fter the death of Caroline Rustigian’s mother earlier this year, her physical health took a tumble. “I stopped eating and couldn’t keep food down,” says Rustigian, a public relations consultant and podcaster in Laguna Beach, Calif.
Rustigian was desperate to feel better and went to urgent care. She was informed that acid reflux could be the cause. Her discomfort was eased by medication. However, the mother of two still didn’t feel like her old energetic self. “I was fatigued and just trying to get through each day,” she recalls.
Rustigian finally met her Naturopathic Doctor, who confirmed that grief was to blame. “My doctor said emotional stress and not eating threw off the healthy bacteria in my stomach, which compromised my microbiome.” A veritable universe living within us, the microbiome has been garnering attention from scientists and the medical community for its impacts on human health.
“The microbiome is made up of trillions of microbes, including bacteria, yeast, and viruses,” says Thalia Hale, a naturopathic practitioner in Palo Alto, Calif. These microbes live in the gut and skin. This network functions in the same way as a hard disk that runs a computer. It helps to synthesize key nutrients such as thiamine. Thiamine is a B Vitamin made from intestinal bacteria.
Hale states that grieving can lead to a body going off-track, which could cause digestive problems. First, stress may activate the sympathetic nervous, also known as the “fight-or-flight” response. In this survival state, “heart rate and blood pressure rise, as do levels of the hormone cortisol,” Hale adds. And when the body is warding off danger, it’s not focused on digestion or eating. Rustigian says that after her mother died, she didn’t eat for days. Research has shown that diet changes can change the microbiome within days.
While it’s well known that heartache can make the belly ache, research examining the connection between bereavement stress and gut health is limited. One 2020 paper was published in this journal. Frontiers in Psychiatry suggests that “gut microbiota may play a role in influencing health outcomes following bereavement” because chronic and ongoing stress can disrupt the microbiome.
It’s challenging to solely examine bereavement, because grief includes other emotions such as anger, sadness, and denial. These feelings can lead to anxiety and depression if they linger. These conditions’ ebbs and flows have been linked to the bacteria residing in the gut.
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The science behind it
It was more surprising than 10 years ago that the brain-gut connection was discovered. Thus far, most of the relevant research has focused on animals, according to Karina Alviña, a neuroscientist at the University of Florida whose lab uses mice to investigate how gut flora influence brain function. “In an animal model, you can [use antibiotics to]Allow the mouse to eat almost all the intestinal microbiome. [of bacteria],” she says, which allows scientists to directly test the effects of a single bacterial species or a combination.
This picture looks murkier in humans. But a team of scientists in Belgium was among the first to tie the characteristics of an individual’s gut microbiome to measures such as overall happiness and depression in a large-scale population study published in 2019. “People who report low quality of life tend to have disturbed gut microbiomes—and there was a notable loss of certain bacteria that was very specifically associated to this loss of well-being,” says Jeroen Raes, a bioinformatician and senior author of the study.
Mental Health and the Gut-Brain Axis
The most difficult life event is the loss of a close friend or family member. “My mom was my best friend,” Rustigian says. “When she died, I lost my true advocate, and I felt numb.” This emotionally low period can result in the loss of sleep and appetite, as well as loneliness. The gut-brain system, which scientists refer to as the “gut-brain” axis, may be affected by the continual stress.
The brain used to be thought of as an isolated entity from the rest. So for Alviña, “the biggest mindset change” was the realization that the brain not only instructs the body to move and breathe, but that signals from the gut as well as other organs and tissues can also alter how the brain functions.
It is not clear how bidirectional communication operates, although there have been several possibilities. People with depression were found to have fewer bacteria in their guts that produce butyrate. This is a vital fatty acid with anti-inflammatory properties. The resulting inflammation in the gut due to the lack of these butyrate producers is “linked to the neuro-inflammation we often see in the context of depression,” Raes says.
Simply put, bacteria in the gut produces neurotransmitters such as serotonin or dopamine. These molecules play a vital role in neurosignaling. Low levels of these neurotransmitters can cause depression and neurological diseases like Parkinson’s.
These neurotransmitters might interact with the nerve endings of the vagus nerve—which is responsible for involuntary movements such as breathing and digestion, and connects the brain to most of the body’s organs, including the gut. These observations are supported by research on mice. The microbiome-mediated effects of the microbiome on animals whose vagus nerve was severed disappeared in those cases.
