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The Gut-Brain Connection: More Than “We Are What We Eat”

“When we talk about health, we can’t just focus on heart health, or liver health, or brain health, and not whole health. You have to see the whole person and make use of the tools and resources that benefit minds and bodies together.” – Mental Health America

It is this connection between our minds and bodies that we here at Passage know all too well. We know how important it is for our kids and their mental health to have access to healthy foods, exercise, fresh air and beyond. But there is one area that we’re just learning about and we’re lucky to have a medical director who knows all about this topic. So, we enlisted Dr. Ammend to discuss the importance of the connection between our brain and our gut. Feel free to reach out to us if you have questions.

The Gut-Brain Connection: More Than “We Are What We Eat”
By David Ammend, MD

A few short years ago, I would cringe when I heard someone say the words “gut-brain connection.” It screamed fringe science, some off-shoot from immunizations-cause-autism or ADHD-is-only-a-food-allergy. But then I actually started to pay attention to what was being said. And it struck me that what they were saying evoked a line of thinking I had been having for years but had never been able to pull into a coherent whole: There is a connection between the increases we are seeing in brain dysfunction and the fact that our environment has been changing dramatically.

What is the “gut-brain connection?”

In its simplest form, the term refers to the many known ways in which a person’s digestive tract (the “gut” – especially the small and large intestines) and central nervous system (especially the brain) interact. The fact that they DO interact could be dramatically demonstrated by asking me to speak in front of a large crowd: My brain will immediately hate the idea, and in turn, my gut will threaten to rid itself of everything it contains. I will leave it to the reader to come up with his or her own list of colloquialisms involving fear and the clearing of one’s bowels. But suffice it to say, on some level the workings of the gut-brain connection are universally known, if not fully understood.

But who cares? The reason to care is that the attempts to understand the simple version of the gut-brain connection led to a better understanding of the links – neurological, biochemical, and hormonal – that exist between the two systems. And from there we began to see how things like neurocognitive impairment and mental illness can be affected by such things as diet, stress, trauma, and toxic exposures. And from THERE we can see how brain dysfunction can cause gut dysfunction (this is a two-way street) and consequently impact our general health. And from THERE we can…but I am getting ahead of myself.

Pulling the pieces together

The best overview that I have heard on this broad topic was in a presentation called “The Gut, the Brain, and Chemicals” by Andrew Campbell, M.D.* It was presented at an alternative and complementary medicine conference I attended in October 2015, and in part it attempts to explain the increase in some chronic conditions – including mental illnesses and neurodevelopmental disorders – that has been observed in recent years. While it is an oversimplification, I would summarize his line of thinking like this:

  • The Gut has two characteristics that make it a very powerful actor in determining our health:
    • A large surface area (the size of a tennis court) that is exposed to the outside world. Think about the digestive tract as essentially being exposed to our environment via our mouth. The things we eat (about a ton of food per year) bring “outside” substances – some of which are potentially harmful – into our bodies.
    • A large number of neurons – more than exist in the spinal cord. And like the spinal cord, the nerves of the gut have intricate connections to the central nervous system. So, unlike Vegas, what happens in the Gut doesn’t stay in the Gut.
  • The Gut also contains a massive community of microorganisms (bacteria, fungi, and viruses) that are collectively known as the human biome. It is a key mediator in the interaction between the gut and the brain. (Technically, the biome includes organisms that live on our skin and elsewhere in our body, but for this discussion, the part of the biome of most interest is that which is contained in the large intestine.) The organisms that make up our biome feed on nutrients in our gut, help break down molecules in our gut, and (write this down; it will be on the test!) produce neurotransmitters and hormones that can impact our own neurological and metabolic functioning. The fact that our gut microbiome contains approximately 4 times as many cells as we have human cells means that the potential for our microbiome to influence our health is great.
  • Both the composition and function of the microbiome are affected by changes in our environment. Dr. Campbell emphasizes that the way that human beings think, feel, and function has evolved over millennia. But the environmental conditions in which we currently live have changed rapidly and significantly from those that determined our evolution. A few examples of changes in those environmental conditions include processing of food; the radical explosion of the number of chemicals that we are exposed to (very few of which have been studied for safety); and our inundation by nanoparticles that can trigger both digestive system and central nervous system inflammation.

