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Mood, brain and gut health

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A few weeks ago, a UCL study, based on decades of research on serotonin levels and depression, found no clear link between serotonin imbalance and depression. The research found no difference in serotonin levels in the blood and brain between people diagnosed with depression and people without depression. Prescriptions have never been based on low serotonin levels, but on a subjective diagnosis made at an appointment.

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The serotonin depression theory has been around for decades, resulting in huge profits for the pharmaceutical industry, at the cost of too many people who suffered serious side effects and great difficulty coming off these drugs. In fact, depression is multifaceted: it is rooted in the psychosocial situation and inflammatory states within the body.

Playing devil’s advocate: If we accept the theory that a serotonin deficiency causes depression, then let’s stop seeing mental illness as a brain problem. Instead, we need to look at the state of our gut, because 95 percent of our serotonin is produced in our GI tract, and generated by our gut bacteria.

Another way to look at depression is to examine our gut and overall health. It is now recognized that depressed people have higher levels of inflammation; this can be quantified through blood tests, such as elevated levels of C-reactive protein, for example. And interestingly, recovery from depression correlates with a reduction in inflammatory proteins to normal levels. So, like physical illnesses, mood disorders have inflammation as their underlying cause.

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So fish oils, rich in anti-inflammatory omega-3 fats, likely work on multiple levels: They nourish the brain and relieve inflammation in the gut and elsewhere. And turmeric (curcumin) has been found to outperform Prozac in several studies. Again, we are seeing the effects of a powerful anti-inflammatory.

But, you say: what about those people who have responded well to antidepressants?

Well, in the drug trials that involved an antidepressant versus a placebo, the placebo group did almost as well as those given the drug. And of those given the drug, most of the time the subjects correctly guessed that they had been given the active drug (because of side effects), which further distorts the response, based on the beliefthat this drug would have a noticeable effect.

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Our minds are extremely powerful when we firmly believe that something will work and benefit us.

In addition, SSRIs (selective serotonin reuptake inhibitors) have been suggested to act to decrease “neuroinflammation” in the brain. Which brings us full circle back to the link between depression and inflammation.

There is a very good reason to call our gastrointestinal tract our ‘third brain’ (our heart is the ‘second brain’, our emotional brain), as all three ‘brains’ contain many millions of neurons and nervous systems. The communication between our brain and our gut also involves our gut microbiome. Problems with our microbiome (an imbalance of good and “bad” microorganisms), as well as gut inflammation, are linked to depression and anxiety, as well as neurological conditions such as Parkinson’s and autism.

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The lessons from all of this are critical: Mood disorders are not simply a ‘chemical imbalance’. Depression is situational and arises from (or along with) stress, isolation and loneliness, loss and grief. There are also physical elements that are associated with a deficiency state, such as a vitamin D deficiency in the winter and SAD (seasonal affective disorder). However, since vitamin D is a powerful antioxidant, we return to an underlying inflammatory state.

Mood disorders need to be viewed from a holistic, whole-body perspective, not a one-size-fits-all recipe.

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