00:00:01.120 --> 00:00:16.239
Welcome to the Psychogastroentermologist, the show where we explore the fascinating intersection of the brain-gut connection through a multidisciplinary lens informed by psychology, neuroscience, and gastroenterology, better known as psychogastroentermology.
00:00:16.399 --> 00:00:23.600
Our mission is to delve into the gut brain access and uncover how this powerful connection influences mental, physical, and overall well-being.
00:00:23.760 --> 00:00:31.760
Whether you work in behavioral health, health care, the criminal justice system, or health and wellness coaching, this podcast offers insights to inform and inspire your work.
00:00:31.920 --> 00:00:39.679
Join us as we break down complex concepts, share evidence-based perspectives, and discuss emerging trends in this rapidly evolving field.
00:00:39.920 --> 00:00:46.640
The information provided in this podcast is for educational purposes only and is not intended as medical or mental health advice.
00:00:46.799 --> 00:00:51.039
The content discussed should not replace professional judgment, diagnosis, or treatment.
00:00:51.200 --> 00:00:56.000
Always consult with a qualified healthcare provider regarding any medical or psychological concerns.
00:00:56.159 --> 00:01:03.200
The views expressed by our hosts and our guests are their own and do not necessarily reflect those of any affiliated organizations.
00:01:03.600 --> 00:01:04.319
Hello, everyone.
00:01:04.480 --> 00:01:13.680
Welcome back to our next episode for the Psychogastral Entomologist Podcast Program offered through Pathways Counseling Center.
00:01:13.840 --> 00:01:15.359
I'm your host, Jared Brown.
00:01:15.519 --> 00:01:23.439
In this episode, we are going to explore the topic of depression within the context of the gut brain access.
00:01:23.519 --> 00:01:25.760
And we're going to talk about a lot of moving parts today.
00:01:25.840 --> 00:01:27.280
We're going to be moving quickly.
00:01:27.519 --> 00:01:34.719
If you want to see this visually and take a look at the slides I'm presenting, please check out our YouTube channel.
00:01:34.959 --> 00:01:42.000
So if you see this visually, if you're new to our podcast program, here's a copy of my brief professional biography.
00:01:42.159 --> 00:01:43.599
I wear a couple different hats.
00:01:43.680 --> 00:01:47.519
I'm a professor, trainer, researcher, and consultant.
00:01:47.680 --> 00:01:52.159
And our agenda, just like all of our other episodes, are very straightforward.
00:01:52.319 --> 00:01:58.959
So today I'm going to give you a really broad spectrum overview of depression, but take it deeper into the weeds.
00:01:59.120 --> 00:02:04.319
I'm going to talk a lot about neuroscience today, nutrition, some biochemistry.
00:02:04.560 --> 00:02:11.919
Part two today, we're going to talk about what do we do with this information and how do we apply it in an intake screening or interviewing process.
00:02:12.080 --> 00:02:17.360
And then part three today will wrap it up with strategies, solutions, and interventions.
00:02:17.599 --> 00:02:28.400
So depression, I think we all have a good understanding of what is depression, but hopefully you walk away from today's talk really realizing how complex depression truly is.
00:02:28.639 --> 00:02:32.080
So if you see this slide here, I like to show this.
00:02:32.240 --> 00:02:40.560
And it's a good reminder why we want to become informed about the topic of depression, because it is one of the leading causes of disability worldwide.
00:02:40.639 --> 00:02:47.520
If you see this slide too, chronic pain and migraines are also leading causes of disability.
00:02:47.840 --> 00:02:55.840
We will be releasing an episode coming out in the following weeks or months on migraine and the gut brain access.
00:02:55.919 --> 00:02:57.520
So be on the lookout for that as well.
00:02:57.680 --> 00:02:59.680
So depression, major topic.
00:02:59.840 --> 00:03:03.840
If you're a human being, I'm sure you've dealt with depression at some point in your life.
00:03:04.000 --> 00:03:06.639
Some people deal with it more frequently than others.
00:03:06.879 --> 00:03:10.960
If you take a look at this slide here, again, it's a leading cause of disability.
00:03:11.120 --> 00:03:16.080
Some research indicates it impacts more than 350 million people worldwide.
00:03:16.240 --> 00:03:19.439
Again, it depends on how you classify this as well.
00:03:19.599 --> 00:03:28.960
But if you're working in clinical forensic settings, you're coming into contact with individuals impacted by various forms of depression all the time.
00:03:29.199 --> 00:03:32.800
Here's a really good statistic I like to show from time to time.
00:03:32.960 --> 00:03:37.280
This is just a reminder, again, why we want to study this topic.
