Mental health has become one of the most challenging frontiers in the human experience.

Join Dr. Zach Bush, Susan Olesek, Dr. Nafisseh Soroudi, and TJ Woodward for a replay of an exploration into the biological and social risk factors behind today’s mental health crisis. Learn how microbiome damage from our environment and our lifestyle habits, coupled with the latest public health interventions, adversely affects our mental health.

We see an incidence of major depression in Western countries, now affecting 50% of adults across a variety of socioeconomic environments. Anxiety disorders rank just behind depression, and the more chronic forms of neurologic dysfunction including disordered sleep and attention deficit disorders are affecting our children by age two.

To achieve today’s mental health crisis at this unprecedented level across all ages, we must simultaneously have achieved severe, widespread changes in the neurochemistry environment of the population. While a series of emotional stressors is commonly involved in the more acute manifestations of mood disorder, we are discovering that the epicenter of our mental health crisis lies in the gut/brain microbiome and the dysfunction of our intestinal linings.

Mental health and microbiome interconnection

The physiology of depression and anxiety begins as we lose the universal production of dopamine and serotonin reservoirs within the hundreds of millions of enteric endocrine cells that line the gut, from the small intestine to the colon. These neurochemistry production centers are now recognized to produce more than 50% of our total body dopamine reservoir and more than 90% of our body’s serotonin reservoir. Interestingly, these human enteric endocrine cells cannot produce these critical neurotransmitters alone. Instead, diverse bacterial populations must be present on the surface of these enteric endocrine cells for the neurochemistry production to occur.
Several studies have found that individuals with a healthy gut microbiome have decreased levels of stress, anxiety, and depression and have a generally more positive outlook compared to individuals with dysbiosis. The health of your microbiome is dependent on the diversity of ecosystems that you breathe and touch in a day, the variety of foods and beverages you consume, and the variety of people that you interact with throughout your day.

Simply stated, the more variety you get in a day, the healthier and happier you are going to be.

As our lifestyles and environments begin to undermine gut epithelial (tight junction) health and microbiome populations diminish, our mental health also naturally declines.

In our daily experiences, we’ve experienced a steady march away from biodiversity — from breathing the same recycled air in our home and car, to working out in the same gym, to eating the same sugared beverages, natural flavorings, and daily meals which lack high-fiber root vegetables and fermented foods. This is not a character flaw nor an emotional overload, but the inevitability of micro and macro-isolation.

In a typical Western civilization day, we face an onslaught of hidden toxins that undermine our microbiome diversity and functionality of our critical barriers at the gut, blood-brain barrier, and kidney tubules. Chief among these threats is the ubiquitous exposure to herbicides through our food, water systems (both drinking and bathing), the air we breathe, and even the rain and snow that participates around us! Glyphosate, liberty-link, dicamba, 2,4-D, atrazine, and nicotinamides are among the most common. But we go further to layer on NSAIDs (like ibuprofen), constipation drugs (MiraLAX), and the myriad of plastic toxins in our foods and cosmetics that we lather on every day in an effort to feel better about ourselves.

As if that is not enough, we tend to self-medicate depression and anxiety with alcohol, marijuana, anxiolytics, sleeping medications, and other depressant/stimulant combinations that can trigger downward spirals in our neurochemistry. These can worsen social isolation and undermine our capacity for self-care (sleep-hygiene being one of the most critical).

Adverse effects of the pandemic

Over the past year and a half, the adverse effects of the pandemic have been well-documented. The use of masks and prolonged social distancing have severely undermined the mental health of our children, adults, and elders.

The lack of intimacy prevalent in our society today can predispose us to a wide range of psychiatric disorders.

Ultimately, as we look at the modern mental health crisis that runs through our homes, workplaces, schools, prisons, hospitals and nursing homes, we must come to terms with the fact that we are experiencing a crisis of isolation. Without constant reinforcement of diversity in the micro- and macro- worlds of our daily lives, we are doomed to a more isolated and monotonous neurologic experience.

Unfortunately, it’s not only the common varieties of depression and anxiety that have become epidemic in these times. It has been frightening to see a new epidemic of PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) in young children over this year. This condition manifests in suicidal or homicidal depressive thoughts in children as young as 4 and 5 years of age, driven by a shift of microbiota in the upper small intestine. Having children wearing masks — and therefore breathing sinus flora into their lungs and upper GI tracks for 4-8 hours a day — has been enough to create the PANDAS phenomena.

I have made it a routine in my clinic to complete medical release letters for mask wearing in these school settings for any child presenting with depressive symptoms. Even in marked cases of PANDAS, the removal of masks can lead to the disappearance of symptoms within weeks, as their gut microbiota returns to normal. If postnasal drainage is present in kids or adults during sleep, then I recommend nightly ION*Sinus Support to reduce the translocation of sinus flora into the intestinal milieu during sleep.

For adults, nasal breathing during sleep is a critical aspect of upper GI microbiome and mental health. If you wake with shortness of breath episodes or suffer nocturnal headaches, I strongly encourage an evaluation for sleep apnea with a home sleep test.

Reinforcing our gut health and mental wellbeing

Of course, the isolation of today’s modern lifestyles does not stop at the microscopic level. Humans are a social species. Physical contact is vital to our overall health, the impact of exchanging smiles, stories, laughter, and physical touch with those around us is critical to our wellbeing. Independent of other factors, social distancing has been linked to increased levels of anxiety, stress, and depression. Profound sleep disturbances are also on the rise as social distancing efforts continue.

Here are some tips to reinforce our gut health and mental wellbeing:

1. Share a meal with someone new today.

2. Focus on whole, organic fruits and vegetables, with an emphasis on root veggies — sweet potatoes, carrots, beets, turnips, and radish are some great ones!
3. Increase the amount of wild fermented veggies in your day (sauerkraut, kimchi, miso, etc)
4. Eat the rainbow – the more color, the more nutrient variety, the more microbiome diversity demands from your diet.
5. Consume healthy fats including raw seeds, nuts, and avocados
6. Reduce intake of refined sugar
7. Reduce intake of refined gluten
8. Reduce intake of dairy
9. Reduce intake of caffeine – herbal teas are a boon for the brain! Mint and Rooibos are two of my favorites day and night.
10. Reduce or eliminate alcohol, especially for those 2-3am awakenings.
11. Drink plenty of water
12. Get in that 4-minute work out twice daily – with friends for extra smiles and extra credit!
13. Breathwork is another powerful tool to reset mood and anxiety levels during your day – engage the parasympathetic with slow ‘square-breathing’ patterns.
14. Foot rubs at bedtime with some magnesium oil to improve sleep!

In the end, we have the opportunity to radically improve our mental health throughout modern civilization. To get there, we are going to have to fundamentally reimagine our homes, our workplaces, our schools, our prisons, hospitals, and nursing homes. We are going to have to turn our attention back to natural systems. We are going to have to rediscover beauty in our daily lives by discovering new paths to walk, new hands to hold, new meals to share, and new sunrises and sunsets to witness.

It is not in our nature to be isolated. Nature knows no form of abandonment. There is only more abundance and more diversity of life as nature continues on her path. We have set ourselves in opposition to the diversity of life on earth, and our mental health proves the consequences. We can change that.

Let’s get up in it…. Let’s chase diversity of experience and live more beauty today.