The link between our mental health and physical health is well-established. A good example of this is when we are sick with something like the flu, we also feel emotionally drained or even depressed. Interestingly, we know now that inflammatory processes in our digestion tract, and throughout our body, directly impact our mental health. Integrative psychiatry provides a holistic approach to managing certain types of inflammation. But how?
Key Takeaways:
Our environment, certain medications, and especially the things we eat can contribute to inflammation in our bodies.
Inflammation can contribute to mental health disorders, like depression and anxiety.
Integrative psychiatry treats mental health disorders from a whole-body perspective by addressing root causes like inflammation.
Why do I care about inflammation anyway?
You might be asking, what is inflammation anyway? Inflammation itself is an immune response that our body does in an effort to try to defend against infection, disease, or injury. This response includes increased circulation and special natural chemicals that lead to swelling – think of when you get a cut. It swells, gets warm, red, and kind of hurts. This is called acute inflammation. Chronic inflammation, the kind that can lead to physical and ultimately mental health issues, is hard to notice. Chronic inflammation is often caused by digestive imbalances – more on that in a bit. For mental health, it’s thought that chronic inflammation leads to imbalances in the brain, resulting in fatty plaque buildup, improper protein-fiber management, and poorly regulated neurotransmitters that regulate mood, focus, anxiety and so forth. Long-term, this kind of chronic inflammation plays a role in cognitive function, dementia, and Parkinson’s, not to mention all the physical problems like diabetes and heart disease.
Digestive inflammation as a root cause explained
Here’s a funky term: the gut-brain-axis. The gut-brain-axis is how your brain and digestive system communicate with each other via our nervous system. Our digestive system is reliant on a complex system of bacteria, fungus, and even viruses that help break down what we eat, protect against infection, and remove toxins. This complex system of living organisms is called our microbiome. Kind of sounds gross, but without it we wouldn’t be able to survive! Think of it this way, our bodies are like entire societies. Processes like trash removal and recycling take a lot of work – just ask your trash person!
Our bodily systems are intricately connected. When our gut or digestive processes are out of whack, this travels up the chain to our brain which can lead to lots of issues there. An imbalanced gut-brain-axis might show up with sensory issues like pain, chronic fatigue, sleep issues, stress management, hormonal dysregulation, and even depression or other mental health disorders. Now this isn’t the case for every diagnosis, but gut-related microbiome inflammation is estimated to play at least a partial role in almost one-third of depression cases – that’s huge! So why does an out-of-sync microbiome lead to all this? Because the good guys in the microbiome suffer, and in some case, the bad guys flourish.
Causes of digestive imbalances that lead to inflammation
Orderly processing of garbage and recycling is a big job. Think of a snow storm in New York – the trash collection comes to halt and quickly becomes a huge mess! Our bodies have the same kinds of issues and can become overwhelmed. Sickness can cause this overwhelm, but so can poor nutrition, environment, and medications.
Nutrition
On a regular basis, poor nutrition is the biggest offender. This includes consumption of too many here-and-there (HAT) foods like we’ve talked about before. When it comes down to it, our bodies are not made to continually process highly refined foods filled with loads of artificial ingredients, alcohol, and food allergens. These foods just aren't natural and can trigger an immediate inflammatory response, but can also starve the healthy microbiome leading to the chronic inflammation we talked about earlier. Diets consisting of mostly highly refined foods often causes nutritional deficiencies. This includes vitamin D, vitamin C, fatty acids, and magnesium. When our nutritional intake is inadequate, our bodies simply do not get enough of what is needed to operate optimally.
Environment
Environmental offenders are also important to avoid. Here we are mostly talking about sleep and exercise habits, chronic stress, and repeated or untreated infections.
Sleep and exercise?
Yes!
Sleep plays an integral role in cleansing our brain, literally, so not getting enough sleep can increase inflammation by allowing buildup of certain substances in the brain. Exercise, we know, helps reduce inflammation because exercise stimulates the release of naturally occurring anti-inflammatory chemicals while also strengthening the immune system as a whole. As a bonus, exercise can be more effective at increasing certain neurotransmitters that improve mood, focus, and cognition.
