Getting Real About What Depression IS and ISN'T

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A Mind of Your Own with Guest Dr. Kelly Brogan

Originally published on well.org.

Dr. Brogan believes that depression isn’t something that should be looked at just through the brain or through blood work, but is a symptom of many different potential sources of imbalance in the body.  Watch her interview with Dr. Pedram Shojai to learn about her bestelling book, A Mind of Your Own.

 

 

Clinical Depression and Society  

It’s hard to turn on the TV without seeing a commercial about depression drugs these days. And the sad truth is that the number of adults dealing with depression is really high- 14.8 million Americans are suffering from it. And the even scarier part to that statistic is that women are twice as more likely to deal with depression than men are. Dr. Kelly Brogan is a psychiatrist and best selling author on the subject of women and the truth behind depression and how they can heal their bodies. 
 
Dr. Brogan came from the traditional world of medicine- went to MIT and was really good at prescribing drugs to her patients. She says that in our society we define depression as having a “chemical imbalance” and that “it’s a brain-based problem, you’re going to have to manage it with other chemicals to compensate for your imbalance, probably for the rest of your life.”  It wasn’t until she was 9 months post having her baby that she was diagnosed with Hashimoto’s thyroiditis and everything changed for her. She stepped out of character and consulted a naturopath, changed her diet completely by taking out dairy and gluten and her potentially debilitating autoimmune disorder went into remission within a couple of months. Pretty life altering!
 

Symptoms Reflect Your Body’s Imbalances

Dr. Brogan believes that depression isn’t something that should be looked at just through the brain or through blood work. She believes it is a symptom of many different potential sources of imbalance in the body be it both physical and emotional. There are psycho-spiritual mismatches going on with people and the question she likes to pose to her patients is “are you living a purpose driven life?” There are many things that our bodies need such as movement, sleep, sunlight exposure, family love and social connections. If some of these areas are disconnected, the symptom of what might be called depression is rearing it’s ugly head and causing pain and disturbance in one’s life. She believes strongly that the first thing to tackle is the mindset shift, where the goal goes from becoming getting your symptoms gone as quickly as possible and suppressed as quickly as possible. Then she says  it’s about understanding what your specific symptoms are actually reflecting about your bodily imbalances and doing major changes to bring about the healing. 
 

It May Not Be Just About the Serotonin Levels

Stress is doing really doing bad things to our bodies. It is causing major harm and inflammation in the body. And because we have bad bacteria floating around and it doesn’t belong circulating around our blood system, when it gains entry to systematic circulation which is often described as Leaky Gut. But the symptoms you can develop is also depression.
 
Dr. Brogan says research is showing there is a major conduit between the gut and the brain. And she believes that serotonin has gotten a lot of attention but wants the medical community to not put all the weight and link depression and serotonin levels together. She says research is showing that depression could be about inflammation in the body as well, not just this focus that has been around since the 1950s that it’s all about the low levels of serotonin.  There are tons of cases of people who change their diets that can change debilitating disease and depression has been one of them. She just believes it’s not getting the attention it deserves because of how much of a strong hold pharmaceutical companies have in our culture. It’s hard to get the message out- that people can change their diet and be free of these drugs like Zoloft and Prozac.  
 
Dr. Brogan’s quest is to bring attention to the reasons behind mental illness like suicidal depression, psychotic mania, and schizophrenia. She knows that other auto immune diseases have been cured with lifestyle change and believes there is strong evidence to support bodily imbalance that is completely reversible in mental illness as well. It’s about cleaning up your act meaning your food and what you’re putting in your body and not being so tied down to the pharmaceuticals everyone seems to be putting in. 
 
For more fascinating info regarding this subject- check out Dr. Brogan’s book “A Mind of Your Own”.
 

Notes From the Show:

Dr. Pedram:
Hey, welcome back to the Health Bridge, Dr. Pedram here talking about depression today. When we looked up the statistics on this, it was kind of staggering. I knew it was bad, but I didn’t know how bad. 14.8 million america adults suffer from it, and women are twice as much as men, so this is a big deal for women. 70,000,000 in medical costs. It’s out of control. It’s spinning out of control.

I am fortunate to have awesome friends, and I have one with us today who just wrote a best-selling book on the subject, and she is … She doesn’t come from the traditional school, although she studied there. She is one of the most innovative kind of go-get-them docs I’ve ever met, and she’s delightful. I want to welcome to her to the show right now, Dr. Kelly Brogan. Hi.

