By Danielle Anderson
Arizona State University
Nutrition (Dietetics)
Mental health has a stigma attached. Still. Stigmas often develop and continue when understanding of a subject is not complete.
You can search YouTube with the words “treating physical health like mental health”, and find a number of videos (like this one), little parodies of interactions showcasing how people struggling with mental health concerns are often viewed by society. Purposely facetious, the clips clearly demonstrate how difficult it can be living with an illness of the mind when others don’t attempt to understand. In these scenarios, physical health symptoms (fever, broken or severely cut extremities, food poisoning, diabetes, etc) are all “treated” with motivational suggestions like “you just need to change your attitude” and “you have to want to get better” instead of acknowledging the person’s level of discomfort.
I grew up aware of a family member diagnosed with schizophrenia and bipolar disorder. Her first schizophrenic “break” came when she was 18 years old; and unfortunately, her battles with her illnesses continued off and on until she passed away in her 50’s. Her bipolar disorder often influenced her reliance on her medications. This meant that when she felt good she stopped taking her prescribed meds. Inevitably, this caused her reentry into periods of psychosis in which her reality and the reality around her did not match.
There is so much about her story that I find sad. She was committed about ten times, and this was back when state mental hospitals weren’t known for being overly compassionate and understanding. That’s bad enough, but what I find especially disheartening is that my own impression of this woman was her illness. I didn’t know growing up that she was a beloved teacher. I didn’t know that she earned a master’s degree. I didn’t know or understand how hard she tried to push through her illness and work with her medications in order to function. I didn’t know because mental health simply wasn’t, and still isn’t, talked about in the same way physical health issues are. But, they need to be.
One in five adults living within the United States experience mental illness within a given year according to the National Alliance on Mental Illness.1 Of those who do have a mental health concern, only 41% receive some sort of health service or treatment.1 Mental health is often connected to increased incidences of chronic diseases such as cardiovascular disease, diabetes, and obesity.2 Depression is the primary cause for disability for those between the ages of 15 and 44.2 (More statistics like these can be seen here, here, and here)1,2,3
Schizophrenia, along with other neuropsychiatric disorders such as depression, anxiety, and autism have connections to the gut microbiome as suggested by recent research.4 The “gut-brain axis” is an interconnected highway that transports information back and forth between the brain (i.e. central nervous system), and the bacteria that live inside your gut. It is believed that the microorganisms living inside the stomach and intestine interact with the epithelial and immune system cells, thereby directing the development of both metabolic and neuropsychiatric disorders.4 It is thought that changes within the communities of bacteria living inside the gut (i.e. both quantity and diversity) can heavily impact how the body and the mind function and/or respond to illness.5
The quantity and diversity of the bacteria in the gut can be altered by diet, stress, and drugs.4,5 Some medications actually require the gut bacteria to become active (e.g. prodrugs), while some have the ability to wipe out the majority of bacterial organisms that exist in the gut (e.g. antibiotics), leaving behind a seriously altered gut microbiome.6 Additionally, it is believed that as medications impact the gut negatively, the medications themselves lose the ability to function in the way they are intended.6 This is important to be aware of given how many neuropsychiatric disorders are treated with medications.