What is the hype about probiotics?
With all the promising evidence available, it would seem that the next step is to supplement the gut with probiotics. Raes stresses, however that the research into gut microbiome, and how it affects grief and mental well-being, is in its early stages. And while “the potential for probiotic intervention is exciting, there’s not [currently] enough evidence to advise people with depression to take them,” Raes says.
Dr. Ripal Shah, an integrative medicine specialist and psychiatrist at the Stanford University School of Medicine, agrees that the jury’s out on which bacterial species will prove most helpful to people. She also discusses gut health with her colleague in the weekly integrative psychological health group.
Grief is an emotional experience that affects the whole body. Hale suggests stress management and healthy eating habits to help you get through it.
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Changes in diet
Researchers have found that diet is an important factor in the survival of gut bacteria. Shah says that eating probiotic-rich foods like yogurt and fermented dairy products is an easy way to restore your gut health. “But because we don’t know exactly which species are helpful—and how much—it’s actually useful to think [of the goal] as increasing the diversity of your gut flora.”
Shah recommends that people change up their cuisine. If you’re having kimchi one week, kombucha the next week, and kefir the following week, you’re exposed to a wider range of active cultures than if you’re just grabbing the same brand of kimchi every time.
A single episode of depressive or anxious episodes can set off a feedback loop and make us more likely to experience them again. “One of the pathologies of depression and anxiety might be that they contribute to the ratio [of gut flora] going out of whack,” Shah says. “And then ongoing stress continues to skew or worsen that ratio.” Because of this, Shah says it’s crucial to find ways to de-stress.
On the flip side, Shah says, “the potential of positive mood to influence the microbiome is actually reassuring” because it means gut health may be able to be manipulated with mental-health interventions.
In times of extreme mourning, managing stress might feel like bandaging a bleeding wound. However, Hale says these tools can help the nervous system switch gears, putting the parasympathetic nervous system (which helps calm us down) back in the driver’s seat.
One easy exercise is called “square breathing” or “box breathing.” Simply take a breath in and hold for four counts, exhale for four counts, and repeat four times. Navy Seals use this technique to relax in situations of high stress.
An article in the journal. Immunology Frontiers Yoga and Tai Chi may be able to reverse stress-induced inflammatory reactions in the body, according to research. The researchers state that these mind-body interventions “reversed genes involved in stress-induced inflammatory reactions.”
Shah recommends acupuncture to her patients. It has been shown to reduce stress and improve mood.
Lastly, “any sort of vitamin and mineral deficiency can be worsened or caused by stress,” Shah notes. So addressing these deficiencies—primarily through diet rather than supplements—is of tantamount importance. Similarly, avoid consuming foods that promote inflammation, such as refined sugar, fried foods, or foods that you’re allergic to.
Learn More Common Digestive Health Fears
Additional support can help you cope with the loss. “We’re not meant to grieve alone,” says Abigail Levinson Marks, a clinical psychologist in San Francisco who specializes in grief. “In nearly all cultures, the way we deal with loss is collective, because community helps us heal,” she adds.
Online forums and grief support groups can help you to be more comforting. Marks adds that seeing your experience reflected in someone else’s story can help you feel less alone.
Since each person’s path differs, group support might not be right for everyone. If that’s the case, speaking with a counselor can also help. Your therapist will listen to you and help you feel better. You can find one paper from the journal in 2022, as an example. Clinical Neuroscience Dialogues reiterates that holding in our emotions may lead to low-level stress, hindering the body’s immune response.
Therapy and group support are not enough. You should also be able to give permission for loved ones to help you. Friends might help with household chores and run errands. Your employer may offer bereavement time. “Anything that lightens your load can give you more time for self-care,” Hale says.
We can be quick to judge others when we are in a rush for recovery. Keep in mind, healing is a process and not a sprint. Even if you lost your child months before or during the pandemic, self-care and support can be very helpful. Hale also stresses the importance self-compassion.
In the end, Caroline Rustigian found that an antidepressant, probiotics, exercise, and therapy helped to ease her grief—and her gut issues. “It took a while to figure out what was going on,” she says. “But once I started a combination of therapies, my stomach troubles disappeared, and I got better.”
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