00:03:37.360 --> 00:03:41.520
And this is a study that relates specifically to the United States.
00:03:41.599 --> 00:03:43.919
So it impacts millions of individuals.
00:03:44.159 --> 00:03:52.800
And on top of that, it causes billions and billions of dollars in loss, productivity, and economic growth.
00:03:53.039 --> 00:04:01.360
This slide here, just a good reminder of some of the symptoms of depression that may present in an individual.
00:04:01.439 --> 00:04:06.319
This can vary from individual to individual depending on a host of factors.
00:04:06.560 --> 00:04:11.759
Folks with depression frequently experience changes in eating and sleeping patterns.
00:04:12.000 --> 00:04:16.319
They might experience more fluctuations in energy, more daytime fatigue.
00:04:16.560 --> 00:04:22.639
It could really get in the way of self-esteem, being productive at school or on the job.
00:04:22.800 --> 00:04:27.600
It could be a triggering event for higher levels of irritability and anger in some cases.
00:04:27.920 --> 00:04:30.000
Here's some more symptoms of depression.
00:04:30.160 --> 00:04:37.839
It could be a factor in higher levels of feelings of helplessness, hopelessness, restlessness.
00:04:38.000 --> 00:04:40.079
And the list goes on and on and on.
00:04:40.240 --> 00:04:43.680
Here's where we start getting into the weeds a little bit with depression.
00:04:43.920 --> 00:04:50.000
So depression is a complex medical and neuropsychiatric condition.
00:04:50.160 --> 00:04:51.920
Depression can be a symptom.
00:04:52.079 --> 00:04:57.759
It can co-occur with all kinds of medical and cognitive and emotional kinds of disorders.
00:04:57.920 --> 00:04:59.920
It can be a standalone condition.
00:05:00.160 --> 00:05:09.360
Some of the common symptoms, again, associated with depression, if we get a little deeper in the weeds here, is your client may experience more negative cognitive styles.
00:05:09.519 --> 00:05:11.519
It can impact neuroplasticity.
00:05:11.680 --> 00:05:18.480
Typically, when someone's dealing with high levels of depression, there's going to be imbalances in hormones and neurotransmitters.
00:05:18.639 --> 00:05:22.480
Gut brain access dysfunction, without a doubt, is a factor.
00:05:22.639 --> 00:05:25.519
Depression really is a chronic inflammatory condition.
00:05:25.600 --> 00:05:27.519
So we'll talk about inflammation today.
00:05:27.680 --> 00:05:35.279
And when someone's dealing with high levels of depression, typically their HPA access is not working properly.
00:05:35.439 --> 00:05:39.439
We have an episode dedicated to the HPA access.
00:05:39.519 --> 00:05:40.639
I encourage you to check out.
00:05:40.800 --> 00:05:42.639
Breaking it down a little bit more here.
00:05:42.800 --> 00:05:46.160
So these are just eight more variables you'd want to consider.
00:05:46.240 --> 00:05:53.600
Again, this can vary from person to person, but some of the common symptoms of depression may include more daytime fatigue.
00:05:53.920 --> 00:06:04.399
You might experience more body-based symptoms, headaches, may have increases in cravings for unhealthy foods, higher levels of insomnia.
00:06:04.639 --> 00:06:09.839
It could be a factor in consuming higher levels of alcohol for some individuals.
00:06:10.000 --> 00:06:15.120
And it can really trigger emotional mood instability problems.
00:06:15.360 --> 00:06:22.240
This is a really good reminder why it's so important to get into the weeds when you study depression.
00:06:22.399 --> 00:06:24.000
Hopefully, this is one reason why.
00:06:24.160 --> 00:06:31.680
If you see this slide here, these are some of the biological models that have examined the topic of depression.
00:06:31.839 --> 00:06:36.800
Depression could be caused partially by genetic vulnerabilities.
00:06:36.959 --> 00:06:41.279
There could be some biological disturbances in one's immune system.
00:06:41.439 --> 00:06:47.759
Typically, when someone's dealing with a high degree of depression, they're going to have more biochemical abnormalities.
00:06:47.839 --> 00:06:54.399
So, again, very important to understand gut dysbiosis, hormones, blood sugar imbalances.
00:06:54.560 --> 00:06:56.399
We're going to talk about sleep today.
00:06:56.560 --> 00:07:09.360
It's very, very important to understand circadian rhythm misalignment and our neuroendocrine system, which part of this is going to be the HPA access and our hormones and the gut brain access, to name a few.
00:07:09.519 --> 00:07:11.360
Going a little bit deeper in the weeds here.