Dr. Kelly:
Total pleasure to be here with you. Really exciting. 

Dr. Pedram:
Great. You and I have hung out socially a couple times, had a few interactions, but you’re on that other coast, which means I don’t get to see you that often. 

Dr. Pedram:
Your book, A Mind of Your Own: The Truth About Depression and How Women Can Heal Their Bodies and Reclaim Their Lives. Beautiful, really well done, and kind of came out of nowhere. There’s almost like a media ban on you, and it was just this weird thing where you weren’t getting any coverage and you should have been, and then it was just this kind of grass roots ground swell that brought your book out, and they couldn’t ignore it. Hear hear, this is great. I’m loving the fact that you’re a best seller. I’m loving the fact that you’ve made your splash, and you’re just getting started.

 
Dr. Kelly:
It’s difficult material to confront, if you’ve sort of cozied into the assumption that we’ve cracked the code on mental health and we know how to help people who are suffering. Not just from depression, but from anxiety, or OCD, schizophrenia, bipolar, you name it. All of these labels that we love to toss around in psychiatry. This material is shocking, and it certainly was to me, believe me. I dedicated my entire career to this paradigm, and so for me to really let it all go was as difficult as it should be, really, for the mainstream to accept. I understand that it has unfolded this way, and I’m just excited that there’s such receptivity on the ground level for the message in this book.

 
Dr. Pedram:
You’re a psychiatrist. You’ve got a booming practice in New York. You’re also a co-editor of a textbook called Integrative Therapies for Depression, and you’ve come from there, right? You’ve looked at all the drugs, you’ve prescribed the drugs, I’m assuming, and so what happened? What happened in this kind of revolution in your thinking where you realized that maybe we’re going the wrong way?

 
Dr. Kelly:
Yeah, so I come from a very conventional background. I was not raised a hippie. My parents are sort of blue collar. My mom is an immigrant. She and my dad very much instilled in me this notion that authority is to be respected, education is everything, and pushed me to the point of medical school. I was always interested in the brain, I guess, and behavior. I worked a suicide hotline at MIT where I went to college, and I was also studying neuroscience, so I really created this illusion that we had all of the tools we needed to help people with human suffering.

We have the science, we have the profession, which is psychiatry. I was supervised by a psychiatrist in this … working this hotline, and so I went to medical school and pursued residency in psychiatry with that intention. I’ve always been a self-identified feminist in many different incarnations. In those days, I was very much sort of interested in how could I obscure all the elements of my womanhood so that I could play in the field with the boys. 

That was the kind of feminism I espoused. I took birth control endlessly for 12 years. I was really excited about the HPV vaccine when it came out. I thought, if I ever have a kid, it’s definitely going to be by elective cesarean. Who would ever bother with experiencing pain of childbirth if you don’t need to? This is very much the mentality that I came from, and I really wanted to be good at prescribing drugs. I focused a lot of my intellectual energy on developing that skill.

I specialized in what what is called reproductive psychiatry, so essentially medicating pregnant and breastfeeding women, so dealing with mental illness in pregnancy and postpartum. It wasn’t until I was pregnant myself in my fellowship, and I remember writing a prescription for a pregnant woman for Zoloft, and I remember thinking, no. I have all this data at my fingertips, 25,000 cases in the literatures, for the most part reassuring science, and I would never want to take this medication as a pregnant woman. What is that about? That I have this conflict. I sort of ignored it, and it wasn’t until I was nine months postpartum myself, my first pregnancy that I was diagnosed with Hashimoto’s thyroiditis, so it was my first medical issue ever.
I’d been trashing my body for decades up to that point, literally, eating Snickers and Twizzlers every day, eating at McDonald’s and White Castle, and drinking Redbull, and not sleeping, never exercise because I never had a weight problem, so why would I exercise? It was really a come-to-Jesus for me to think about the prospect of taking a prescription for the rest of my life. That’s all I cared about. I was like, there’s got to be an escape hatch. How do I get out of this? I don’t want to deal with this.

It’s from that mentality that I consulted with a naturopath, which was so out of character for me to do something like that. Our entire training is really built upon putting natural medicine and alternative medicine quote-un-quote, into a nice, harmless box in the corner, and really dismissing it as benign at best and dangerous at work. I consulted a naturopath, changed my diet, put a potentially chronic and even debilitating autoimmune disorder into remission within a couple of months.

