The Anti-Anxiety Diet Read online

  What Fuels Dysbiosis?

  Many factors of your day-to-day function greatly influence your gut bacteria balance. Your stress levels, drug interactions, and dietary intake can either provoke or prevent dysbiosis.

  The digestive process begins as soon as food enters the mouth, where enzymes and bacteria in the saliva play a role in turning food bites into a slurry. Then, as the food passes through the gastric pouch, ideally being denatured by hydrocholoric acid and additional enzyme exposure, microbes in the small and large intestines complete the digestion process. The metabolic end products in the presence of probiotics (beneficial microbes) are short chain fatty acids (SCFA), including butyrate and organic acids (lactic and acetic acids). SCFA tend to lower the pH of the intestinal contents, creating conditions less desirable for harmful bacteria and cancer while providing a fuel source for healthy cells. They are also able to regulate the environment so helpful bacteria can thrive, influence the memory and learning process, balance the sympathetic nervous system, and support neurotransmitter release while promoting serotonin secretions. In this sense, the end products of bacterial balance have a final say on mental health.

  When the body is under stress, we produce less saliva, which means our bodies provide less bacteria battling and digestive enzyme support. Stress can also hinder your digestive processes by slowing down food breakdown. This drives a stagnant fermentation state in the gut where bad bacteria, when overgrown, can have a heyday eating the foods you just consumed. Dysbiosis paired with stress or unregulated anxiety can be a big driver of the “food baby,” where some individuals experience dynamic bloating of greater than 2 inches post meal consumption. Essentially, the bad bacteria or yeast strains are attempting to brew beer or bake bread in your digestive system!

  In addition, when your body is under high stress or a state of anxiety, the sympathetic nervous system (which controls fight-or-flight responses) will likely reduce the amount of good bacteria and increase susceptibility to pathogens, further perpetuating a dysbiotic environment. Hence stress management and anxiety go hand in hand with optimizing your microbiome. Research also demonstrates that adding probiotics to the gut can alleviate schizophrenia, mania, and anxiety.

  Managing stress in the time of anxiety may seem like an uphill battle. The areas where you potentially have the most control over your microbiome are your medications and diet, both of which have a significant influence on driving dysbiosis. Antibiotics kill most bacteria in the gut, yet the undesirable bacteria tend to be resistant or resilient, quickly reappearing and leading to dysbiosis. These unfriendly microorganisms, such as pathogens, yeasts, fungi, and parasites, can upset the balance by taking over the tract if probiotics are not there to defend it. Antacids, including both PPIs (proton pump inhibitors) such as Protonix and Nexium, and over-the-counter chews or drinks such as Tums or Pepto-Bismol, may soothe the burn of acid reflux temporarily; however, over time, this basic elevated pH of the stomach sets up an environment that supports bacterial and yeast overgrowth, only fueling the fire! Beyond drugs, medical intervention such as radiation and surgery can be sterilizing to the gut bacteria, reducing probiotic function and allowing bad bacteria overgrowth.

  Two of the most damaging substances to intestinal flora balance are chlorine and sodium fluoride, both present in most city water. Drinking filtered water is important in avoiding these sterilizing compounds. Drinking alcoholic beverages, taking birth control pills, and many other NSAID pain-relieving medications can also cause damage to intestinal lining and flora. In addition, poor eating habits, including a diet high in refined sugar and excessive carbohydrates, drive and fuel continued dysbiosis and bacterial imbalance. On the contrary, diets that are low-glycemic and balanced with ample fiber can support a healthy gut ecology, driving symbiosis.

  Drivers of Dysbiosis

  Birth and early infant nourishment: A sterile C-section and formula-fed babies will have less favorable bacterial state.

  Stress: Suppresses the production of probiotics and reduces stomach acidity.

  Antibiotic use: Acts as a “bomb” to good bacteria; bad bacteria or opportunistic yeast typically rebound more quickly and aggressively than good bacteria.

  Steroid use: Inhibits the immune system’s ability to respond with inflammation so the yeast or bacteria can spread; often, thrush is seen with oral inhalers.

