Self-Care

Serotonin, Your Gut, and Mental Health

Jim Sugel on June 15, 2024

Most people know of serotonin as the “happiness” chemical. That’s so much true that you can buy jewelry with the chemical formula for serotonin alongside words like “Happy”. The truth is, serotonin is much more complicated than simply prompting an emotion or a reaction in the brain. Instead, it’s a chemical known as a neurotransmitter, which works to move messages between the nerve cells in the brain and body. Its role is in mood, cognition, reward, learning, memory, and physical processes like the digestive tract, organ development, and bone metabolism. As a result, serotonin has wide-reaching impacts on a significant portion of your body’s daily functions.

In fact, if your body isn’t producing or processing serotonin like it should be, you’ll see major issues across your body. That can mean depression, fatigue, gut health problems, and much more. Worse, because mental health disorders often result in reduced serotonin production or absorption, side-effects of mental health disorders like substance abuse also reduce serotonin production, and stress reduces your ability to produce serotonin, these issues are likely to be self-aggravating, meaning that depression results in reduced serotonin, resulting in a downward spiral where you feel worse and worse.

Understanding serotonin, how it impacts the gut, and your mental health can give you better insight into that process so you can get the help you need.

What is the “Gut-Brain Axis”?

The “Gut-brain Axis” is a term used to refer to how changes in the gastrointestinal tract impact mental health and vice versa. Persons who have mental health problems such as depression and anxiety are significantly more likely to experience major problems with digestion and gastrointestinal health. Vice-versa, individuals with gastrointestinal health problems such as chronic diarrhea, Cronn’s disease, etc., are more likely to experience mental health problems such as fatigue, depression, and anxiety.

This axis happens because serotonin impacts the nervous system. This includes the central nervous system, which runs from your brain down your spinal column, and into the body. It also impacts the Enteric nervous system, or the network of neurons that line the gut. That also includes the Vagus nerve, which is well-known as the nerve that runs from the brain to the colon – and which plays a major role in nausea and vomiting. As a result, individuals experiencing a significant amount of stress are more likely to experience nausea and vomiting.

Finally, the gut-brain axis refers to how serotonin actively influences the ecosystem of bacteria and other microorganisms that live in the gut and vice-versa. When things go wrong with gut bacteria, you experience negative effects that impact the rest of the body. That in turn influences mental state, emotional regulation, and regulation of the adrenal and pituitary axis – meaning you have more trouble with managing your emotional state and your mental health.

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Serotonin’s Role in the Body

Serotonin plays a far-reaching role in the body. In most cases, it can be considered a communicator. It transmits messages across the central nervous system and across the enteric nervous system – which goes on to impact the adrenal system, pituitary system, metabolism, and multiple other functions. This allows the reward circuit in the brain to function by transmitting signals to and from the brain and body as necessary. It allows the brain to properly process information. It regulates emotions and mood. It also helps to regulate feelings of anxiety and worry – both through the central nervous system and through the HPA (hypothalamic-pituitary-adrenal axis) which is behind the human stress response and cortisol production.

Eventually that breaks down into:

Emotional Regulation – Healthy serotonin production means you can regulate emotions more easily and manage stress, negative emotions, etc., as they come up.
Stress Regulation – Serotonin impacts cortisol production and adrenal production, both of which cause stress and feelings of stress in the body. Healthy serotonin levels mean you’re better able to regulate that in the body, which means stress levels better match what’s happening, you process cortisol more quickly, and go back to feeling better more quickly.
Digestion – Serotonin impacts microbial gut health as well as nerve regulation. Nerves impact muscles moving food through the digestive tract. Low levels of serotonin can lead to indigestion in the form of constipation and poor nutritional absorption. However, serotonin also impacts the vagus nerve, which impacts the colon as well as your vomit and nausea reaction. This can result in chronic diarrhea and nausea.
Sleep – Serotonin plays a significant role in healthy sleep-wake cycles as well as in having energy throughout the day.

As a result, people with low serotonin or unregulated serotonin reuptake typically experience symptoms like:

Depression
Anxiety
Fatigue
Insomnia
Chronic pain
Brain fog
Memory issues

All of that can be self-reinforcing, which means you feel worse because of low serotonin, and then produce less serotonin because of the side-effects. As a result, depression, anxiety, and even gut health problems often spiral and become worse over time if you don’t get treatment, even if the original issue is a physical one rather than a mental one.

