Mind/Body Medicine
The ‘chemistry of thought’ is not localised to the brain because the same neurotransmitter receptors are also found in the gut, on the surface of white blood cells, and numerous other bodily locations, which explains why emotional states cause physiological effects and conversely, why physiological states induce particular moods. Hence, taking care of the body supports mental vitality and taking care of the mind supports physical wellbeing.
Mood disorders, such as depression, involve a multifaceted interplay of bio-psycho-social-environmental influences. As part of a multi-disciplinary approach, nutritional and lifestyle factors play a significant role. The traditional biological model of depression has focused on neuro-transmitter dysregulation (including genetic polymorphisms e.g. in serotonin receptor function/enzyme regulation in serotonin production pathways). Research is now also increasingly focusing on the inflammatory hypothesis of depression. Multiple pro-inflammatory cytokines, high indices of excessive oxidative damage and neurodegenerative biomarkers are evident in depressed individuals compared to non-depressed people. External stressors (e.g. psychosocial stress, nutrient deficiencies, poor sleep, inadequate sunlight, and environmental contaminants) and internal stressors (e.g. elevated inflammatory markers and reactivity in the hypothalamic-pituitary-adrenal axis including cortisol hyper-reactivity) all exacerbate inflammation. Furthermore, gastrointestinal-derived inflammation in particular is hypothesised to predispose towards depression. Impaired digestion (dyspepsia, gastrointestinal dysbiosis) and increased gut permeability contribute to both localised and systemic inflammation. Irritable bowel syndrome, while being present in 10–20% of the general population, is evident in 70-90% of people with mood and anxiety disorders.
Most antidepressants (e.g. selective serotonin re-uptake inhibitors) have specific anti-inflammatory effects. Hence, some researchers hypothesise that supporting mental health from an anti-inflammatory perspective offers avenues for new treatments (including treating gut-derived inflammation which can be assisted by supporting better digestion, modulating the gastrointestinal microflora matrix and maintaining mucosal gut wall integrity). Selective use of anti-inflammatory agents may also be beneficial (e.g. COX2 inhibitors such as asprin/celebrex/fish oil/phytochemicals). And, in a more general capacity, treating from the perspective of reducing inflammation and improving cellular function by using nutrient dense, protein adequate, fatty acid appropriate, low glycaemic load, base yielding diets – on the backdrop of health supportive lifestyle factors – offer untapped treatment potential.