Psychobiotics Get Real: A Case Study

Are you in a rainy mood even when the sun is shining? You may be depressed. If so, you have plenty of company. The World Health Organization states that depression is the number one cause of disability worldwide. This is despite all the antidepressants, old and new, available in psychiatry. And yet, all is not gloomy. This is the story of a woman who managed to escape the dark clutches of depression by balancing – among all things – the microbes in her gut.

Happy together.

Source: Gatsi/iStock

April (her name has been changed to protect her identity), is a 38-year-old middle school teacher. Eight years ago, she met a college professor on a ski trip. On the slopes and huddled around the chalet fireplace, they discover a lot in common. They fell in love and soon got married. A year later, April gives birth to one child and two years later to another. The four loved nothing more than spending time together.

But behind this idyllic exterior, a problem simmered. Several months ago, April started having stomach pains and diarrhea. During the day, she took half a dozen bathroom breaks. It was tiring. The distraction was enough to drive her to a doctor who prescribed her a low dose of Elavil, an antidepressant sometimes used off-label to calm a sensitive bowel. In addition, the doctor suggested a high fiber diet.

But after a month, April realized it wasn’t working, and her doctor referred her to a gastroenterology clinic. There she underwent an ultrasound to rule out any major problems in her intestines, as well as a colonoscopy to directly inspect her intestinal lining. Everything looked good. Perversely, that’s not always good news: when you have a bad gut but have no visible signs, it often indicates IBS, which is defined in part by its lack of apparent damage. But as any sick person will attest, it is a very real disease.

April saw a dietitian who recommended extremely low levels of fiber, contrary to her previous doctor’s advice. These contradictory messages did not inspire confidence. Still, some IBS patients have found comfort in a diet like this, which eliminates gas and bloating by dramatically reducing the numbers of certain bacteria.

A new point of view

This is where Dr. Ted Dinan came into the picture. Dinan, a psychiatrist and researcher at University College Cork (UCC), found himself treating more and more people with both depression and gut issues. Working with John Cryan, professor of neuroscience at UCC, Dinan found that certain probiotics not only help the gut, but also improve mood. To describe these special probiotics, Dinan coined the term “psychobiotic”. In some animal studies, these psychobiotic microbes worked as well or better than Prozac in reducing anxiety and depression. Human clinical trials reveal equally striking results.

After a consultation, he realized that April wasn’t just suffering from IBS, she was also depressed. For the past few months, she’d found herself hanging out all day. She was constantly worried and anxious and had trouble falling asleep at night. Normally outgoing, she found herself running away from her friends. Dinan offered to prescribe an antidepressant, but April grew skeptical of standard medical treatments. His low-fiber diet wasn’t working either. When Dinan told her that psychobiotics might be effective in treating IBS, April jumped at the chance to try something that felt natural and simple. She gave up her low-fiber diet and started taking daily capsules of Bifidobacterium long, a probiotic found in some yogurts.

Fortunately, April found some relief. During the first week, her bathroom visits became less urgent and less frequent. Soon his anxiety began to fade. After a few more weeks, her depression cleared completely and she was down to two BMs a day. As for April, she was healed and her family got her mother back.

April’s story has a happy ending, but it’s not the only one: Dinan has helped other patients find peace through a personalized readjustment of their gut microbes. Not all depressions come from the gut, of course. Grieving can lead to depression, and that’s completely normal. Stress is another major cause of depression and, curiously, it also has an impact on the microbiota. Depression travels a two-way street between the gut and the brain. For depressed patients who also have gut issues, balancing the gut microbiota is always therapeutic and – as this case study shows – sometimes even curative.

Essential readings on depression

There’s such a strong association between depression and an imbalanced microbiota that Dinan says psychiatric patients should be asked about their gut issues at the first meeting. For those with both brain and gut issues, Dinan often recommends exercising and adding more fiber to the diet, which helps balance the microbiota. Sometimes, like April, he suggests a probiotic capsule.

Depression, with its sadness, insomnia and loss of interest, can quickly drain the joy and meaning of life. No one knows exactly why, but women are almost twice as likely to be depressed as men. One in three women can expect to experience depression in her lifetime. And yet, less than half will seek treatment. Many abstain because they are not fans of the current crop of psychoactive drugs. However, if left untreated, depression can lead to other mental disorders and even suicidal ideation.

For sufferers, a natural way to treat depression would be a godsend. This is exactly the promise of psychobiotics and the prebiotic fiber that feeds them.

Try it yourself

Felice Jacka from Deakin University in Australia showed that people who followed a Mediterranean-style diet for three months showed significant improvements in their mood. A third of them were actually cured of depression. Psychobiotics aren’t hard to find, and a blend of prebiotics will help feed them.

The fiber conjures up images of tree bark, but it’s really a collection of long sugar chains with a slightly sweet taste. Humans cannot digest prebiotic fiber, but it is essential for your gut bacteria, which absorb it and in turn create substances that nourish and strengthen your gut lining. This is important because if your gut lining is leaking, bacteria can enter your bloodstream. Once there, your heart will pump them to every organ and tissue in your body. This can cause systemic inflammation, negatively affecting your brain and crushing your mood.

The idea that gut microbes can affect your mood is somewhat humbling. How can simple microbes control our feelings? Surprisingly, some bacteria can produce psychoactive chemicals, including dopamine and serotonin. Microbes probably use these chemicals to talk to each other. But they can also try to talk to your brain.

If you’re suffering from the blues, take note: you can eat psychobiotics in pill form or fermented foods like yogurt with live cultures. And, even if it didn’t work out early for April, you can eat prebiotic fiber.

If you have IBS, talk to your doctor first. You should not take probiotics or prebiotics when you have an active flare-up. But given at the right time, they can do wonders. If you are currently taking antidepressants or anti-anxiety medications and are happy with them, great. Under no circumstances should you stop without talking to your doctor. But psychobiotics can allow you and your doctor to lower your dose and alleviate some of the worst side effects.

Your gut microbiota is like a garden and needs to be nurtured. If you neglect it, pathogens can take over like weeds. Prebiotics act as fertilizer and fermented foods are like compost, full of life and potential. Now that you know the story, you have all the tools you need to maintain a thriving and diverse “environment”, improve your mood, and keep yourself in the pink of health.

About Margie Peters

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