00:07:11.519 --> 00:07:21.519
So looking at this article, great article published in 2023 that really encourages us to learn about changes in neuroplasticity.
00:07:21.759 --> 00:07:27.360
Very, very important to understand again the hypothalamus, pituitary adrenal access.
00:07:27.519 --> 00:07:30.240
This is our body's main stress response system.
00:07:30.399 --> 00:07:31.920
It's a hormone regulator.
00:07:32.079 --> 00:07:43.759
And as I mentioned before, when you work with folks with depression, there's a pretty good chance that we're talking about someone that probably has higher levels of inflammation going on in their body.
00:07:43.920 --> 00:07:47.120
This is where it gets really interesting and complicated.
00:07:47.519 --> 00:07:55.279
So if you take a look at this, these are some of the brain structures and functions that are associated with depression.
00:07:55.439 --> 00:08:00.959
So we might have more brain-based changes in some of these or all of these areas.
00:08:01.120 --> 00:08:06.319
So very important to learn about the neuroscience aspects of depression.
00:08:06.560 --> 00:08:15.360
Some of these you're probably very familiar with, like the amygdala, the orbital frontal cortex, the hippocampus, the basal ganglia, the thalamus.
00:08:15.519 --> 00:08:20.480
A lot going on in the brain of somebody when they're dealing with chronic depression.
00:08:20.720 --> 00:08:36.559
When you work with folks with high levels of depression, especially over a long period of time, there's a pretty good chance, not always, but in a lot of cases, that client may also be dealing with higher levels of medical health comorbidity.
00:08:36.720 --> 00:08:45.039
So very important to understand when we talk about depression, it's not just the emotional and behavioral side of things we need to be aware of.
00:08:45.200 --> 00:08:49.519
We also need to be aware of any kind of chronic health conditions.
00:08:49.679 --> 00:08:59.919
If you work with clients with a long history of depression, it is also more common for some of your clients to be dealing with something called depressive rumination.
00:09:00.080 --> 00:09:04.879
This is when that client maybe overly thinks about something over and over and over again.
00:09:05.039 --> 00:09:07.120
And this is like pouring gasoline on a fire.
00:09:07.200 --> 00:09:11.360
And if this is going on with your client, this can just make the depressive symptoms grow.
00:09:11.440 --> 00:09:17.759
And if this happens to the client too, in a lot of cases, that client is probably not sleeping well.
00:09:18.159 --> 00:09:31.519
Just in general, if you take a look at this slide, when we talk about rumination, and this can vary from client to client, but if you have a client that deals with chronic rumination day in and day out, this can amplify negative emotions.
00:09:31.759 --> 00:09:41.360
It can contribute to more intrusive thinking, it can lead to longer-lasting depressive symptoms and an increase in occurrence of depressive episodes.
00:09:41.440 --> 00:09:44.000
So really important to understand the topic of rumination.
00:09:44.159 --> 00:09:46.080
So here's a little bit about inflammation.
00:09:46.159 --> 00:09:55.120
So when you study depression, very, very important to have at least a basic understanding of inflammation and chronic low-grade inflammation.
00:09:55.360 --> 00:10:01.360
So if your client's dealing with a high level of depression, pretty good chance they're dealing with higher levels of brain inflammation.
00:10:01.600 --> 00:10:18.240
If you look at this slide here, if somebody's dealing with a lot of brain inflammation, that client may be dealing with more brain fog, they may have slower processing speed, they may have lower levels of brain endurance, their thinking may be more unclear and disorganized, just to name a few.
00:10:18.399 --> 00:10:22.799
When you study inflammation, understand the topic of neuroinflammation.
00:10:22.879 --> 00:10:27.679
This is basically the brain and spinal cord dealing with higher levels of inflammation.
00:10:27.759 --> 00:10:33.360
And there's a multitude of factors that can contribute to higher levels of neuroinflammation.
00:10:33.600 --> 00:10:35.519
Depression being one of them.
00:10:35.679 --> 00:10:42.240
This slide here has a lot of these variables you'd want to consider, including problems with the gut brain access.
00:10:42.399 --> 00:10:44.799
When you study depression, this is a great article.
00:10:44.879 --> 00:10:53.919
If you see this here visually, the research really encourages us to learn about the HPA access and dysfunction in the autonomic nervous system.
00:10:54.080 --> 00:10:57.840
We also did an episode on autonomic nervous system dysfunction.
00:10:58.000 --> 00:10:59.279
Check out our YouTube channel.
00:10:59.360 --> 00:11:02.559
I think that episode is on our channel right now.
00:11:02.720 --> 00:11:13.440
When you study depression, it is also important to take into account that some of your clients' depression could be partially driven by adverse childhood experiences.