I had antibodies in the high 2,000s that came into the normal range. My entire gastrointestinal system and brain function was revolutionized, basically by taking gluten and dairy out of my diet, and a lot of red flags were raised because I basically said to myself, I never learned about any of this in my very expensive training. I never learned that diet mattered. I never learned you could put a chronic autoimmune disease into remission, you could only manage it, largely with medication. 

That’s when I began turning stones over. I left none untouched. I started to look at common medications that I’d always thought were God’s gift to humanity. Things like statins, birth control, antibiotics, pain killers. I began looking at the real science, the science that I had not been exposed to in my training, or from my mentors, around psychiatry. What is psychiatry? Is it a science? What are we working with in terms of these medications? What are they really based on? What I had to unlearn was epic. 

I basically had to let almost everything that I had come to hold dear, in terms of my understanding of the human body, and our ability to manage diseases, both acute and chronic, I had to turn it all on its head. It wasn’t until I really embraced this departure that I began to really see changes in my outcomes in clinical practice, and I began to actually cure people, for all intents and purposes, rather than just manage them. The mindset that has come with that has been so, so empowering and liberating that I want to share it.

Dr. Pedram:
I think it would be nice to kind of take a step back real quick and just say, okay, what is depression? What’s the definition of clinical depression so that we can start looking at some of the psychiatric views, and then stuff that you kind of stumbled into … I wouldn’t say stumbled into because you worked your ass off to go learn all this stuff, and it’s kind of created a whole new frame of mind and a frame of reference for you on it. 

Dr. Kelly:
Yes, yes. We’re told a story about depression. We’re told that it’s probably something that you’re born with, and it manifests under stress at a certain point in your life, and it reveals that you have this chemical imbalance. It’s a brain-based problem, you’re going to have to manage it with other chemicals to compensate for your imbalance, probably for the rest of your life. You’ve just been dealt this bad hand, and thank goodness we’ve learned as much as we have about human biology that we have something to offer you that’s largely safe and effective.
 
That is not only the message that we are indoctrinated with in our conventional training, but it’s also really a myth that permeates on a social level, so deeply that I find even many of my open-minded practitioner colleagues have come to believe this about depression. Most of it is because we are victims of direct-to-consumer advertising. We’re one of two countries in the world, New Zealand being the other, that allows corporations, pharmaceutical companies to speak directly to consumers about their health, and so they have been telling us for many decades now that depression is a chemical imbalance. They have little pictures of neurons with bubbles floating between them, to depict its – 

Dr. Pedram:
Looks very smart.

Dr. Kelly:
Right, it looks really official. To depict what they believe is going on on a biochemical level, and of course psychiatry as a discipline has sought to legitimize itself medically for many, many decades, and so with the opportunity to engage in pharmaceutical medicine, that really emerged in the 1950s with observations around anti-tuberculosis medications and their potential effect on mood, there was the development of MAO inhibitors, and of course the incidental use of anti-psychotics, and there really was this groundswell of just this energy like, yes, we finally have our tools, we’re finally legitimate science-based doctors. 

The humble origins of the chemical imbalance theory of depression are pretty concerning, actually. There’s not a lot there. It was really an opportunistic moment in the history of medicine where psychiatry just sort of jumped on this wagon. Since that, in six decades, believe it or not, there is no legitimate science to suggest that depression has anything to do with irreplicable chemical imbalance, and this is pretty shocking to me because we are taught that it has, most likely, something to do with serotonin imbalance, or maybe serotonin deficiency, and you’ll even learn of the alternative options to Zoloft of Prozac is St. John’s Wort or tryptophan or 5HTP for its serotonin boosting capacity.

You might even see drinks and bars at the health food store that claim to boost your serotonin for your mood. The truth is that we really don’t have any scientific evidence that serotonin has much to do with mood, let alone deficiency being a direct causal link to depression. I know that that’s … confusing, because how did we get that idea, but the truth is, in many ways, we have worked backwards from observed effects of medication, and tried to come up with underlying disease mechanisms.  

That’s sort of like saying, if you’re an anxious person and you have two shots of vodka and you feel better, it’s sort of like saying, you probably have an alcohol imbalance, and you probably should just do this every single day to prevent this from occurring in the future. We sort of intuitively know that wouldn’t be great advice, and we know there would be consequences to that if you were to actually adhere to that advice, but in many ways, that’s exactly what’s going on with psychiatric medications, is that not only are we not fixing an underlying imbalance, but we’re actually creating an imbalance.