Of course, Serotonin also plays many other roles in the body. Therefore, it can impact your body in other ways. Often, that means you’ll see side-effects from mental health and from gut health problems that can look like a range of mental and physical health problems. However, mood regulation, gut health, and fatigue issues are generally the most common problems and very often tie in together – so that if you start with one, you eventually end up with all three.

Getting Help

Getting help for mental health problems, especially when they are tied into physical health problems, can be complicated. For example, it’s often difficult or impossible to tell which came first, gut health problems or mental health problems. For that reason, the starting point is often medication and taking steps to ensure you’re producing serotonin at a healthy level.

You might be aware that one of the most common medications for people with depression is an SSRI or a Selective Serotonin Reuptake Inhibitor. This class of drugs reduces how quickly your brain breaks down or reabsorbs serotonin, meaning you have more serotonin available in the brain and in the body, even if serotonin production is low. These drugs are safe, non-addictive, and allow you to increase serotonin levels in the body, which can be used as either a short-term measure to aid in treatment or a long-term measure if your body is not producing enough serotonin.

In each case, treatment is generally also backed up with additional treatment including nutritional therapy, behavioral therapy, and counseling. That means creating a tailored and personalized approach to treatment, adapting it as you respond or not. That can also include medication for gut health, it can include exercise and nutrition, it can include behavioral treatment to help you improve how you regulate emotions even when you feel bad. All of that comes together to give you a toolkit to better manage your mental and physical health, both of which will work to improve each other.

Otherwise, getting help for serotonin issues, even if they are mental health problems or rooted entirely in physical health problems, means getting a tailored approach that specifically targets your actual health problems and works to respond to those as you move forward in treatment.

What Are the Best Foods for Fighting Depression?

Jim Sugel on April 15, 2024

If you’re struggling with mental health, you’re probably aware that nutrition is an important part of managing your health. For many of us, who have little to no experience with nutrition, eating well can sound like picking a few foods. After all, most of us have heard of superfoods and specific fruits or vegetables or healthy fats that are good for your brain health.

Unfortunately, that’s not quite how it works and there’s no magic wand to cure depression or improve your mental health. The good news is that healthy eating for your mental health and to support recovery from depression often means eating a diverse range of foods and getting a varied diet. Of course, there’s more to it and we’ll go into that in the rest of the article.

What Foods are Good for Fighting Depression?

Often, it’s the case that some foods are extremely good for you because they are healthy, affordable, and accessible. For example, apples are one of the best fruits you can eat. However, food is better when you eat a diverse range of fruits, vegetables, and protein sources. The more you mix your diet up, the higher the chances that you’re having a healthy and well-balanced diet.

About half of every meal should be unprocessed fruits and vegetables
About half of your grain intake should be whole grain
You need about 3 servings of low-fat high calcium dairy or equivalent per day
About ¼ of every meal should be made up of protein sources
You should eat different foods as often possible to vary your nutritional intake

It’s also important to keep in mind that what you avoid can be almost as important for your mental health as what you do eat. For example:

Don’t rely on caffeine or sugary beverages that can disrupt your dopamine and serotonin systems and therefore disrupt how you feel.
Don’t have more than about 1-4 cups of coffee per day
Try to stick to no more than a can or about 12 ounces of carbonated beverages per day.
Keep sugar to less than 10% of your daily calorie intake. That normally means less than 50 grams/12 teaspoons of sugar per day
Keep fat to less than 20% of your daily calorie intake. That’s usually about 44-78 grams per day.

Following those rules, you automatically have to watch your intake of:

Fruit juice
Soda
Energy drinks
Baked goods
Prepared / frozen meals

For example, if you look at the back of a pack of frozen lasagna, it’s about 12 grams of fat per 290 calories, meaning you’d max out your recommended fat intake before meeting your daily caloric requirements for the day if you ate nothing but that.

If you want more advice, including meal advice and shopping lists, government resources like MyPlate.gov offer it for free.

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Talk to Your Doctor and a Nutritionist

Nutritional disorders and deficiencies are very commonly co-occurring with depression and other behavioral health problems. Why? They feed into each other. You feel bad so you don’t cook a healthy meal and eat something unhealthy, rely on caffeine and sugar to get through your day, and then have a comfort meal to feel better at the end of it. You feel down later so you have chips or donuts to boost your mood. That eventually catches up with you and you feel worse. Or, you’re actually low on nutrients like Vitamin A, which can actually cause your mood to drop and for you to feel bad.