  Use of PPIs or antacids: Reduces stomach acidity, which increases environment for pathogenic bacteria and yeast.

  Excessive alcohol use: Weakens the immune system, alters the stomach pH, and can kill off probiotics.

  Oral contraceptives: Alters gut bacteria; estrogen in excess (often seen with synthetic form in birth control) can promote yeast growth.

  A diet high in sugar and refined carbohydrates: Fuels yeast growth and activity.

  Bacteria and Mood Connection

  Now that you understand the impact of stress, medications, and diet on your microbiome, it is important to emphasize the role of the microbiome on your mental health. The gut is also known as the enteric nervous system (ENS), which controls heart rate, digestion, respiratory rate, and sexual arousal, and serves as the primary driver of fight-or-flight response. The ENS has over 500 neurons, only secondary to the brain; this is why the gut is often deemed the second brain of the body. It can work in connection with or independent of the central nervous system in response to rest-and-digest mode or fight-or-flight mode. The gut serves as the manufacturing plant for over 30 neurotransmitters, most of which act in the same way as those neurotransmitters in the brain. In fact, over 90 percent of the body’s serotonin is manufactured and stored within the gut as well as about 50 percent of the body’s dopamine.

  The vagus nerve is the largest nerve of the autonomic nervous system. It goes from the brain stem to colon and works in both parasympathetic (relaxed) and sympathetic (stressed) response. This highway of information carries signals from the microbiome, which can either instigate an anti-inflammatory and anti-anxiety response or drive dysfunction in the HPA-axis.

  Neurotransmitters and Probiotics

  GABA

  Function of neurotransmitter: Feel-good inhibitory compound, natural anti-anxiety effects

  Probiotic producers: Lactobacillus and Bifidobacterium

  Serotonin

  Function of neurotransmitter: Most popular known contributor to a feeling of well-being and happiness, plays a role in blood pressure regulation and digestion while reducing anxiety and stress response

  Probiotic producers: Lactobacillus and Bifidobacterium

  Norepinephrine

  Function of neurotransmitter: Increases arousal and alertness, promotes vigilance; in excess, can drive racing thoughts and difficulty concentrating; increases restlessness and anxiety

  Probiotic producers: Escherichia, Bacillus, and Saccharomyces

  Dopamine

  Function of neurotransmitter: Excitatory compound playing a significant role in reward mechanisms; in deficiency, can drive restless leg and even neurological conditions such as Parkinson’s; in excess, can drive mania and schizophrenia

  Probiotic producers: Bacillus and Serratia

  Acetylcholine

  Function of neurotransmitter: Aids in REM cycle and memory; in stress response, stimulates norepinephrine; plays a role with calcium channels in activating muscle response as well as vasodilation, or widening, of blood vessels, increasing blood flow

  Probiotic producers: Lactobacillus

  In this sense, optimizing your microbiome supports not only digestive and immune health, but also promotes optimal neurotransmitter production and mood stability. Social stress and anxiety drives excessive output of stress-responding neurotransmitters, including dopamine, norepinephrine, and epinephrine, to be released, which influences the growth of imbalanced gut bacteria, further emphasizing the two-way street of brain-gut connection.

  As you work to reset your microbiome to a more favorable symbiotic state, the probiotics in your gut will enhance neurotransmitter prod
uction to aid as inhibitory compounds that promote relaxation and reduced anxiety. Increased production of serotonin and GABA will aid neurochemically, resulting in less anxiety or stress response, and thus, less output of stress-responding neurotransmitters. You will also have fewer stress chemical compounds as a result of lower levels of dysbiotic bacteria.

  View the table on page 26 to learn about specific neurotransmitters, their functions, and which probiotic strains support their production. As you will see, Lactobacillus and Bifidobacterium are the primary strains of focus for the two major anti-anxiety neurotransmitters, GABA and serotonin.