The uber-oversimplified recap is this: Changes in our environment (food, chemicals) and new forms of stresses can change the composition of the microbiome, leading to changes in the neurotransmitters produced in the gut. The changes in neurotransmitters can effect changes in mood, behavior and neurological functioning. All of this is further complicated by the inflammatory changes that may be going on in our intestines and/or brains as a result of exposure to toxic substances, and the end result is manifested as disruptions of our physical and mental health. (I will resist the temptation at this point of launching into a discussion on the false separation of mental and physical health.)

Hard stuff.

I once had a professor that, when approaching a particularly difficult to understand topic, would lean in and say “This is hard stuff.” Well, this is hard stuff indeed. Much is yet to be learned about the interweaving of gut and brain health. We still do not understand exactly how particular substances or stressors impact brain functioning. There are many potential mediators that might determine whether exposure to a particular substance ends up causing health problems: the strength of the exposure (“dose”); the time in one’s life one is exposed; one’s genetic susceptibility to suffering harm from the particular substance; simultaneous exposure to other substances; the presence or absence of protective factors; and the relative state of health of one’s microbiome, to name but a few. Change just one of those factors, and you may very well change whether the substance has no real impact on health or causes devastating health problems.

Until we work through all of the complexities of the system summarized above, it remains difficult to say with certainty which substances or stressors must be considered toxic from those that are safe. That is, which substances or stressors impair our gut and brain functioning vs. those that do not. But as these details become clearer, there is hope that we can develop more effective ways of treating mental illness and cognitive dysfunction – or avoiding those problems altogether.

There is a lot of work left to be done. But what we know so far suggests that our changing environment and rapidly evolving lifestyles may be causing harm to us in ways that we have only recently begun to understand.

Plenty of food for thought there. Hard stuff.

*For an interview with Dr. Campbell on this topic, see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712858/

All the Boos Without the Booze: How to Have a Haunting Halloween in Sobriety

Article Submitted by guest author Caleb Anderson of Recovery Hope
Photo Credit: hzv_westfalen_de, Pixabay

While celebrating Halloween may have previously entailed dressing up in a costume, heading to a party, and drinking alcohol or using substances, now that you’re in sobriety, that’s obviously not a party you want or need to attend. Luckily, there are plenty of more low-key and sober options that are fun or scary, and some are a little bit of both. From themed parties to scary movie marathons, you’re sure to find a way to have a haunting Halloween in sobriety.

Throw a Themed Party

Hosting your own sober Halloween party is a great way to celebrate the holiday without the presence of substances. Make the party a themed celebration to take the festivities up a few notches. The decorations, food, beverages, and costumes can be centered on the theme. For example, you can host a Harry Potter-themed party, complete with a Sorting Hat game and Golden Snitch cake pops. Ask guests to dress like their favorite houses or characters.

A Nancy Drew Mystery Party and a Clue-themed party are also great ideas. Either option sets up the opportunity to have guests solve mysteries during the get-together. For Clue, guests can wear colors of their favorite characters, and a Nancy Drew can feature magnifying glass cookies and campy detective decor. Other themes can be The Nightmare Before Christmas, a mad scientist’s lab, or a haunted house.

Host A Pumpkin Carving Party

Carving pumpkins is one of the most popular Halloween traditions, so why not host a pumpkin carving party on Halloween night? You can either provide pumpkins for everyone or ask guests to bring their own pumpkins. If you choose the latter, you should still have a few on hand in case someone forgets to bring one. The best carving pumpkins are smooth, firm, and symmetrical. You can also print out pumpkin-carving templates and patterns.

Carving outside is ideal since pumpkin carving can get messy, but if the weather doesn’t permit outdoor carving, set up a station inside. Cover the tables with newspaper, kraft paper, or a disposable tablecloth. Because pumpkin flesh and seeds can be slippery, consider covering the floors too. Serve fall-inspired food, drinks, and desserts like pumpkin-shaped cheese balls, warm apple cider, and leaf-shaped cookies.

Go to a Halloween Party

Instead of hosting your own Halloween party, you can attend a friend’s spooky bash. However, planning ahead before you go is crucial if you go this route. Bring a sober friend with you if possible, and always determine transportation arrangements beforehand. Either drive your own car or have the number of a cab company in your phone so that you can leave when you’re ready, especially if you start to feel uncomfortable.