00:11:13.600 --> 00:11:23.039
So very important to understand how earlier forms of trauma in some cases may play a role in depression symptoms, even in adulthood.
00:11:23.279 --> 00:11:25.360
Has a very quick overview of part one.
00:11:25.440 --> 00:11:30.799
So part two, practical things you'd want to consider during your intake screening and interviewing process.
00:11:30.879 --> 00:11:33.200
So there's a lot of risk factors for depression.
00:11:33.360 --> 00:11:53.039
This article was published in 2014, 2024 that talks about you'd want to learn about disability status, socioeconomic status, unemployment status, histories of childhood trauma, education factors, even smoking cigarettes could be risk factors for depression.
00:11:53.279 --> 00:12:08.000
This is a great article published a few years ago that talks about why a higher percentage of clients with serious and persistent mental health issues, including folks with major depressive disorders, may experience more poor health outcomes.
00:12:08.080 --> 00:12:22.639
So some of the contributors are sedentary behaviors, alcohol use, drug use in some cases, tobacco use, unhealthy eating practices, stigma-related problems, cognitive-based impairments, and the list goes on.
00:12:22.799 --> 00:12:28.480
When you study depression, it's important to understand nervous system dysregulation.
00:12:28.639 --> 00:12:32.159
Again, we have an episode dedicated to the autonomic nervous system.
00:12:32.399 --> 00:12:37.279
So when you think about nervous system dysregulation, what do we want to think about?
00:12:37.519 --> 00:12:40.320
Well, it can trigger more depression.
00:12:40.559 --> 00:12:44.559
Depression and nervous system dysfunction do go hand in hand.
00:12:44.720 --> 00:12:49.120
What are some of the signs and symptoms of a dysregulated nervous system?
00:12:49.279 --> 00:12:50.799
Well, they're many and varied.
00:12:51.039 --> 00:12:59.519
It could be digestive health problems, body tension, a racing heart, problems focusing, sleep issues, dizziness.
00:12:59.679 --> 00:13:01.679
The list goes on and on and on.
00:13:01.840 --> 00:13:13.840
These are some factors that can impact our nervous system: poor sleep, traumatic stress, relationship conflicts, anxiety problems, depression, and many, many more.
00:13:14.000 --> 00:13:20.720
So the more we can understand the interconnectedness of all of these topics, I think we're going to be in better shape helping our clients.
00:13:20.960 --> 00:13:25.919
And what are some of the factors that can impact client cognition and brain-based functioning?
00:13:26.080 --> 00:13:30.480
Well, this slide should sum up several variables you'd want to take into account.
00:13:30.639 --> 00:13:33.360
Obviously, we're focusing on depression today, right here.
00:13:33.519 --> 00:13:46.960
But your client, if they smoke a lot of cigarettes, they're dealing with unmanaged diabetes, hypertension, high cholesterol issues, sedentary behaviors, obesity, these are all things that can impact cognition in your clients.
00:13:47.120 --> 00:13:53.279
When we look at this through a cognition lens, depression can impact the brain, obviously, on many levels.
00:13:53.440 --> 00:13:55.440
So this can vary from client to client.
00:13:55.600 --> 00:14:07.919
But according to empirical-based literature, when you're working with clients with high levels of depression, they may be dealing with more attention issues, working memory problems, disinhibition, and the list goes on.
00:14:08.000 --> 00:14:19.519
So very important to understand that when you work with people with high levels of depression, they're probably dealing with higher levels of executive function impairment, metacognitive impairments, to name a few.
00:14:19.679 --> 00:14:21.600
I mentioned neuroplasticity before.
00:14:21.679 --> 00:14:25.840
We have an episode on this very topic coming out very soon.
00:14:26.080 --> 00:14:31.679
High levels of depression can contribute to maladaptive neuroplasticity.
00:14:31.840 --> 00:14:33.600
Why do you want to care about this topic?
00:14:33.759 --> 00:14:39.200
Because good neuroplasticity really goes to the heart of memory and attention and learning.
00:14:39.360 --> 00:14:46.000
When our neuroplasticity isn't working properly, that really can impact attention, learning, and memory capabilities.
00:14:46.159 --> 00:14:54.720
As you can see on this slide, there's a multitude of factors that can contribute to maladaptive neuroplasticity, including depression.
00:14:54.960 --> 00:15:03.600
So this is a slide here you've seen in other episodes, but I wanted to remind us why do we want to learn about the gut microbiota access?
00:15:04.480 --> 00:15:14.240
Because alterations and changes in the gut brain access, including our gut microbiome, have been linked with higher levels of serious mental health issues, including depression.