  Beyond neurotransmitters, the microbiome influences the brain-derived neurotrophic factor (BDNF), a specific protein that works on growth, maintenance, and stability of neurons. A study published by the Journal of Gastroenterology demonstrates the influence of good bacteria on the brain. Researchers examined the influence of antibiotics and gut sterility on BDNF, specifically focusing on the hippocampus and amygdala. When levels of BDNF drop in the hippocampus, depression and anxiety are seen at higher rates. Thus, some anti-anxiety medications are targeted at increasing BDNF in this brain region. However, in the fear center of the brain, the amygdala, low levels are associated with less anxiety as to not upregulate fear response. An increase of BDNF in the hippocampus and a reduction of it in the amygdala aids in more exploratory behavior and reduced anxiety expression.

  BEYOND BLOATING…FINDING MYSELF!

  Laurie was seeking a solution for her chronic bloating and constipation and came to the Naturally Nourished clinic with a desire to get off her daily Miralax and flatten her abdomen. In our initial consultation, we determined she was a likely candidate for dysbiosis and set up to do a 3-day stool test. Upon review of panel we identified a pathogenic bacteria, Proteus mirabilis, often associated with UTIs and trended in research studies with anxiety and panic. Laurie was working as a busy attorney, so she often wrote off her panic attacks as just a part of the job. I worked with Laurie using my a 6-week cleanse to address dysbiosis and candida. At our 4-week check-in, Laurie shared something phenomenal: not only was she experiencing bowel regularity and less bloating, but she was thinking clearer, sleeping better, and experiencing fewer palpitations. Following our 6-week cleanse, we worked on rebuilding her gut microbiome with the Targeted Strength probiotic, providing 60 billion CFU in a 50:50 blend of lacto and bifido strains. She didn’t just tolerate the probiotic; she found herself more social, laughing more, and ultimately feeling like herself again. Not only is she experiencing less bloating with improved bowel regularity, she is panic-free, even-keeled, and living in a balanced, joyful state of mind.

  Getting Your Microbiome to Work For You

  You know the significant role that gut bacteria have on brain chemistry and understand that the gut is like a second brain due to the amount of nerves and neurological production in the GI tract. Now, you can empower yourself by managing mood with regulation of your microbiome. In this sense, probiotics can be seen as “nature’s Prozac.” A symbiotic gut drives a happy, mellow mind.

  Probiotics exhibit direct effects in the GI tract and indirect effects in other parts of the body and brain. Effects on joints, skin, and the brain are due to the impact that probiotics have on immunity via changes in inflammatory mediators making the overall body less reactive. As probiotics in the digestive tract aid in breaking down foods, absorption and digestibility of nutrients increases, leading to increased production of proteins, vitamins, and other functional compounds in the body. Symptoms and conditions that can be treated with probiotics include diarrhea, gastroenteritis, irritable bowel syndrome, inflammatory bowel disease (IBD), Crohn’s disease and ulcerative colitis, cancer, depressed immune function, food allergies, low weight or malnourishment, depression and anxiety, obesity, and liver disease.

  All probiotics can be well-received and proliferate if welcomed by prebiotics, non-digestible fibers that selectively stimulate the growth and activity of beneficial bugs. When probiotics and prebiotics are mixed together, they encourage a symbiotic, synergistic relationship that is beneficial to the host. However, if the gut is in a state of dysbiosis, prebiotics can fuel growth of bad bacteria, instead. Also, in dysbiosis there often isn’t room for the probiotic to grow, and there can be intolerance or a battle-like environment.

  Using the anti-anxiety diet, you will starve off potential bad bacteria during your ketogenic state. You will have the opportunity to reset your bacterial balance in the low-glycemic phase by bringing prebiotic fibers into synergy with an abundance of probiotic cultures. Beyond mellowing out your mood and supporting a healthy production of feel-good brain chemicals, this phase of microbiome reset may aid in brain fog, difficulty concentrating, bloating and distension, and stubborn metabolism.

  Plowing the GI Tract with a Bacterial and Yeast Cleanse

  The best way to understand the microbiome is to envision a garden bed. There is only so much room for things to grow. You will see the beneficial vegetation you intended to grow, wild flowers, and weeds. In some cases of dysbiosis, the garden bed is filled with so many weeds or even overgrown with wildflowers that there is no room for intended vegetation (probiotics) to thrive. As there is an upper capacity in your microbiome, when in a state of dysbiosis, you may not be able to resolve the situation with a probiotic food or supplement. Probiotics may help on some level but in order to reset the microbiome, one must plow the fields of the garden bed to allow space for good bacteria to thrive and then fertilize and support healthy growth for symbiotic effects.

