Parvati Magazine’s Wellness editor, Dr. Karen Ho, spoke with Dr. Kelly Brogan, MD, a holistic women’s health psychiatrist about depression and the brain-gut connection.
Parvati Magazine: You say that depression is “not about the brain”, and that “mental health is grounded in the whole body health”.
Dr. Kelly Brogan: My medical training taught me that depression is a legitimate entity, with certain characteristic patterns, genetic underpinnings and chemical imbalances that need to be managed chronically through medication. After my own health experience with autoimmune illness woke me up to the limitations of what I had been taught, I went back to the literature and had a lot of trouble validating these assumptions—including that depression is a neurological entity. That was very provocative for me. I began to see that depression is a descriptor, and can have many drivers. Depression could in fact be due to low thyroid function, inflammation caused by particular foods, blood sugar imbalance, medication side effect, or a micronutrient deficiency like vitamin B12. What has helped me to weave together all these drivers is a 20-year-old science called psychoneuroimmunology, which attempts to break down the false barriers between the immune, neurological and endocrine (or hormonal) systems. Through this, we see that our thoughts and beliefs alter our immune system, our gut and our hormones, which are inextricably linked. These different systems interact in ways that can result in the behavioural manifestations of depression.
PMAG: Depression through the psychoneuroimmunology framework—what does that mean practically for an individual?
KB: The idea that the gut is connected to the brain seems intuitive—we’ve all had the experience of feeling nervous and having diarrhea or losing our appetite—that is, our brain affecting our gut. What is less intuitive is that the gut impacts the brain. One of the ways that this can be applied in day-to-day life is through nutrition. From life as toddlers, we put things in our mouth to sample the environment and as a way to direct our immune system. We now understand that bacteria in the gut, making up the gut microbiome, is involved in immune regulation, nutrient synthesis, critical digestion of compounds, and other functions. You can influence your gut ecology and these important functions through nutrition. Research suggests that within 72 hours, we can change the nature of that inner ecology through food. That’s why I have emphasized nutritional intervention in my practice and I am astounded by the outcomes. There is growing literature to support that antigenic foods such as wheat, dairy, or refined sugar have the potential to derail patients in a way that appears psychiatric but is completely reversible. Psychoneuroimmunology helps us to understand how this healing can be possible.
PMAG: Do you see any role at all for antidepressants?
KB: For many years, I prescribed antidepressants to hundreds of patients. However, the available science raises significant concerns I cannot ignore—habit forming properties, increasing homicidal tendency or suicidality. I’m not here to tell anyone what to do, but I believe in informed consent and part of that includes exploration of alternatives beyond medication. I now have a pharma-free practice, completely dedicated to bringing women off medications and I have seen amazing outcomes.
There is also a cost to saying no to your experience, and opting in to a pharmaceutical model that says– whatever you are feeling or going through, it’s unacceptable to society or to the maintenance of your life. We need to look as a culture, at how we view struggle, grief, suffering as something to be avoided. Pain and suffering are part of the human experience and in engaging pharmaceutical treatment of the symptoms, we are opting out of a very important process of integrating these experiences and their meaning. I believe that symptoms of mental illness have deep meaning, which can range from an indication that you’re eating the wrong stuff, or being exposed to a toxic substance, all the way to a psychospiritual message about the incomplete expression of your soul in the life that you’ve chosen. I don’t believe we should dismiss these messages. The discomfort of these experiences is when we begin to grow, towards a place of greater authenticity.
Kelly Brogan, M.D.is a holistic women’s health psychiatrist, author of the NY Times Bestselling book, A Mind of Your Own, and co-editor of the landmark textbook, Integrative Therapies for Depression. She is board certified in psychiatry, psychosomatic medicine, and integrative holistic medicine. She serves on the board of numerous foundations, and is Medical Director for Fearless Parent and a founding member of Health Freedom Action. She is a certified KRI Kundalini Yoga teacher and a mother of two.