00:15:14.399 --> 00:15:19.120
What are the factors that can adversely impact our gut microbiota?
00:15:19.360 --> 00:15:25.840
Untreated depression, unmanaged anxiety problems, and even self-indurous behaviors, the research indicates.
00:15:26.000 --> 00:15:33.440
We'll have an episode coming up in the next several months on irritable bowel syndrome, but I wanted to show you here and plant a seed.
00:15:33.600 --> 00:15:38.000
If you work with folks with IBS, irritable bowel syndrome, take a look at this.
00:15:38.159 --> 00:15:46.879
The prevalence of depression in folks with IBS may be as high as 84%, depending on what study you look at.
00:15:47.039 --> 00:15:51.519
We'll go a lot deeper in the weeds with IBS during that episode, but take a look at this.
00:15:51.600 --> 00:15:57.360
If you're working with folks with IBS, irritable bowel syndrome, depression is a very common comorbidity.
00:15:57.519 --> 00:16:02.080
So is anxiety, sleep issues, and even chronic pain-related problems.
00:16:02.320 --> 00:16:03.200
So back to the gut.
00:16:03.440 --> 00:16:13.360
So if you work with clients with an unhealthy gut, what could be some signs and symptoms that may alert you to the fact that maybe their gut's not working at optimal levels?
00:16:13.519 --> 00:16:24.240
Well, high levels of anxiety, depression, acid reflux, brain fog, unexplained fear, migraine, skin problems, the list goes on.
00:16:24.399 --> 00:16:29.279
These are signs that maybe that individual's gut is not working at optimal levels.
00:16:29.440 --> 00:16:36.159
We'll have several episodes coming up on various forms of various talks related to diet and nutrition.
00:16:36.320 --> 00:16:39.519
And what we're talking about today is for educational purposes only.
00:16:39.600 --> 00:16:44.399
Again, please consult with qualified professionals, including dietitians, nutritionists.
00:16:44.639 --> 00:16:52.399
But taking a look at this here, what are some potential nutritional factors associated with higher levels of depression?
00:16:52.559 --> 00:17:05.440
Well, this is a really great article that does talk about if clients eat processed foods day in and day out, like fried foods, pastries, donuts, processed meats, sugar-sweetened beverages, things like that.
00:17:05.599 --> 00:17:09.680
These factors could trigger higher levels of depression.
00:17:09.920 --> 00:17:18.079
When we talk about ultra-processed foods, junk food, things of that nature, those are foods that fall under the umbrella of the Western diet.
00:17:18.240 --> 00:17:28.880
This way of eating, day in and day out, year after year, may play a role in higher levels of depression, obesity, allergies, autoimmune issues, diabetes, and the list goes on.
00:17:29.039 --> 00:17:30.160
Here's another variable.
00:17:30.400 --> 00:17:31.519
Wish we had more time.
00:17:31.680 --> 00:17:34.240
We'll probably do an episode on vitamin D in the future.
00:17:34.400 --> 00:17:37.359
Vitamin D is a complex topic, it's an important topic.
00:17:37.519 --> 00:17:44.559
But if someone's dealing with depression, it probably wouldn't hurt that individual to go to their medical doctor, obviously get lab work.
00:17:44.640 --> 00:17:51.279
And you know, could it be one piece of the puzzle that that individual is dealing with low levels of vitamin D?
00:17:51.519 --> 00:17:57.440
Food insecurity, another variable to consider that has been linked with higher levels of depression.
00:17:57.599 --> 00:18:00.160
Why do you want to care about the topic of food insecurity?
00:18:00.319 --> 00:18:05.759
Well, it's very common in clinical and forensic populations, folks with substance use issues.
00:18:05.920 --> 00:18:12.160
And if you look at this slide here, there's a lot of mental health implications associated with food insecurity.
00:18:12.319 --> 00:18:25.039
It could amplify more mental health issues, including anxiety and depression, and trigger more stress in your client, which then can all trickle down into adversely impacting the gut brain access.
00:18:25.200 --> 00:18:28.319
Here's another piece of the puzzle that maybe we don't think about enough.
00:18:28.559 --> 00:18:47.920
Exposure to nighttime noise could be a factor in more depression because if that client is constantly getting woken up in the middle of the night from a lot of noise, from whatever noise exposure it is, that could overactivate the HPA access, which then could contribute to more depression.
00:18:48.240 --> 00:18:51.680
Alexithymia, another major topic to take into account.
00:18:51.759 --> 00:19:10.400
And if you work with folks with major depressive kinds of issues, some research has found that maybe 45, sick, 40, around 45% or so, according to literature, of your clients with major depression may actually be dealing with something called alexithymia, which is emotional blindness.