We’re creating a gradient against which the body has to adapt, and then it’s in that adaptation that we see sort of how we set people up to not only experience more and more repetitive relapses in their mood and stability, the development of diagnoses like bipolar disorder, when all you were dealing with was … initially was some flat mood and cheerfulness, let’s say, but then we also have this epidemic of people who are stuck on these meds and having a lot a lot of trouble coming off them, because from my clinical experience at this point, now a decade into taking people off of these medications, I honestly have to say that I don’t think there’s a more habit-forming chemical on the planet.

I don’t see anyone taking people off of heroin or Oxycontin or alcohol at one to five percent of the total daily dose per month. Never heard of such a thing, and I have to do this regularly in my practice just to keep people literally medically stable. This is big stuff we’re dealing with. There’s an untold story of these medications, and they really only come into play if we believe that depression is a chemical imbalance that they are going to fix.
Something important to know about psychiatry is that we don’t have any tests. We don’t have any objective measures for determining what your diagnosis is. You go to your family practice doctor, you go to a psychiatrist, you have a conversation, sometimes for as little as 10 to 12 minutes, and you’re given a label, and that label goes with a pill. The truth is that depression isn’t something we can assess for through a brain scan, through an EEG, through blood work, so we really are left back at your question, which is, what is it then?

My argument is that I like to reframe it as a symptom. It’s just a sign of many, many, many different potential sources of imbalance. I focus a lot on physiology, maybe because I come from a medical background, and I’m interested in the fact that conditions like what I was diagnosed with, thyroid dysfunction, that blood sugar imbalance, that specific food reactions, that medication side effects can all buy you a diagnosis of depression, and are completely reversible if you identify, what is your driver?

Of course, there are other mismatches. There’s psycho-spiritual mismatch. There’s, are you living a purpose driven life? Are you attending to the many meta signals that your body expects in terms of movement, in terms of sleep, in terms of sunlight exposure. Often, depression is just the expression on the part of your mind, body, and spirit that there is a vast mismatch here, and in the literature it’s called evolutionary mismatch because we’ve come all these millions of years to expect certain stuff, and we’re not giving ourselves that stuff. Sometimes it’s just a reminder of that, and really an opportunity to check out what’s behind it.

Dr. Pedram:
The first half of your book is called The Truth About Depression, and it’s basically getting into all this. Sunlight, movement, exercise, family love, social connections, all these things that are part of this vast ecosystem that used to make us whole, and you look at modern life and it’s just fragmented, and so it’s obviously a serotonin deficiency, and you’ve got to take these pills. It’s incredibly limiting, and it’s one of these things where … People suffer from lots of very terrible things with depression. People kill themselves. It’s obviously a very challenging issue in our society, so then the question becomes, looking at this the way you are kind of coming at it and re-framing it, what then becomes the type of solution set if it’s not pharmacological?

Dr. Kelly:
You might be interested in the fact that, actually, according to research, much of which I’ve recently synthesized because there was an announcement in the New York Times that there’s been a vast increase in suicides across the nation. You would think that’s a call to action for more treatment, but if you look behind the veil of the pharmaceutical research, you’ll find that in many, many studies, there is a four-fold increase in risk of suicide if you are medicated.

Dr. Pedram:
On the drugs, yeah.

Dr. Kelly:
Right. That’s tough news because we want to think that, well, you’ve got to do something for these people who are struggling, but what if they’re falling off a cliff and what we’re handing them is a knife instead of a hand. There is a hand to offer people who are struggling, and in my opinion, it’s as close as we can probably come to a relatively quick, safe, and easy fix.

It’s what we were looking for, it’s just that we thought that it was supposed to come in a pill, and if I could disabuse anyone of any assumption, it’s that these pills are safe, and really that they’re effective. They don’t work in the ways that we think they do, and there’s a lot of literature to suggest that when they do have an effect, that it’s short term, and that it’s potentially driven by the belief that they will have an effect.

It doesn’t mean you’re being duped or fooled or anything, it’s called the active placebo effect. It’s a very real phenomenon. It’s a beautiful phenomenon actually, if you understand there’s even neuroendocrinology to explain why what we believe about our health engagements has an effect when it does, but it’s not worth it at the cost that these meds come at.

Dr. Pedram:
There’s been a lot of different kind of data points that people have kind of chucked at me over the years about how a lot of these drugs barely outperform placebo. 

Dr. Kelly:
Yeah. It’s hard to wrap your mind around. Every time I lecture about this, there will be someone in the audience who is all indignant, and gets up and says, I don’t care what you say. Prozac saved my life, or my husband’s only alive because of Zoloft. It’s sort of like this feeling of having been convicted by what I’m sharing, and it’s absolutely not the case. The fact that there are some people who perceive these medications to be helpful is not in question. It’s, why and how are they helpful? That’s the surprising data.