In a healthy microbiome environment, the bacteria live encased by a thin but tight epithelial lining and mucus layer. One aspect of an unhealthy microbiome is permeability within the epithelial cells allowing systematic access (e.g. movement throughout the body) for anything produced by the bacteria, including products that can be harmful to the person.4 Additionally, it is believed that the health of the bacteria directly corresponds with the health of the person. Dysbiosis is a term used to describe either a bacterial imbalance or a bacterial impairment, neither of which are beneficial.7 When the bacteria are unhealthy and/or the gut is inflamed due to bacterial dysbiosis, mood and cognitive capabilities can be negatively impacted.7,8
Studies are indicating more and more that diet quality corrections can be a fast and effective method to help care for the bacteria.5 Basically, a “we provide for them and they provide for us” plan is suggested. Overall, a plant-based diet has shown some significance in maintaining a healthy gut as it can provide many types of beneficial bacteria capable of helping with immunity and resilience against illness; and it typically does not impact the body negatively.5 Some research suggests that high fat/low fiber diets and diets high in processed foods reduce diversity within the microbiome as well as disrupt the microbial balance.5 It is also believed that some food additives (e.g. “emulsifiers and food colorants”) may negatively impact the gut microbiome.8 To help combat some of the consequences from eating a more westernized diet, some research has demonstrated how probiotics and prebiotics can not only alleviate gastrointestinal distress and discomfort, they can also help reduce symptoms of neuropsychiatric disorders.5
Prebiotics are often described as what is needed to maintain the health of the bacteria that already exist within the gut. Prebiotics are foods (i.e. non-digestible by humans) that enter into the stomach and intestine, and help aid in bacterial growth and survival.5 Garlic, onion, leeks, barley, oats, and asparagus are just some examples of foods that provide components that benefit the established bacteria. Probiotics are actual microorganisms that can be consumed to help re-establish the gut bacteria colonies, known more or less as the “good” bacteria. They can be accessed through supplementation as well as through foods like yogurt, and fermented foods like kimchi and sauerkraut.7
The use of probiotics and prebiotics as treatment measures for mental illness has yet to be established, but the research does show the possibility of such measures (along with diet quality corrections) occurring in the future.5,7 Perhaps the most important take away is the sheer number of research studies that are looking into the connection at all. Sixty years ago, this was not the case. With each new study, we gain more respect for how important diet is for mental health as well as physical health. Hopefully with clarity comes understanding, and perhaps with that understanding the stigma that is often associated with mental illness will be weakened.
References
Arizona State University
Nutrition (Dietetics)
Mental health has a stigma attached. Still. Stigmas often develop and continue when understanding of a subject is not complete.
You can search YouTube with the words “treating physical health like mental health”, and find a number of videos (like this one), little parodies of interactions showcasing how people struggling with mental health concerns are often viewed by society. Purposely facetious, the clips clearly demonstrate how difficult it can be living with an illness of the mind when others don’t attempt to understand. In these scenarios, physical health symptoms (fever, broken or severely cut extremities, food poisoning, diabetes, etc) are all “treated” with motivational suggestions like “you just need to change your attitude” and “you have to want to get better” instead of acknowledging the person’s level of discomfort.
I grew up aware of a family member diagnosed with schizophrenia and bipolar disorder. Her first schizophrenic “break” came when she was 18 years old; and unfortunately, her battles with her illnesses continued off and on until she passed away in her 50’s. Her bipolar disorder often influenced her reliance on her medications. This meant that when she felt good she stopped taking her prescribed meds. Inevitably, this caused her reentry into periods of psychosis in which her reality and the reality around her did not match.
There is so much about her story that I find sad. She was committed about ten times, and this was back when state mental hospitals weren’t known for being overly compassionate and understanding. That’s bad enough, but what I find especially disheartening is that my own impression of this woman was her illness. I didn’t know growing up that she was a beloved teacher. I didn’t know that she earned a master’s degree. I didn’t know or understand how hard she tried to push through her illness and work with her medications in order to function. I didn’t know because mental health simply wasn’t, and still isn’t, talked about in the same way physical health issues are. But, they need to be.
One in five adults living within the United States experience mental illness within a given year according to the National Alliance on Mental Illness.1 Of those who do have a mental health concern, only 41% receive some sort of health service or treatment.1 Mental health is often connected to increased incidences of chronic diseases such as cardiovascular disease, diabetes, and obesity.2 Depression is the primary cause for disability for those between the ages of 15 and 44.2 (More statistics like these can be seen here, here, and here)1,2,3
Schizophrenia, along with other neuropsychiatric disorders such as depression, anxiety, and autism have connections to the gut microbiome as suggested by recent research.4 The “gut-brain axis” is an interconnected highway that transports information back and forth between the brain (i.e. central nervous system), and the bacteria that live inside your gut. It is believed that the microorganisms living inside the stomach and intestine interact with the epithelial and immune system cells, thereby directing the development of both metabolic and neuropsychiatric disorders.4 It is thought that changes within the communities of bacteria living inside the gut (i.e. both quantity and diversity) can heavily impact how the body and the mind function and/or respond to illness.5
The quantity and diversity of the bacteria in the gut can be altered by diet, stress, and drugs.4,5 Some medications actually require the gut bacteria to become active (e.g. prodrugs), while some have the ability to wipe out the majority of bacterial organisms that exist in the gut (e.g. antibiotics), leaving behind a seriously altered gut microbiome.6 Additionally, it is believed that as medications impact the gut negatively, the medications themselves lose the ability to function in the way they are intended.6 This is important to be aware of given how many neuropsychiatric disorders are treated with medications.