00:19:10.480 --> 00:19:15.759
This is when your client is going to have a hard time naming, labeling, and processing emotions.
00:19:16.000 --> 00:19:18.000
What are the causes for alexithymia?
00:19:18.240 --> 00:19:19.519
Really fascinating topic.
00:19:19.680 --> 00:19:20.640
A call to action.
00:19:20.720 --> 00:19:22.960
I encourage all of us to learn about this topic.
00:19:23.119 --> 00:19:28.799
Well, if you take a look at the causes here on this slide, there could be some genetic factors.
00:19:28.960 --> 00:19:39.839
There could be psychological kinds of issues, there could be physical health diseases that contribute to this, traumatic exposures, stress, anxiety, and depression.
00:19:40.000 --> 00:19:47.599
Here's another piece of this pie, this big puzzle we're trying to put together when we study depression is smoking.
00:19:47.759 --> 00:19:56.640
And if you look at this slide here, we know, according to the literature, that tobacco use is higher among folks with a psychiatric condition.
00:19:56.799 --> 00:20:13.440
When we talk about this within the context of psychiatric disorders, people with depression, anxiety, certain phobia, psychosis, agoraphobia, mania, hypomania, and even folks with antisocial personality disorder are going to be more likely to smoke cigarettes.
00:20:13.599 --> 00:20:21.680
This is a very important area to consider because smoking cigarettes can impact depression and sleep and/or gut brain access.
00:20:21.839 --> 00:20:23.279
Here's another piece of the puzzle.
00:20:23.519 --> 00:20:25.119
Air pollution exposure.
00:20:25.279 --> 00:20:33.519
Several studies are finding exposure to air pollution day in and day out could play a role in higher levels of depression.
00:20:33.759 --> 00:20:42.319
Chronic sedentary behaviors really is a threat to human health, and it can drive the bus with inflammation and depression.
00:20:42.480 --> 00:20:47.119
So really consider the role that exercise plays in combating depression.
00:20:47.279 --> 00:20:51.279
What are some of the health effects associated with prolonged sedentary behavior?
00:20:51.359 --> 00:20:53.680
This is someone that lives this way day in and day out.
00:20:53.839 --> 00:20:55.519
Well, take a look at this article.
00:20:55.839 --> 00:20:57.599
This is overwhelming.
00:20:57.759 --> 00:21:05.039
Chronic sedentary behaviors can impact blood sugar imbalances, joint problems, fatigue.
00:21:05.279 --> 00:21:06.799
It's not good for our brain.
00:21:06.960 --> 00:21:08.240
It's not good for our heart.
00:21:08.400 --> 00:21:09.920
It's not good for our gut.
00:21:10.160 --> 00:21:17.759
Very, very important to consider this when you're doing a screening session intake and developing a goal plan with clients.
00:21:18.079 --> 00:21:23.200
Ruling out sleep apnea, another can of worms we're opening here, but it's important to be aware of this.
00:21:23.519 --> 00:21:28.960
Untreated sleep apnea can play a role in triggering more depression.
00:21:29.359 --> 00:21:32.799
And we'll have an episode too on obstructive sleep apnea coming up.
00:21:32.880 --> 00:21:34.160
So be on the lookout for that.
00:21:34.240 --> 00:21:39.759
But here's a really great article that talks about obstructive sleep apnea within the context of depression.
00:21:39.920 --> 00:21:41.119
How can it lead to that?
00:21:41.279 --> 00:21:42.880
How can it cause more depression?
00:21:43.039 --> 00:21:49.440
Well, it can cause more inflammation, oxidative stress, and it can impact our gut microbiota.
00:21:49.519 --> 00:21:52.880
And all of these things can play a role in triggering more depression.
00:21:53.119 --> 00:21:54.960
Attachment has a lot to do with this.
00:21:55.119 --> 00:21:57.519
What is your client's attachment style?
00:21:57.680 --> 00:22:02.079
Interestingly, if you work with folks With insecure attachment patterns.
00:22:02.240 --> 00:22:16.079
This has been linked with higher levels of inflammatory markers because of chronic loneliness in some cases, problematic social relationships, difficulty handling social stressors, and higher levels of depression symptoms.
00:22:16.240 --> 00:22:21.200
If your client is dealing with loneliness or social isolation, take a look at this.
00:22:21.359 --> 00:22:22.960
This comes from several studies.
00:22:23.119 --> 00:22:32.079
Chronic loneliness and social isolation over a long period of time may be comparable to smoking 15 cigarettes a day on the human body.
00:22:32.160 --> 00:22:34.799
So if you see here, look at all these factors.