There’s this guy, Irving Kirsch, who’s a psychologist who did some pretty tremendous research that really should have decimated the paradigm of psychiatry if it was allowed to. This was back in 2008 that he put out this definitive meta-analysis that when he called upon literature that was not published, so that was hidden basically by a pharmaceutical company’s … They’re allowed to do that, actually. They can have a file drawer that’s locked with all the inconvenient truths inside it.

When he included that, he found that the active placebo effect, which is when you are using a sugar pill to contrast your treatment, people are not going to have side effects like dry mouth or headache or some gastrointestinal distress with a sugar pill, so when they have those side effects versus not, they start to tell themselves, oh gosh, I’m in the treatment group. Yes! All of that healing is happening, all of those chemical balances are being resolved just like I saw on channel four after the news the other day.

All that messaging begins, and it’s only because they had the side effects because it’s being compared, not to a medication with the same side effects, but to a sugar pill. That’s called the active placebo effect, because what happens is, if you compare Zoloft, for example, to an active placebo like atropine, to a medication that has the same side effects, there is no difference at all in their outcomes.

When you control for this, which he did through some very complex analysis, inclusive of all of the literature itself, which when you look at all of it, shows that placebo outperforms these medications more often than not, period. Just like the percentage of studies that actually are positive, when you include the unpublished ones, is pretty concerning. He showed that the active placebo effect accounts for the vast majority of what we are calling, leaving about 10 to 15% of what we are calling medication effect, to only be attributed to the medication itself. 

It’s hard to appreciate that, but I also think it’s worth saying that these medications do have effects. It’s not that they don’t do anything. They have effects, and you may like effects. Remember the alcohol analogy? You might like the effects. They may be sedating in the right way for the right moment in your life. They may be activating or energizing in the right way, but they are not fixing anything. They’re not curing anything, and that’s a really important point, because then you sort of get into how they are actually creating a different state for your body to sort of struggle with.

We’re really looking at a palate of treatment options in the conventional realm that overpromise, and not only under-deliver, but really expose us to risks that are pretty concerning. When we’re talking about impulsive behavior including homicide and suicide, when we’re talking about a number of potential run-of-the-mill pharmaceutical side effects like increased bleeding risk and risks to liver and kidney function, et cetera, risks of lethal – 

Dr. Pedram:
Small stuff. 

Dr. Kelly:
Yeah. It really almost becomes small stuff relative to these lesser known side effects and the dependency issue. Then what can you do instead? Could something else really even work, let alone as well? That’s when you have to sort of first accept that there is something in your symptoms that you need to pay attention to. First is that mindset shift, where the goal goes from becoming getting your symptoms gone as quickly as possible and suppressed as quickly as possible. The goal then shifts to understanding what your specific symptoms are actually reflecting about your bodily imbalances.

That’s why I’ve become really, really passionate about food and nutrition forward interventions, because there are a number of different imbalances that could be operative. You could be working with someone who could help you to figure that out, relatively easily, but you could also just do one thing that addresses many, many of these potential imbalances, like the ones I mentioned, including food reactions. There’s very compelling literature implicating gluten and dairy, for example, in various different mental illnesses. Blood sugar instability.

I have a patient who was having six panic attacks a day when she came to me, on two psych meds, on her way to electro-convulsive therapy, literally, who changed her diet, basic changes. A month later she came back and she said, this is the first month of my adult life I have not had a panic attack. This is not rocket science. All that we had done was balance her blood sugar. She was just on this epic roller coaster all day long of fight-or-flight induced by hypoglycemia, of low blood sugar.

You look at thyroid dysfunction and autoimmunity. Autoimmunity is a huge issue today, with a hundred diagnoses plaguing the population. It is so comorbid, meaning it almost always coexists with mental illness of some variety, whether it’s chronic fatigue, or inattention, or anxiety, or insomnia, or depression, and so if you can address that immuno-inflammatory signal through anything, all of us would agree in the holistic world, it’s going to first be cleaning up the source of epigenetic information that your putting in your body every single day through your diet.

I’ve become pretty passionate about getting there, and then seeing, what actually are you dealing with? Through my own personal experience, through my years of working with women, and then through my brief but very formative work with my now late mentor Dr. Nicholas Gonzalez, who was a holistic cancer doctor here in New York, I’ve come to understand that there actually is a starting template that is effective for the majority of people, and then the responsibility rests on you to beginning to listen to your inner compass, your preferences. To re-engage with more intuitive eating to see how to tailor it more personally to you, but I’ve found that it’s like, I don’t know, near-miraculous intervention.

