One of the most direct ways is via metabolites secreted from the ‘biome: GABA, norepinephrine, acetylcholine, serotonin, dopamine, etc. (Jacka 2018).
Germ-free mice (ie, no ‘biome) have all sorts of behavioral abnormalities: pronounced changes in their stress responses, brain plasticity, immune function, neurotransmitters, etc.
And most interestingly, fecal transfers from humans with depression to germ-free mice induces a depressive phenotype in the latter (Kelly et al., 2016).
Over 50% of people with irritable bowel syndrome (constipation, diarrhea, or alternating) have depression, anxiety, or sleep problems (Li et al., 2018).
In my experience, people have multiple complaints at once but with enough discussions and trial & error, we can pinpoint the lowest hanging fruit and it usually turns out to be just one of those factors controlling the rest. Get that sorted and many aspects of health improve.
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