00:22:34.960 --> 00:22:38.880
We need to be aware of when we're talking about chronic loneliness and isolation.
00:22:39.119 --> 00:22:41.440
And I'm not advocating for you to use these scales.
00:22:41.519 --> 00:22:42.880
I just want to plant the seed here.
00:22:42.960 --> 00:22:45.759
There's many depression scales out there in the literature.
00:22:45.920 --> 00:22:51.759
Some of you are probably very familiar with most of these, but I just wanted to show some of them that come up in the literature frequently.
00:22:51.920 --> 00:22:53.039
So take a look at this.
00:22:53.119 --> 00:22:54.079
You'll have to decide.
00:22:54.160 --> 00:22:57.599
Look at the credentials you need, look at the research behind these scales.
00:22:57.920 --> 00:23:01.359
But there's many more out there, but these are some of the big ones you'd want to be aware of.
00:23:01.519 --> 00:23:06.160
Our last section today is all about tips, strategies, solutions, and interventions.
00:23:06.319 --> 00:23:09.839
So you hear me talk a lot about lifestyle medicine in our other episodes.
00:23:10.000 --> 00:23:21.200
We'll have a six-part series from one of our colleagues that will be doing a complex overview, really digging in the weeds on this topic of lifestyle medicine.
00:23:21.359 --> 00:23:28.079
But the research supports the fact a lifestyle medicine approach can be very good for combating depression.
00:23:28.240 --> 00:23:29.519
What is lifestyle medicine?
00:23:29.599 --> 00:23:31.440
Well, it's rooted in six core features.
00:23:31.519 --> 00:23:40.559
Again, getting good sleep, exercise, eating healthy, managing stress, avoiding harmful chemicals, and promoting positive social connection.
00:23:40.720 --> 00:23:46.960
Getting clients really feeling connected to others, helping them feel like they belong and matter.
00:23:47.119 --> 00:23:48.559
These are interventions.
00:23:48.799 --> 00:23:54.480
And if you see this slide here, what are the benefits associated with social belonging?
00:23:54.640 --> 00:23:58.400
Improving sleep, reducing pain, improving fatigue.
00:23:58.480 --> 00:24:01.279
It's a great way to combat anxiety and depression.
00:24:01.440 --> 00:24:07.519
So helping clients reduce loneliness and isolation and feeling like they belong is an intervention.
00:24:07.759 --> 00:24:11.759
Having a balanced lifestyle is very important to treating depression as well.
00:24:11.920 --> 00:24:24.480
If you take a look at this article here, creating more balance, not overdoing it in one area, not overcommitting, taking more time, slowing down, breathing more, not burning out.
00:24:24.720 --> 00:24:25.759
Very, very important.
00:24:25.920 --> 00:24:29.920
A balanced lifestyle is an intervention to treating depression.
00:24:30.079 --> 00:24:32.160
We know how important it is to exercise.
00:24:32.319 --> 00:24:37.279
Exercise is medicine, probably the greatest medicine ever developed, some say.
00:24:37.440 --> 00:24:38.720
Take a look at this slide here.
00:24:38.880 --> 00:24:44.640
Again, I'm not advocating for you to go out and do exercise with your client unless you have the proper credentials, education, and training.
00:24:44.720 --> 00:24:47.680
And the client's been cleared by their healthcare provider, of course.
00:24:47.759 --> 00:24:53.440
But getting exercise consistently, good for the brain and body, and it's a great way to combat depression.
00:24:53.680 --> 00:24:58.160
Walking interventions, very good for depression and anxiety.
00:24:58.400 --> 00:25:02.319
We have an episode that we will be releasing in the future.
00:25:02.559 --> 00:25:07.279
Check out our podcast program, and it'll be on therapeutic walking.
00:25:07.440 --> 00:25:09.039
So that be on the lookout for that.
00:25:09.119 --> 00:25:11.759
That really ties into what I'm showing here on this slide.
00:25:12.000 --> 00:25:18.240
Walking interventions are very helpful, very therapeutic, and supported in the literature.
00:25:18.480 --> 00:25:27.599
This slide here gives us seven reminders why it's so important to maybe consider implementing walking interventions into the good work you already do.
00:25:27.839 --> 00:25:36.640
Here's a really lovely article that was published last year in 2025 that talks about the use of walking within the context of talk therapy.
00:25:36.799 --> 00:25:45.279
This study looked at how therapists incorporated walking into talk therapy for male clients with depression.
00:25:45.359 --> 00:25:55.359
And the study results found that it definitely was positive in affecting positive change for men with depression.
00:25:55.599 --> 00:25:58.480
Eating healthy foods is another intervention.