Someone may offer you a drink without knowing you’re in sobriety, or someone may try to pressure you into using substances. Think of a script to say “no” so the person knows you’re definitive in your decision. Also, when you arrive at the party, scope out the layout so you can have a smooth exit if you need to leave.

Visit a Haunted City

This Halloween, take a trip to a city with a haunting history. Whether you live on the East Coast or the West Coast or somewhere in between, there’s bound to be a haunted city near you. Charleston, SC and Savannah, GA are two of the most popular destinations. Some hauntings in Charleston have been reported since the 1700s when pirates were hung, and Savannah is dubbed “the most frightening city and seaport in all of America” by the Travel Channel.

Boston, MA is an obvious choice because of the soldiers who perished in the Revolutionary War, but it’s also home to the first person to be persecuted as a witch. San Antonio, TX features a few haunted hotels, which have been the site of murder and disruption throughout history. You can also add St. Paul, MN; San Francisco, CA; Chicago, IL; New Orleans, LA; Gettysburg, PA; Fort Lauderdale, FL; Portland, OR; Washington, DC; and Charlotte, NC to your list.

Of course, you shouldn’t feel bad about staying home and watching scary movies or handing candy out to trick-or-treaters. You should do whatever you feel comfortable doing that doesn’t involve using substances. As long as you make a plan and prepare for the evening, you can have a fun and frightful Halloween while staying focused on your goal of sobriety.

New Research Supports Efforts at Passage

BEHAVIORAL THERAPY PAIRED WITH PSYCHOTHERAPY REDUCES SELF-HARM

We see evidence of the power of residential treatment paired with living a therapeutic lifestyle in our clients progress towards mental health up close and personal, but it is always nice to read research to support that experience. This year, a Norwegian study found that using “behavioral therapy that teaches coping skills, used in conjunction with psychotherapy, not only significantly reduces self-harm among adolescents but also more rapidly leads to recovery from suicidal ideation and depression than enhanced usual care.”

Program Director, Ellen Race, says that “we are always happy to see evidence that supports what we are doing for our clients.” The specific therapy addressed in the article is one that Northwest Passage uses in its Prairieview and Riverside programs, Dialectical Behavior Therapy (DBT). DBT is, “a type of therapy that focuses on developing the behaviors skills and coping mechanisms for our kiddos so that they can navigate life’s challenges in a healthy and sustainable way.” Angela Fredrickson, Clinician Director for Riverside explains. She goes on to say that, “DBT is a part of our efforts to promote the skills and experiences necessary to commit to living a therapeutic lifestyle long after treatment ends. We are giving access to our clients to practice living a healthy lifestyle and DBT fits right in with that. It is grounded in mindfulness, being active and expressive in a healthy way, and building healthy relationships – which are key elements necessary to live therapeutically.”

To learn more about the PassageWay and living a therapeutic lifestyle, please visit our website and to read the article summarizing the research in full, please visit the Medscape article: Self-harm in Teens: Rapid Response With Novel Behavior Therapy. 

We know it is essential to pair expert psychotherapy with the tools necessary to make change, it is something we do every single day with our kids. Our guiding principles are articulated through the PassageWay, which proposes that the journey to building a healthy lifestyle includes the building of skill and insight through psychotherapy intervention, the judicious use of psychotropic medication, and a commitment to providing access to therapeutic lifestyle moments for our clients to actively heal and practice being well.

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Prairieview harvests a healthy snack

The ladies at Prairieview started a garden this spring and they just harvested the fruits, or should we say vegetables, of their labor.  The girls were able to harvest some fresh green beans, cucumbers, zucchini, and broccoli, giving them organic and fresh produce to serve for their evening snack.

They also grated up some zucchini and froze it to make bread, cake, and other goodies over the fall and winter.

The peppermint, spearmint and chamomile should be ready soon for the group to make a calming tea after they are harvested.

After gaining this gardening experience, the group may also try experimenting with growing hoops this fall.

Tracey Mofle, Prairieview Weekend Primary Staff


Growing and harvesting a garden teaches the residents of Northwest Passage many things. It teaches them a respect for the environment and shows them where their food comes from. It teaches them to care and nurture the plants.  It gets them eating healthy. It teaches them to work together to reach a goal.

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