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More PsychNotes: Depression

Gut Bacteria, Auto-immune Diseases, and Depression
by Monica A. Frank, PhD

I often wondered why many of my clients with chronic depression and/or anxiety disorders also suffered from multiple physical conditions. Although many answers have been forthcoming such as certain psychotropic medications increase obesity and susceptibility to diabetes, the most intriguing answer seems to be related to gut bacteria.

Through my decades of practice I've come to believe through observation that depression is more a physical disorder than a mental one. Although it has an emotional component (and doesn't any severe chronic illness?), the life-debilitating symptoms are more physically based: sleep disturbance, lack of energy, eating disturbance, physical aches and pains. In fact, most of the emotional symptoms appear to be caused by the physical. The lack of interest in usual activities, for instance, can be explained by the lack of energy. The mood disturbance (sadness, hopelessness, anger) can be explained by the daily frustration of not being able to engage in what should be simple activities.

Believing that depression has a physical basis, I've always encouraged my clients to eat well even when they didn't feel like it because I believed that food affected depression in a couple of ways:

1) Lack of calories. If a person is not getting enough calories they will further stress their system. The body will lack energy, they will feel more fatigued and have more problems with motivation, interest in activities, and sleep disruption.

2) Type of foods. Evidence from many years ago indicated that complex carbohydrates and certain other foods seemed to help with depression. It wasn't clear why and most health professionals ignored it.

In recent years, however, more and more research is being conducted looking at the good bacteria in the body. And it seems that when this bacteria is out of balance, people are more susceptible to developing certain types of disorders including depression and anxiety.

Other disorders that may be related to gut bacteria are diabetes, asthma, inflammatory bowel disease, and a variety of autoimmune diseases. This is not to say that these disorders which frequently have a genetic component are caused by the imbalance of bacteria in the system, but perhaps the healthy bacteria in the gut may help to fight these diseases. As such, it can explain why some people are more susceptible to disease and if they have one chronic problem, they are more likely to suffer from another.

An interesting book by Drs. Finlay and Arrieta called “Let Them Eat Dirt: Saving Your Child From an Oversanitized World” explains why these disorders may be on the rise. The overuse of antibiotics and antibacterial cleaning products in our society can create an imbalance of the bacteria in our guts. Also, our focus on cleanliness in childhood may contribute by preventing children from coming in contact with certain healthy bacteria that can be found in our environments. So there may be a real connection between depression/anxiety and other chronic illnesses because they are all impacted by the balance of bacteria in the gut.

In addition, evidence is accruing regarding the effect of antidepressants on gut bacteria. These medications may kill good bacteria and contribute to the unhealthy balance. In other words, it might be similar to chemotherapy for cancer which kills the good cells as well as the cancer cells. Thus, the major side effects of antidepressants such as weight gain and constipation may be due to the imbalance of healthy bacteria.

What can you do? Help your body fight the depression by developing a healthier bacterial balance in your gut. Some ways to do this include:

1) Eating fermented foods such as yogurt.

2) Increase complex carbohydrates found in whole grain foods, beans, and starchy vegetables.

3) Reduce overly processed foods and eating in restaurants.

Obviously, for those who are severely depressed this can be difficult when you lack ability to take care of your everyday needs. However, try to make your support system aware of this research and get assistance where you can.

What I describe here is not a cure for depression or autoimmune diseases. Instead, it is about helping your body function at its optimum so that it can fight these illnesses. This is also why cognitive-behavioral therapy (CBT) can help people with depression. CBT helps remove the obstacles to better health by changing thinking and habits.