flux symptoms, slippery elm is a fantastic herb/prebiotic to use as it soothes an inflamed digestive tract as well. It can be taken as a powder mixed into water, as a chewable tablet or capsule.
7. Avoid the heavy use of anti-bacterial cleaners and disinfectants around the house - there is no need to use these every day and don't be afraid to let your kids play in the dirt. Exposure to bacteria is an important part of healthy immune system development especially in children and will shape the microbiome for years to come.
8. Supplement with a good quality probiotic during pregnancy especially during the last trimester and while breastfeeding as this not only supports healthy maternal gut flora balance but will also help shape your baby's microbiome. Studies show that supplementing with a probiotic during pregnancy may decrease the incidence of allergy in your infant, support healthy immune system development and have a positive influence over growth patterns and development.