00:25:58.640 --> 00:26:02.240
Working with dietitians, working with nutritionists, very important.
00:26:02.480 --> 00:26:06.960
And it is supported in the literature that healthy eating can reduce depression.
00:26:07.119 --> 00:26:11.200
I'm not advocating, please don't go out there and give clients advice on this here.
00:26:11.279 --> 00:26:12.160
This is complex.
00:26:12.319 --> 00:26:14.559
Talk to dietitians, nutritionists.
00:26:14.799 --> 00:26:42.400
But this is a great article that reminds us why we want to consider collaborating with dietitians, nutritionists, functional providers, doctors who have an expertise in this, because there's many nutrients that are very, very good for combating depression: magnesium, vitamin B6, folate, potassium, iron, zinc, long-chain omega-3 fatty acids, thiamine, vitamin B12, vitamin A, and the list goes on.
00:26:42.559 --> 00:26:48.400
Eating foods that fall under the Western diet, processed foods, not good for human health.
00:26:48.559 --> 00:26:53.519
The Mediterranean diet is probably one of the healthiest dietary patterns on the planet.
00:26:53.680 --> 00:27:06.000
Again, work with a nutritious dietitian who knows this stuff, but eating foods consistently under the Mediterranean diet may lead to reductions in depression, according to literature.
00:27:06.240 --> 00:27:19.119
Here's another great article that was published last year in 2025 that does talk about eating the Mediterranean diet consistently may be a good intervention for people with depression.
00:27:19.279 --> 00:27:25.279
What are some of the health benefits associated with living and eating a Mediterranean diet and lifestyle?
00:27:25.440 --> 00:27:32.880
Well, taking a look at this, it's good for cardiovascular health, it's good for blood sugar regulation, it's good for cognitive health.
00:27:33.039 --> 00:27:35.119
And the list goes on and on and on.
00:27:35.440 --> 00:27:42.559
When you are learning about depression, you're working with clients and you want to treat it holistically.
00:27:42.880 --> 00:27:56.880
Working with a provider who understands gastrointestinal behavioral health, working with a provider who has training in psychogastroentinology can be very, very helpful and is supported in the literature.
00:27:57.039 --> 00:28:00.000
So I want to remind us I showed us this slide earlier.
00:28:00.160 --> 00:28:06.160
There are a multitude of factors that can impact the gut brain access, depression being one of them.
00:28:06.319 --> 00:28:14.400
So by default, if you are working with people with depression, learn about the gut brain access, treat both simultaneously.
00:28:14.480 --> 00:28:16.480
It likely will lead to better outcomes.
00:28:16.720 --> 00:28:30.640
Another intervention, and we know this, but it's just a reminder working with individuals and helping them maybe develop a greater sense of gratitude can be a protective factor against stress and depression in some cases.
00:28:30.880 --> 00:28:32.799
Obviously, easier said than done.
00:28:32.960 --> 00:28:37.839
What does the literature say about the positive impact of gratitude on human health?
00:28:38.000 --> 00:28:42.880
Well, it's great for thinking, it's great for energy, it's great for sleep health.
00:28:43.039 --> 00:28:44.000
The list goes on.
00:28:44.160 --> 00:28:54.480
So the more we can cultivate an attitude of gratitude day in and day out, that might be one piece of the puzzle that can help reduce depression.
00:28:54.720 --> 00:29:01.039
And another intervention before we wrap it up today, and there's many more, but for sake of time, I'll end it on this note.
00:29:01.200 --> 00:29:03.119
Self-compassion interventions.
00:29:03.359 --> 00:29:08.400
Teaching people how to have greater levels of self-compassion is an intervention as well.
00:29:08.480 --> 00:29:15.920
And it's very, very good for our brains and our bodies, our thinking, and it can help reduce depression in some people.
00:29:16.160 --> 00:29:17.279
Appreciate all of you.
00:29:17.440 --> 00:29:18.960
Please reach out anytime.
00:29:19.119 --> 00:29:23.440
Here's my email address, and look forward to having you back for our next episode.
00:29:23.599 --> 00:29:24.400
Thanks, everyone.
00:29:24.720 --> 00:29:30.160
We hope today's episode provided you with valuable insights into the gut brain connection and its impact across diverse settings.
00:29:30.319 --> 00:29:32.559
If you enjoyed this episode, please subscribe and share.
00:29:32.720 --> 00:29:37.680
For more information on this topic, resources, and services, visit Pathways Counseling Center.org.
00:29:37.759 --> 00:29:43.279
Thank you for joining us on the Psychogastro Intermologist, where mental health and digestive science converge.