Environmental toxins like lead poisoning or pesticides are a concern, but far less than a hundred or even 20 years ago. That’s not to say toxins aren’t a problem, but now they can be much more easily avoided than in the past. Certain individuals who work in potentially toxic or polluted environments should be cautious of the dangers of their work environment.
Chronic stress is a topic for a future post, but to give you a quick summary: chronic stress leaves your body in an activated "fight of flight" mode which strains just about every bodily system. Anyone who has been stressed, even briefly, understands how difficult it is to remain centered during those times. Over time, chronic stress impairs our bodies, including our immune system, so much that inflammation begins to impact every function from head to toe. Reducing or managing stress is important to our physical and mental health!
Untreated infections, or infections in general, can lead to inflammation - just think of your last sore throat. I'm oversimplifying again, but the idea is to paint the picture that we must take care of our bodies in order to allow our bodies to perform in tip-top shape. No, a sore throat doesn't necessarily lead to chronic inflammation that impairs mental health. Some infections like long-covid increase inflammation throughout the body and can significantly impact mental health with symptoms like brain fog, fatigue, and lack of motivation.
Medication
Perhaps the most surprising cause of an imbalance is the use of certain medications – primarily antibiotics and acid blockers. Antibiotics are one the greatest inventions in human history. They’ve saved countless lives! But antibiotics also have a secret: they don’t just kill the bad bacteria, they kill the good bacteria, too! So we really want to use antibiotics only when necessary in order to avoid the potential inflammatory response to an imbalanced microbiome. Acid blockers can also be an issue. Occasional use, or when medically required, is fine. When we take too many acid blockers it causes the microbiome to become less diverse. This is because some of the good bacteria need the acid to thrive. Again, the idea is not to spur panic here, but to increase awareness surrounding the use of medication, especially over-the-counter medication.
How does integrative psychiatry provide a holistic approach to managing inflammation?
Integrative psychiatry looks for root causes. With an integrative approach, we aren’t interested just in masking symptoms with pills. If possible, we want to identify the problem and work to
correct it. Remember, there is no one-stop-shop treatment plan with integrative psychiatry. The things I may utilize in my assessment include:
- Nutritional analysis including what, where, when, how often we are consuming food, beverage, and anything else we ingest
- Determine physical activity levels to understand how much and what type of exercise may be missing
- Medication use, including any supplements or over-the-counter medication
- Lab testing for certain inflammatory markers, allergens, and nutritional deficits
- Stress inventory at work, home, and socially
- Sleep profile and/or study
All of the above can help us identify if there are potential inflammatory conditions present that may have a hand in the presentation of mental health symptoms. Once we have a better idea how the above systems are working, we are better equipped to come up with a game plan. I tell folks they should expect to make some changes in their life in order to maximize our work together. We can’t expect to have results unless we put in the work, right? The changes I suggest are just that, suggestions. But they are evidence-based. That’s not to say anyone should become some steadfast robot that has no fun in life! To be clear, this is not dieting or a fad. We are talking about making meaningful, targeted lifestyle changes. Some of these changes or treatments may include:
- Our daily routines including diet, exercise, and sleep
- Stress reducing therapies
- Supplementation
- Medication as a supportive measure, not as a singular treatment
This can be overwhelming… but we’re in this together! We don’t want to make changes too fast. Any changes made should always be a part of a larger, ongoing treatment plan.
Wrapping it up: Using integrative psychiatry to address inflammation in the context mental health
Inflammation is a natural bodily response, but it can be a problem if it becomes chronic. The gut-brain-axis suggests a strong link between the microbiome in our digestive system and our brain, ultimately impacting our mental health. For a significant number of individuals, an imbalanced microbiome may lead to a number of mental health issues. We have control over some of the inflammatory processes by being aware what we put into our bodies, our environment, and what medications we take. With integrative psychiatry we are empowered to address root causes, like inflammation, from a holistic perspective.
If you have questions about integrative psychiatry, are interested in seeking care, or are interested in learning about how to practice integrative psychiatry, please reach out to me via email at ryan@proactivepsychiatry.com. Feel free to repost this blog, just give me a backlink!