In a healthy microbiome environment, the bacteria live encased by a thin but tight epithelial lining and mucus layer. One aspect of an unhealthy microbiome is permeability within the epithelial cells allowing systematic access (e.g. movement throughout the body) for anything produced by the bacteria, including products that can be harmful to the person.4 Additionally, it is believed that the health of the bacteria directly corresponds with the health of the person. Dysbiosis is a term used to describe either a bacterial imbalance or a bacterial impairment, neither of which are beneficial.7 When the bacteria are unhealthy and/or the gut is inflamed due to bacterial dysbiosis, mood and cognitive capabilities can be negatively impacted.7,8
Studies are indicating more and more that diet quality corrections can be a fast and effective method to help care for the bacteria.5 Basically, a “we provide for them and they provide for us” plan is suggested. Overall, a plant-based diet has shown some significance in maintaining a healthy gut as it can provide many types of beneficial bacteria capable of helping with immunity and resilience against illness; and it typically does not impact the body negatively.5 Some research suggests that high fat/low fiber diets and diets high in processed foods reduce diversity within the microbiome as well as disrupt the microbial balance.5 It is also believed that some food additives (e.g. “emulsifiers and food colorants”) may negatively impact the gut microbiome.8 To help combat some of the consequences from eating a more westernized diet, some research has demonstrated how probiotics and prebiotics can not only alleviate gastrointestinal distress and discomfort, they can also help reduce symptoms of neuropsychiatric disorders.5
Prebiotics are often described as what is needed to maintain the health of the bacteria that already exist within the gut. Prebiotics are foods (i.e. non-digestible by humans) that enter into the stomach and intestine, and help aid in bacterial growth and survival.5 Garlic, onion, leeks, barley, oats, and asparagus are just some examples of foods that provide components that benefit the established bacteria. Probiotics are actual microorganisms that can be consumed to help re-establish the gut bacteria colonies, known more or less as the “good” bacteria. They can be accessed through supplementation as well as through foods like yogurt, and fermented foods like kimchi and sauerkraut.7
The use of probiotics and prebiotics as treatment measures for mental illness has yet to be established, but the research does show the possibility of such measures (along with diet quality corrections) occurring in the future.5,7 Perhaps the most important take away is the sheer number of research studies that are looking into the connection at all. Sixty years ago, this was not the case. With each new study, we gain more respect for how important diet is for mental health as well as physical health. Hopefully with clarity comes understanding, and perhaps with that understanding the stigma that is often associated with mental illness will be weakened.
References
- NAMI. NAMI: National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers. Published 2017. Accessed November 5, 2017.
- Data on behavioral health in the United States. American Psychological Association. http://www.apa.org/helpcenter/data-behavioral-health.aspx. Published 2017. Accessed November 5, 2017.
- Any Mental Illness (AMI) Among U.S. Adults. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-us-adults.shtml. Published 2015. Accessed November 5, 2017.
- Evrensel A, Ceylan ME. The Gut-Brain Axis: The Missing Link in Depression. Clinical Psychopharmacology and Neuroscience. 2015;13(3):239-244. doi:10.9758/cpn.2015.13.3.239.
- Bruce-Keller AJ, Salbaum JM, Berthoud H-R. Harnessing Gut Microbes for Mental Health: Getting From Here to There. Biological Psychiatry. 2017. doi:10.1016/j.biopsych.2017.08.014.
- Cresci GA, Bawden E. The Gut Microbiome: What we do and don’t know. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. 2015;30(6):734-746. doi:10.1177/0884533615609899.
- Clapp M, Aurura N, Herrera L, Bhatia M, Whilen E, Wakefield S. Gut microbiota’s effect on mental health: The gut-brain axis. Clinics and Practice. September 2017. doi:10.4081/cp.2017.987.
- Kennedy PJ, Murphy AB, Cryan JF, Dinan TG, Stanton C. Microbiome in Brain Function and Mental Health. Trends in Food Science & Technology. 2016;57:289-301.