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Digestion and Mental Health

The intestinal tract, or the gut, is oft­en called the “second brain” because it’s a major source of neurotransmitter

production in the body. It’s therefore unsurprising that people with chronic digestive problems are often anxious and depressed. Healthy bacteria, known as probiotics, help lower the stress response by regulating GABA, the relaxation neurotransmitter, via the vagus nerve. Probiotics may be bought in capsule or liquid form in a healthfood store, but fermented foods are among the best foods for intestinal health. In fact, most traditional diets of the world include fermented foods, such as sauerkraut, kimchi, kefir, natto, miso, and yogurt. Where fermented foods are not available, yogurt and sauerkraut can be made at home easily and inexpensively and are a wonderful food preparation and “science experience” to share with children.

Inflammation, a healing process that normally occurs as a result of an injury or infection, is another nutritional issue for therapists to consider, as it can also occur as a result of poor diet, physical inactivity, obesity, smoking, increased gut permeability, lack of sleep, and vitamin D deficiency. In these cases, inflammation can become a chronic condition, causing the sustained production of inflammatory cytokines, which contribute to depression and the breakdown of nerve cells, negatively affecting neurotransmitter function. A 2007 study by Zhang and An in International Anesthesiology Clinics demonstrates that counterregulating the production of inflammatory cytokines may even increase treatment response to conventional antidepressant medication. Certain foods, such as refined sugars, trigger inflammatory cytokine responses, so eliminating these foods helps stabilize mood and reduce systemic inflammation over time.

When discussing diet and nutrition with clients, I usually ask them to use a food, mood, and exercise diary to keep detailed track of what they eat, how they feel, and when they exercise for three days. This diary is a valuable tool for revealing clients’ self-care routines—or lack of them—and can greatly enhance awareness of what they eat and how it affects their energy and mood. Ultimately, recognizing that mood is a mind–body experience and not just based on personal history or mental processes can be crucial in increasing clients’ sense of self-efficacy and broadening their perspective on the many pathways to change.

Leslie Korn, PhD, MPH, practices somatic psychotherapy and mental health nutrition, specializing in the treatment of trauma and chronic physical illness. She trained and taught in the department of psychiatry at Harvard Medical School and has lived and worked in the jungle of Mexico for more than 35 years. She’s the author of Rhythms of Recovery: Trauma, Nature and the Body. Contact:


Zhang, Jun-Ming and Jianxiong An. “Cytokines, Inflammation and Pain.” International Anesthesiology Clinics 45, no. 2 (2007): 27-37.

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