How Your Gut Health Effects Your Emotional Wellbeing

The synergy of mood, food and gut - and how Post Natal Depression might just be avoided.

Six months after the birth of my second child, the world was out of joint. I was physically healthy with a supportive husband and family.

 I was aware of how lucky I was and yet the joy that had poured out of me as I cradled our first baby was missing.After breaking down in front of my GP, I was prescribed antidepressants. This was my  first brush with depression and I didn't know any better. 

They had the side effect of making me lose my appetite – hurrah, I was too exhausted to make meals anyway – but they dulled the desire I had to curl up behind the sofa and weep. 

They also prised the lid open just far enough that I could reconnect with my son Luke, nine months  old, and daughter Elsa, two.Still feeling low but functioning, I went back to work three months later. 

While researching an article about Omniya, a London clinic working in preventative health (stopping illness before it happens rather than treating it after you get sick) I met Peter Cox, a doctor who had moved from traditional medicine into clinical nutrition. Cox described the link between various nutritional deficiencies and depression. 

Then, looking at my gaunt frame and hearing a description of how tired and fragile I felt, he suggested some blood and saliva tests.'What we eat contributes markedly to our mental health, and it amazes me that this area of treatment is not taken more seriously,' he explained. 

'There is overwhelming evidence that a lack of certain nutrients, for example B vitamins, vitamin D and omega 3, are common contributors towards mental health disorders.

 The amino acid tryptophan is required for the synthesis of serotonin (the calming and joy-giving hormone).' Tryptophan, which is found in spirulina and egg white, among other foods, is the building block from which serotonin is made.

 'Without it, you cannot manufacture serotonin and will be more prone to depression. It amazes me that doctors do not test for these deficiencies.' It's terribly sad that we're preoccupied with being thinner and fitter but we're ignorant to the fact that our diet has the power to make us happier, too. 

Unfortunately, as Cox tells me, 'doctors are only trained for a week in nutrition', and even then the time they have with each patient is sparse. Knowledge about the gut is progressing rapidly but the NHS is slow to adopt new and expensive routes.

Cox's research was a revelation to me. Digging deeper, I found that eating badly was only one in a series of ways that gut health and happiness are  related. 'In a healthy gut, you absorb the nutrients from food through your gut wall,' nutritional therapist Eve Kalinik told me. 'If your intestines are inflamed, they cannot process the nutrients. 

Instead of the saying, "You are what you eat," you are what you can absorb.' Kalinik argues that poor diet, illness or the modern triumvirate of alcohol, caffeine and stress can damage the lining of the gut and your subsequent ability to access essential nutrition. 

The other key player in gut health, which is increasingly being proven central to overall wellbeing, is the microbiome: the collection of bacteria in our gut.In 2015, scientists at Üsküdar University in Turkey published a paper titled The Gut-Brain Axis: The Missing Link in Depression, pointing out the relevance of the microbiome-gut-brain connection. 

In short, the gut is being viewed as the second brain; there are more serotonin receptors and if you're not feeding yourself the right food to make your gut happy, it may be preventing you from feeling happy.The bacteria in the gut's microbiome is so important, let us pause for a few facts. There are at least 1,000 species of bacteria in the gut, known collectively as the microbiome*. 

There are more bacteria in your gut than cells in the body, and (fun fact) they can weigh up to 2kg, roughly the weight of a rabbit.Each of us has our own unique microbiome. We live in symbiosis with it – we host the bacteria and in return, it does a range of jobs for us, including synthesising certain vitamins (B12 and K), breaking down foodstuffs that we cannot and modulating our immune system**.

 It also makes all kinds of mood-altering chemicals. Yes, like your body, the microbiome is able to create happy-making serotonin. So far, so rosy. But, if your gut and its flora are upset, you're in trouble.Even in a healthy gut there will be some 'bad' bacteria. 

However, too many of these nasty organisms cause far-reaching damage. 'In terms of depression, an overgrowth of unfriendly bacteria (such as klebsiella) may not only affect our ability to produce neurotransmitters such as serotonin and dopamine,' says nutritionist Henrietta Norton. 'They may also release chemicals that prevent our brain from being able to use the neurotransmitters we have already produced.'

So, what to do? Good bacteria can be boosted either by eating bacteria-rich food like yoghurt, sauerkraut and kimchee, or probiotic supplements. These are ever more sophisticated, and both Cox and Kalinik recommend Symprove, a liquid-based formula. Its live bacteria are delivered in extract of germinated barley that is dissolved in a water base so the stomach thinks it's a water-like drink and there's little challenge from the digestive juices. 

This means its live strains of bacteria drop straight through the stomach into the small intestine and colonise rapidly. Happily in this case, healthy equals tasty too. Symprove is delicious, and the trend for Korean food has made kimchee easy to find. Win.As for the bad guys, they're fed by any kind of sugar, and discouraged by a diet which is rich in natural fibre, so ditch the juicer and eat your food whole. 

'It is so annoying and disheartening when I see people come into the clinic not eating dairy, meat or gluten. Cutting out major food groups is misinformed – people indiscriminately alter their diet because of something they've seen on Instagram,' adds Kalinik. 'We should stop vilifying whole food groups. Rather than eating a delicious slice of sourdough – which has friendly bacteria in it – we pay extra for some awful, fake, gluten-free product.'If you have extreme symptoms such as painful digestion, zero energy or a real change in mood, the ideal step would be to discover exactly what is happening in your gut. 

The cost of a complete stool analysis done through Kalinik costs £277 and provides an astonishingly detailed picture of what is going on in your gut and microbiome. 'It isn't a small amount of money. But you would be amazed how much people spend on Amazonian berries and powders that may be irrelevant to their condition.'

A stool analysis was transformative for a friend of mine, Katherine, 34, who works in publishing. She found that the combination of a childhood spent on antibiotics and a year living in Nigeria had left her bacteria hideously out of kilter. What she thought was a dairy intolerance was an overgrowth of intestinal candida (fungus).

 'I was chewing my arm off for sugar, and feeling constantly wretched,' she says. 'It hadn't occurred to me that the pain in my stomach could relate to how depressed and anxious I felt. When I treated the candida, my symptoms vanished and my normal mood came back.'While researching this article, the details Norton told me about magnesium and zinc had particular resonance: these minerals have a key role in the production of serotonin.

 Deficiencies in them have been related to premenstrual anxiety, and 70% of Western women are deficient in magnesium***. Surely this detail is relevant to the fact that one in three women experience anxiety or depression at some stage in their life†. 

When my tests came back, I found that I had such low levels of both magnesium and zinc that Cox said the results would be 'commensurate with anorexia – though in my case, may relate to two pregnancies in a short space of time, with breastfeeding and a limited diet.' 

Two months on, with a new eating plan designed by Cox with plenty of omega and zinc-rich shellfish, seeds, leafy greens and various supplements, my energy and zeal for life is transformed. I  haven't stopped taking my antidepressants yet, but I'm doing tests to see how I might optimise my good bacteria, have lined up the probiotics and am doing my best to eat the widest possible range of vegetables (dear kale, we can no longer be monogamous).

 For Katherine and me – and for who knows how many other women – it may be that gut health is the key to wellbeing and happiness (and I'll have a side of kimchee and sauerkraut with that). 

Original article published in Elle, in December, 2016