As a result, many mental health support centers actually incorporate nutritional therapy and recovery into their programs. That means you get a blood panel to see if you’re deficient on anything and then a targeted meal plan to help you get and stay healthy. Those plans also often involve helping you learn skills like meal prep and cooking nutritious food as part of it.

Talking to your doctor can get you that same blood panel and a recommendation to a dietician. From there, you’ll typically get a meal plan recommendation and help with planning food. Getting into meal prep and similar programs also means you’ll be able to prepare meals for the week ahead and you’ll have less temptation to go for unhealthy convenience meals.

What Does Eating Well Do for Depression

Nutrition impacts your mood, your energy levels, and your physical health. Those, in turn, impact your long-term mental health. Eating well makes you feel good. That will ensure you have a baseline of health to manage your depression so you can move towards recovery. Nutrition also impacts your mental health in fairly basic ways. For example, if you don’t eat enough proteins, your body can’t produce the serotonin and dopamine you need to feel good. If you don’t get enough vitamin D, you might actively experience symptoms of depression and fatigue. That’s also the same with Vitamin A. Yet, many Americans don’t get enough of either. Often, ensuring you have enough dairy and eat enough vegetables can balance both of those issues out – though you may need supplements if your doctor recommends it.

However, supplements are always an inferior choice to simply eating diverse foods. In fact, you don’t digest everything from supplements, which means that often you are wasting money because supplements pass through your system before being fully digested. Therefore, fruits, vegetables, whole grains, and diverse protein sources are still a much better way to boost your mental health.

Eating well will also boost your mood. Most of us are aware of how we feel bad after a day of eating nothing but fast food. The high salt and fat content of fries is satisfying in the short-term, but over a few days, offers nothing for the body other than sugars that are quickly used for energy or stored as fat. You need healthy food, and for about 80% of meals that you eat.

Improving Nutrition for Depression

If you’re struggling with depression, improving your nutrition is one good step you can take. Many of us struggle to cook and eat well at the best of times, let alone when depressed. That normally means you’ll have to take steps to ensure you have the resources to do so. For example:

Ask for help with cooking and preparing meals
Do meal prep if you can manage
Move into a social living or support housing situation with communal meals
Go to inpatient therapy and get help with depression while building the skills and routines you need to eat in a healthy fashion
Talk to your doctor and ask for advice

Eventually, everyone is different. You might have an easy time switching to a healthy diet. You might already have a healthy diet. On the other hand, you might not know how to cook, you might be too busy to easily add food prep into your routine, and you might have no real idea of what counts as healthy. Getting help means you’ll have someone help you with building habits and routine, with food prep, and with anything else you need to make your lifestyle support recovery and feeling good. That may mean you need a nutritionist or dietician, it may need you need social support, it may mean you need therapy, and it may mean you need something small like a meal box or other solution. You’re the only person who can gauge what that is. Good luck.

How Can I Rebound After Psychosis and Jail?

Andrea Wagner on November 10, 2023

Psychosis is a largely unacknowledged but extremely prevalent factor behind people committing violent crimes and going to jail. In fact, an estimated 3.6% of male and 3.9% of female prisoners have a psychosis diagnosis in prisons worldwide. Psychotic episodes from personality disorders, schizophrenia, or other psychotic disorders can wreak havoc on your life – not just because they make it harder to maintain routines and relationships but also because they can get you into very real trouble with the law.

How do you bounce back from that after having hit rock bottom? If you’re getting out of jail or prison after a psychotic episode, you probably want to take steps to protect yourself and your future. Ensuring you have the tools to stay healthy and in control is important. Of course, your treatment will typically depend on your diagnosis and what you’re facing. However, these tips will help you rebound after psychosis.

Talk to Your Doctor

Your first step should always be to talk to your doctor. That’s true whether or not you have a diagnosis. Here, you should:

Verify your diagnosis or attempt to get one
Get a prescription for anti-psychotics
Get a referral into a mental health treatment program so that your health insurance covers it

Nearly everyone with a psychosis diagnosis will require medication either permanently or intermittently throughout their lives. Most schizophrenia patients require medication for their entire lives. Data shows that about 30% of schizophrenia patients can manage without medication – after 10 years of treatment and learning to cope with symptoms.

This means that talking to your doctor and working out your prescription, if your prescription is still right for you, and how to combine it with therapy is an important first step. You likely need antipsychotics to benefit from mental health treatment. That will mean getting a prescription if you don’t already have one, waiting for it to take effect, and then moving into treatment that can work with you based on those symptoms.