Antidepressants, theoretically, any conventional psychiatrist will tell you, you need to give them six to eight weeks to work. My patients from consultation to first followup give me a month, and what happens in that month is so reconfiguring. Of course, they’re expected to take this prescription pretty seriously. I run a tight ship when it comes to readiness for change, and expectation of real compliance around this, taking it pretty seriously, but what happens in a month continues to shock me, because I still have that hat on that says that food doesn’t matter. I only had an hour of nutrition education in my entire training. 

Dr. Pedram:
Yeah, and it’s so hard to think that all these kind of fancy interventions aren’t the answer. You said something I want to come back to, because this is something I was looking at. It’s like a decade or so ago, there’s some old clinics in Russia that were doing gut cleansing for people that had severe psychiatric disorders, and they were having complete resolution. I looked at this way before any of this stuff was cool. I was looking at this saying, what the hell’s going on?

Dr. Kelly:
It pokes a hole in the theory, right? 

Dr. Pedram:
Yeah, absolutely. It’s like, so you’re saying, cleansing the colon is taking care of their psychiatric illness. What is that even implying? You mention this in your book, we’re talking about the new biology of depression. When we’re talking about gut micro-bio, and what that does to our mental state, and then just kind of chronic inflammation, which usually starts in the gut, and so as we’re talking about food, I’ve for you to tie those together.

Dr. Kelly:
Yes, yes. Yeah, there was a case in the literature recently, actually. It was a woman who developed psychotic mania after a bariatric surgery, so like a stomach stapling. Never had it before, not like a mental patient per se. They gave her charcoal, so to absorb intestinal toxins, and they didn’t do anything else. No psych meds or anything, and her symptoms resolved within 48 hours. 

That one case alone should send us back to the drawing board about mental illness, because there is nothing in that case that says she was born with a mental chemical brain imbalance that needs to be managed with Depakote and lithium for the rest of her life. There was nothing in that case that reflected back the gold standard treatment paradigm. When we begin to encounter these sort of really challenging cases, we are forced to reconsider what it is that we’re working with, and that just hasn’t been happening on the grand scale, but it is happening quietly in the literature.

It’s been happening, actually, for almost 20 years, that there has been a move away from what’s called the monoamine hypothesis, so the chemical imbalance theory, and a move toward what is called the cytokine theory, or the inflammatory model of depression, and the encompassing of that in a new discipline which is called psychoneuroimmunology, which is what it sounds like. It’s the connection of all of these seemingly disparate systems that we thought had nothing to do with each other.

When I was in medical school, we didn’t know, this was not that long ago, that the brain has an immune system. We only were taught that the brain has immune activity if you had like a knife driven through a skull or something, or an injury, not on a daily basis. We discovered, I think it was like last year or in the past 18 months, that the brain has lymphatics. This is basic anatomy we’re still … It’s so humbling.

We just have so little idea what we’re doing when it comes down to it, but the most cutting-edge science is telling us is that, and reflecting back to us what a lot of ancient, traditional healing practices and medicine have known for a very long time, which is that the gut is the seed of health, and that there is interrelationship between all of these seemingly unrelated and distinct entities.
 
I think for many of us it’s intuitive that our brain has an effect on the gut. We’ve all had butterflies before a presentation, or we’ve lost our appetite when we fall in love, or these sorts of … This direction seems to make sense to us, but what is really requiring some mass education, particularly of the conventional medical world, is that the gut itself also signals directly to the brain. Not only is there a nervous system, the enteric nervous system, at the gut level, but that … Who’s in charge of setting the tone of what’s going on, and really reading the environment, is the microbiome, so is that ecology in our guts that essentially dictates whether or not an inflammatory and associated immune response is necessary.

We think that the vagus nerve, which is a major conduit between the gut and the brain, is obviously much of how this signal is transmitted, but we’re actually learning about many different ways that inflammatory messengers travel from the gut to the brain, and even how our beliefs and fears can stimulate inflammatory messages from the periphery, so like from bone marrow, that then recruits the whole system to cooperate together, because that’s the idea.

This mechanism is designed for a reason. It’s designed to help arm us for response. It only becomes problematic when we have to arm ourselves all day, every day, for years on end, for decades on end, and there’s unremitting stress and danger signal. Th

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