Therapy for the Future
Fighting depression: Nurturing our mind and feeding our gut
Scientists have coined the gut our second brain. A powerful ally in our fight against depression, it produces 95% of serotonin and 50% of dopamine in our bodies. As we know, these neurotransmitters are crucial for mood regulation and motivation, two factors that those who suffer from depression struggle with.
In recent years, a strong link has been discovered between clinical depression and cardiovascular disease. Those who have major depressive disorder are put at an increased risk of developing hypertension and arteriosclerosis. Furthermore, their outcomes are far less favourable following a cardiovascular event compared to non depressed patients.(1)
Shockingly, as the World Health Organisation has stated, the biggest killer in the developed world over the past 15 years has been coronary heart disease.(2) The fact that major depression is a significant risk factor to developing heart disease has further highlighted the importance of helping those afflicted with this mental health issue.
An association between inflammation in the body and cardiovascular disease has also been noted in research.(3) So, too, have increased inflammatory responses in the chemical makeup of some depressed individuals in certain subpopulations.(4) "Depression and inflammation are closely connected and may fuel each other."(5) It can be surmised that both heart disease and depression have symptomatic inflammation in common.
When we speak about inflammation we understand it as an immune response.
Quite remarkably, nearly 70% of the immune system is found in the gut microbiome (6), which is host to about 100 trillion bacteria (7) that have a fundamental impact on our "immune system development and differentiation."(8) These microscopic critters feast on a diversity of plant based foods which enable them to maintain and regulate a myriad of essential chemical and hormonal processes that keep our body in homeostasis. When we feed our gut the nutrients it needs, we are supporting the microbiome to do the essential work that keeps us healthy.
This can especially be noted in the fight against depression when we regularly consume plant foods, such as probiotics, vitamins, omega 3s and undigestible plant fibres. These foods populate our gut with beneficial bacteria that manufacture the precursors to the neurotransmitters serotonin and dopamine.(9) Therefore, by taking in the right nutrients to support neurotransmitter functioning, we are giving our body what it needs to tackle the symptoms of depression, such as fatigue and lack of motivation.
When it comes to the connection between the immune system's inflammatory response and depression, research has shown that individuals who had higher levels of inflammation were less successful on antidepressant treatment than those whose inflammation levels were lower. The former also responded much better to an immune targeted intervention,(10) which can also be achieved through plant based nutrition (11) and heal gut inflammation.
Healing gut inflammation to treat depression through nutritional interventions can nevertheless be challenging. We all have a relationship with food. Aside from seeing it as a necessity to keep us alive and healthy, it can comfort us and relieve stress and anxiety. We treat ourselves and celebrate around rich dishes, and even misuse it to numb emotional pain and uncomfortable feelings. As a result, making dietary changes is not that easy and requires a special approach, not only to want and implement change, but most importantly to sustain change.
Mindful Nutrition Therapy can help us implement healthier sustainable food choices. It teaches us about nutrition, raises our awareness about food and helps us get in touch with our body's responses when eating certain foods. Ultimately, it changes our relationship with food and our body. As a consequence, we naturally and easily make food choices that can heal gut inflammation, support the microbiome to function optimally and contribute to maintaining a balanced mood. All are necessary factors for reducing the prevalence and severity of depressive episodes.
Furthermore, by working with a psychotherapist who integrates Mindful Nutrition with other psychotherapeutic interventions such as CBT, Compassionate Focused Therapy, Attachment Therapy and Person-Centred Therapy, our chances of getting over depression are significantly increased.
Given that the gut and the brain communicate bidirectionally through the gut-brain-axis (12), when we nurture our mind through talking therapy and feed our gut microbiome we build a strong defence against depression.
(3) https://www.bmj.com/content/321/7255/199.full https://www.ahajournals.org/doi/full/10.1161/01.cir.101.3.252 ,https://journals.lww.com/cardiologyinreview/Abstract/2001/01000/Inflammation_and_Coronary_Heart_Disease__An.7.aspx