Seek Out Mental Health Treatment

Attending psychosocial rehabilitation programs is one of the most important steps you can take in ensuring your recovery and rebound. In fact, primary treatment for psychosis is a personally tailored mix of talking therapy and medication. This means that you’ll need treatment to ensure that you have the tools to manage psychosis symptoms. Mental health treatment typically includes 30-90 days programs of in-house or outpatient treatment, where you’ll attend a clinic with group therapy, individual therapy, and counseling. There, you’ll learn how to manage symptoms, how to change behaviors to reduce symptoms, and how to build skills and coping mechanisms that improve your quality of life around your symptoms.

Depending on you, that can mean learning to accept symptoms and your psychosis and working to manage it. You might also need help building stress management, routines, and self-care skills. Many people also need help building social networks, managing relationships, and learning to ask others for help. Your treatment will typically depend on where you are and what you need. However, you can expect it to involve behavioral therapy such as cognitive behavioral therapy or dialectal behavioral therapy. You’ll also get counseling and group therapy to help you deal with the problems that psychosis cause in your life, to deal with psychosis itself, and to recognize the symptoms of psychosis and react to them with enough time to get help.

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Look for Assisted Living

Assisted living and supported living solutions are an ideal way to rebound from psychosis and jail. Here, you’ll stay in a shared home for several months, sometimes longer. There, you’ll have a routine, set meal times, people to check up on you, and accountability. If you stop going to treatment or stop taking care of yourself, people notice. If you stop spending time with the group or sharing meals, people notice. That forced accountability can be an important part of recovery because it forces you to adopt the routines and schedule of self-care that can help you to stay in recovery.

Of course, assisted living centers aren’t right for everyone and some people get the same out of an inpatient treatment program. However, it can be a valuable way to bridge the gap between no autonomy in prison and total autonomy out of prison by giving yourself accountability and someone to help you with schedules and routines.

Long-term Support and Aftercare

If you’re living with psychosis, it’s a permanent part of your life (although you may have drug-induced psychosis like marijuana psychosis, in which case it may be temporary). However, that normally means you’ll have to look for long-term aftercare and support. That means having people who will notice if you start to slip, having people to check up on you, and ensuring that you maintain your routines. For many, a simple self-help group with weekly meetings will be more than enough for therapy maintenance. However, you’ll want to discuss your options with your therapist based on your progress.

In addition, it’s generally a good idea to have more rather than less support. If you have a probation officer checking up on you, that’s good. If you have a social worker doing so, even better. If you have recurring visits with your therapist to check in on your mental health, even after your treatment is over, even better. Ensuring you have long-term support, options to go back into treatment, and people to help you stay on top of your mental health is important for your long-term recovery.

Tracking Signs of Relapse

For many people, preventing relapse and recidivism is about tracking early warning signs of relapse. For most people with psychosis those symptoms include:

Irritability or nervousness
Reduced concentration and focus
Requiring time alone or more than usual
Sensitivity to stimulus (noise, light, touch)
Reduced quality of sleep
Nightmares
Unusual thought experiences

Depending on your specific diagnosis, that can vary a great deal. Therefore, you should sit down with your therapist to build a list and to learn how to recognize them in yourself.

Long-Term Care

Long-term care means investing your health for the long-term that means investing in self-care and ongoing support. This means:

Taking care of yourself with good sleep, eating, and exercise habits
Having a good routine
Learning communication and problem-solving skills
Having social support
Having meaningful things to do with your time
Getting ongoing treatment

Many people do prefer to get help with this, especially in the first few years after diagnosis. However, that should often be in the form of professional support and not simply relying on family to help you. This means assisted living, visiting social workers, social care, and even at-home nursing and care. What works for you will vary depending on your situation, but it is an important thing to consider.

Getting Help

If you’re moving back into your life after a psychosis breakdown and incarceration, it’s important to reach out and get help. That almost always starts with your doctor, where you can talk about what your options are, review your diagnosis and prescription, and get a referral into mental health treatment. From there, you can get mental health treatment to ensure you have the tools to manage your disorder long-term, so you can recover, and so you can learn to recognize and act when your mental health starts to go downhill. Good luck rebounding!

Redeemed Mental Health is a mental health & dual diagnosis treatment center offering PHP, IOP, and individual levels of care. Contact us today to begin your journey of recovery!