  Low in carbohydrates and refined sugars, the anti-anxiety diet is supportive of a bacterial and yeast cleanse to starve off bacteria. During this time it is recommended to consider a cleanse with antimicrobial and antifungal supplemental support to remove potential overgrowth of bad dysbiotic strains and make room for beneficial probiotics to set up camp and proliferate. Taking supplements to support a bacterial and yeast cleanse would be especially recommended if you have experienced intolerance to a probiotic supplement or food or experience significant bloating, bowel irregularity, dermatological flares, or have taken multiple rounds of antibiotics. Take the Gut Bacteria Balance Quiz below to determine if your gut is in a state of dysbiosis. Learn more about advanced approaches in the Appendix supplements and labs sections.

  Gut Bacteria Balance Quiz

  Respond to the following questions with Never, Sometimes, or Often. Give yourself a score of 2 for each Often response, 1 for Sometimes, and 0 for Never. This quiz will be used as a tool to determine if yeast, small intestinal bacterial overgrowth (SIBO), and gut bacteria imbalance or dysbiosis is a root cause of your anxiety, requiring additional support such as advanced testing or nutritional supplementation.

  The recommendations on the following pages correspond to formulas carried in my clinic. In Supplement Support for the Foundational 6 Rs (page 159), you will find information on dosage, active ingredients, and mechanism of action so you can determine if these formulas are a good fit, or find comparable ones that have similar composition.

  1. Have you taken antibiotics in the past three years? Give yourself a score of 4 for frequent use of more than twice per year and/or long-term use of tetracycline, Bactrim, or another antibiotic for over a month.

  Never

  Sometimes

  Often

  2. Have you taken prednisone, corticosteroids, or steroid inhalers over the past three years?

  Never

  Sometimes

  Often

  3 a. Women: Do you get yeast infections, UTIs, and/or vaginosis, or have you been with a partner that has these conditions or a man that has had penile thrush?

  Never

  Sometimes

  Often

  3 b. Men: Have you been with a partner that suffers from yeast infections, UTIs, and/or vaginosis, or have you had penile thrush?

  Never

  Sometimes

  Often

  4. Do you experience athlete’s foot, ear wax, or other chroni
c fungal infections of the skin or nails?

  Never

  Sometimes

  Often

  5. Do you regularly consume alcoholic beverages or experience alcohol intolerance?

  Never

  Sometimes

  Often

  6. Do you experience significant bread and sugar cravings?

  Never

  Sometimes

  Often

  7. Have you struggled with blood sugar irregularities such as shaking, irritability, crashing in energy, or headaches?

  Never

  Sometimes

  Often

  8. Do you experience bloating and distension in the abdomen?

  Never

  Sometimes

  Often

  9. Do you wake with a flat abdomen but as the day goes on, get more bloated and notice brain fog following meals?

  Never

  Sometimes

  Often

  10. Do you have irregular bowel movements, such as constipation or diarrhea?

  Never

  Sometimes

  Often

  11. Does your stool have a fruity odor, flaky or sticky texture, or mucus?

  Never

  Sometimes

  Often

  12. Do you have bad breath, a white-coated tongue, or dry mouth?

  Never

  Sometimes

  Often

  13. Do you experience aches in the soft tissue of your fascia or muscles?

  Never

  Sometimes

  Often

  14. Do you experience brain fog or difficulty concentrating in general?

  Never

  Sometimes

  Often

  Total Scoring:

  Less than 10

  It looks like your gut is not imbalanced and the addition of probiotic-rich foods with prebiotic fibers will be enough to set up your gut to produce serotonin, GABA, and other feel-good mood stabilizers! Consider a 50:50 blend of bifido and lacto bacteria strains, such as Restore Baseline Probiotic, to optimize probiotic function for digestive health and beyond.